CONTACTS 
0201 - Doctor Gloria Tucker                                                                                                                                               
020101 - Dr. Gloria Tucker                                                                                                                                                
020103 - Medical Offices                                                                                                                                                  

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 74 0000. ref SDS 73 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 - Meeting Doctor Tucker at her clinic in Novato.  Arrived 10 minutes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040504 - late, due to unusually heavy traffic on highway 37 at 0930.  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040505 - doctor was treating another patient. ref SDS 0 V54H  Doctor Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040506 - advised that VA's order for care in this case has not yet been                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040507 - received, so agreed to pay for medical services today. ref SDS 0 OJ4F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040508 - Discussed scope of work. ref SDS 0 SO4N  Doctor Tucker's clinical                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040509 - examination determined there are no evident rotator cuff tears in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040510 - shoulders. ref SDS 0 W16H  Recommends resuming pushups at low level of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040511 - effort. ref SDS 0 0Q9L  The doctor drew blood from left arm inner                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040512 - elbow, with assistance of husband, Paul.  Kathy also assisted.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040513 - Required 2 sticks to get full compliment of blood required for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040514 - centrifuge process. ref SDS 0 PS4K  Doctor Tucker palpated prospective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040515 - sites, and marked locations for injections.  Paul sprayed sites with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040516 - numbing agent.  Doctor Tucker injected lidocaine into each site.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040517 - ref SDS 0 O26N  Injecting knees was easily tolerated; injecting feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040518 - is more difficult. ref SDS 0 J47J  Hamstring pull on left leg was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040519 - examined without express findings nor treatment. ref SDS 0 055F  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040520 - doctor made 2 lateral PRP injections into right knee - both pain level                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040521 - 0. ref SDS 0 GE9L  The doctor made 1 lateral PRP injection into left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040522 - knee.  This went deeper, and so was difficult to tolerate.  There were                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040523 - 2 medial injections into left knee, and were well tolerated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040524 - ref SDS 0 TF4H  Both feet had 5 PRP injections and were all difficult                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040525 - to tolerate.  This was 15 PRP injections. ref SDS 0 IH4F  Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040526 - Tucker advised that shoulders take a lot of PRP to treat, so this was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040527 - omitted today. ref SDS 0 EA7O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040528 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040529 -            [On 190101 0730 on 7 mile hike, at about mile 4.5 pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040530 -            level 1 across left knee below knee cap lasted to end of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040531 -            hike - very unusual, after 6-prior PRP injections to left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040532 -            knee pain level 0 hiking, running, sprinting, for several                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040533 -            months. ref SDS 63 RXVT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040535 -             ..
040536 -            [On 190412 0931 letter to Doctor Tucker requests amend                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040537 -            Progress Notes to report centrifuge equipment - whether                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040538 -            1-spin or 2-spin high-platelet-concentration process.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040539 -            ref SDS 78 SL30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040541 -             ..
040542 -            [On 190414 2007 letter asks Doctor Tucker to call and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040543 -            clarify proposed ozone treatment. ref SDS 80 HX55  Asks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040544 -            about risks of complications getting ozone therapy.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040545 -            ref SDS 81 HX66                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040547 -             ..
040548 -            [On 190414 2145 letter to Doctor Tucker presents treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040549 -            achalasia once per month with EGD dilation, presents                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040550 -            similar approach for PRP treatments every 3 - 6 months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040551 -            ref SDS 82 FA6H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040552 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040553 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040554 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040555 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040556 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040557 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040558 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040559 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041130 -  ..
0412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0414 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041501 - Meeting...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041503 -        Doctor Gloria Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041504 -        250 Bel Marin Keys Boulevard #G1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041505 -        Novato, CA 94945                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041506 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041508 -  ..
041509 - Implement planning in call from Connie yesterday, to meet with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041510 - Tucker for PRP treatment today at 1000, reported on 190402 0838.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041511 - ref SDS 74 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041513 -  ..
041514 - Departed house in Concord driving to Doctor Tucker's office in Novato.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041515 - Missed turn-off for highway 680 North, so took highway 680 South                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041516 - turnoff.  Drove to Concord Boulevard and went East a few miles to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041517 - Detroit Avenue.  Drove past Future Ford, where car service is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041518 - performed.  Turned right and drove South to the sign that said Highway                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041519 - 680 North.  Drove North on 680 through toll booth across                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041520 - Benecia-Martinez bridge to Vallejo.  Took highway 80 East about 10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041521 - miles, then took highway 37 West.  Got caught up in morning commute                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041522 - traffic still heavy at 0920.  A police car was attempting to navigate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041523 - through heavy traffic to reach problem.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041525 -  ..
041526 - Called Doctor Tucker's office and notified may be few minutes late due                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041527 - to heavy commute traffic.  Paul said another patient was scheduled                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041528 - ahead.  If we arrive by 1030, Doctor Tucker can see us 30 minutes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041529 - late.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041530 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041531 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041533 -  ..
0416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0418 - 1010                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041901 - Arrived at Doctor Tucker's office 10 minutes late.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041903 - Paul said we arrived 20 minutes early for meeting at 1030.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041905 -  ..
041906 - Kathy and I went for a walk.  Returned at 1030.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041908 -  ..
041909 - Paul said the doctor is with another patient.  He thinks she needs                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041910 - another 10 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041911 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041912 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041913 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041915 -  ..
0420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0422 - 1100                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042301 - Entered procedure room, removed shoes and socks, and shirt for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042302 - examination of feet and shoulders.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042304 -  ..
042305 - Gloria related having called and left a message returning Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042306 - Edwards' call placed during the meeting at VAMCSF on 190327 0915.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042307 - ref SDS 70 556N  Doctor Edwards returned Gloria's call at a time when                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042308 - she was with a patient.  She called Sara back and left another                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042309 - message.  At this time the doctors have not yet spoken to each other,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042310 - contrary to understanding from call with Connie on 190402 0838,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042311 - ref SDS 74 9K5L, and the letter to Gloria later that day. ref SDS 74                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042312 - IQ55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042314 -  ..
042315 - Gloria further advised that she has not received documention for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042316 - order Sara placed at the VA for Gloria to perform PRP care in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042317 - case, reported on 190327 0915. ref SDS 70 EZ3G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042319 -  ..
042320 - Gloria explained that without the order from the VA, she will need                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042321 - payment from the patient for care today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042323 -  ..
042324 - Agreed to direct payment for today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042325 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042327 -  ..
042328 - Develope Scope of Work for Regeneration PRP Injection Treatments                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042329 - 
042330 - Follow up ref SDS 62 HP5O, ref SDS 48 HP5O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042331 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042332 - Gloria asked for scope of work?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042334 -  ..
042335 - Reviewed letter to the doctor explaining scope, submitted on 190402                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042336 - 0838. ref SDS 74 IQ61   This says in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042337 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042338 -        Scope of work:  feet and shoulders.  If any PRP left, lets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042339 -        inject knees, and at least the left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042340 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042341 -        Metatarsalgia both feet and burning sensation in right foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042342 -        reported in the letter yesterday on 190402 0838. ref SDS 74                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042343 -        IQ64                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042344 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042345 -            [On 190101 0730 during slow rehab hike, burning sensation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042346 -            occurred about mile .5. ref SDS 64 RQXV                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042348 -  ..
042349 - The doctor asked about continuing symptoms of "restless legs,"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042350 - discussed in her call on 190329 1110. ref SDS 73 4W5H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042352 -  ..
042353 - Reported recurrence has declined after ending hiking a week ago.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042355 -  ..
042356 - Doctor Tucker asked about pain medication.  How long since taking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042357 - NSAID drugs?  She said these should have been stopped for at least                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042358 - the past 7 days.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042360 -  ..
042361 - Reviewed the letter submitted to Doctor Tucker on 190402 0838, saying                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042362 - in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042363 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042364 -        Have not taken NSAIDs, hydrocodone, nor oxycodone, since                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042365 -        190317.  Took Tramadol about 3 days ago to resolve rising                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042366 -        "restless legs" attack. ref SDS 74 IQ5X                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042368 -  ..
042369 - Gloria said Tramadol is not an NSAID, so she can perform PRP today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042370 - based on this record.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042371 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042372 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042374 -  ..
042375 - Shoulders Clinical Examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042376 - 
042377 - The doctor performed clinical examination of shoulders cited in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042378 - patient's letter yesterday on 190402 0838, ref SDS 74 IQ70, and also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042379 - cited in a letter this morning, explaining need shoulders to recover                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042380 - for doing pushups by mid-August in time to build strength for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042381 - ascending cables to top of Half Dome on 190912. 190403 0809,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042382 - ref SDS 76 NW5O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042384 -  ..
042385 - Doctor Tucker's shoulder examination today, was similar to examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042386 - Doctor Sara Edwards did at VAMCSF on 190327 0915. ref SDS 70 ML6H  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042387 - doctor said the report today, doing push-aways against the sink                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042388 - without pain, shown in the letter to Doctor Tucker yesterday on 190402                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042389 - 0838. ref SDS 74 IQ70, is a positive signal that healing is occurring.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042391 -  ..
042392 - Placed feet on a chair and did about 10 pushups to assess location of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042393 - pain in shoulders.  Pleasantly surprised experienced only pain level 4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042394 - in left shoulder and level 2 in right shulder.  This was far below                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042395 - pain level 8, that required pausing pushups 5 weeks ago on 190225,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042396 - reported in case study on 190101 0730. ref SDS 63 GW3I  Doctor Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042397 - attributed reduced pain today, to recovery of strained ligaments and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042398 - tendons after 5 weeks rest.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042400 -  ..
042401 - Doctor Tucker seemed to indicate clinical examination today, does not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042402 - find rotator cuff tears.  Most likely there are ligament and tendon                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042403 - strains from increasing pushups, reported during the call on 190329                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042404 - 1110. ref SDS 73 UI5L  She diagnosed tendenosis.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042406 -  ..
042407 - Gloria said these injuries may recover with further rest from doing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042408 - pushups for another few weeks to a month or so.  When pushups are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042409 - resumed, increase reps slowly.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042411 -  ..
042412 - The doctor's examination today, seems to align with Doctor Edwards                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042413 - examination on 190327 0915. ref SDS 70 M14I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042415 -  ..
042416 - Doctor Tucker further advised that if pain persists she would treat                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042417 - with ultrasound-guided PRP injections.  She has done this successfully                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042418 - in cases with similar diagnosis of tendenosis.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042420 -            [...below on 190403 1000 doctor's Progress Notes report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042421 -            finding rotator cuff tendenosis, but no tear; exepects good                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042422 -            response to PRP. ref SDS 0 N13O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042424 -  ..
042425 - This aligns with research following the meeting with Doctor Edwards at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042426 - VAMCSF, reported on 190327 0915. ref SDS 70 U45I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042428 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042431 -  ..
0425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0427 - 1125                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0428 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042801 - Blood Draw for PRP Completed with Two Needle Sticks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042802 - 
042803 - Follow up ref SDS 62 YY6N, ref SDS 48 YY6N.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042804 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042805 - The doctor drew blood from the left arm, again using the vein on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042806 - inside of the elbow, which she has used previously, reported on 180824                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042807 - 1515. ref SDS 48 YY6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042809 -  ..
042810 - Gloria said there was good blood flow.  After 20 seconds or so, she                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042811 - said blood flow stopped before they had the amount needed for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042812 - centrifuge equipment to operate correctly.  Gloria went to the waiting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042813 - room and asked Kathy to come into the procedure room, because Kathy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042814 - has 40 years experience setting IVs and doing blood draws for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042815 - Maternity care at Sutter General in Sacramento.  Gloria and Kathy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042816 - assessed the arm.  Ultimately, Gloria decided to re-enter the initial                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042817 - site.  This was successful in getting the remaining 5 CCs needed for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042818 - the centrifuge equipment to produce PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042819 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042827 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042829 -  ..
042830 - Identify Injection Sites Numbing Agent and Lidocaine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042831 - 
042832 - While platelets were being centrifuged, Doctor Tucker examined feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042833 - and knees.  She palpated the areas and marked where injections would                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042834 - be made...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042835 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042837 -   
042838 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042848 -  ..
042849 - Doctor Tucker injected lidocaine to further numb each PRP injection                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042850 - site.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042857 -  ..
042858 - Injecting lidocaine into the knees is about pain level 2 - noticable,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042859 - but easily tolerated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042861 -  ..
042862 - Injecting licocaine into the top of each foot between metatarsals and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042863 - into Tailor's Bunions on the fore-edge of each foot is pain level 6+.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042864 - It lasts only an instant, and so can be tolerated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042865 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042866 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042868 -  ..
042869 - Hamstring Left Leg Behind Knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042870 - 
042871 - Doctor Tucker examined hamstring injury behind left knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042876 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042877 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042879 -  ..
042880 - PRP Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042881 - 
042882 - After all sites were marked and numbed with spraying agent and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042883 - lidocane, and after the centrifuging process completed, the doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042884 - made PRP injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042886 -  ..
042887 - For this treatment, the doctor reversed the usual order of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042888 - injections.  Today, she injected the knees first...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042889 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042891 -         ..
042892 -        Right Leg                                         Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042893 -        
042894 -        Knee joint............................................  2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042896 -  ..
042897 - Injections on the lateral side of right knee about 3" apart.  This was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042898 - pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042899 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042901 -   
042902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042908 -             ..
042909 -            [...below on 190403 1000 doctor's Progress Notes recommend                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042910 -            adding ozone to PRP injections 2 weeks after getting PRP in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042911 -            the knees today. ref SDS 0 N13O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042912 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042914 -         ..
042915 -        Left Leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042916 -        
042917 -        Knee joint............................................  3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042919 -  ..
042920 - More PRP was applied with 1 injection into lateral side of left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042921 - today, because it has expressed more pain than the right knee - see                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042922 - case study in the record on 190101 0730. ref SDS 63 RJ9K and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042923 - ref SDS 63 WYSU; see hike on 190326, ref SDS 63 PSWQ, and on 190329                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042924 - reporting knee hurt 30% of 15 mile hike, despite taking Glucosamine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042925 - Chondroitin. ref SDS 63 PWQW  This reflects severe injury OA July                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042926 - 1973, with subsequent surgery removed cartilage, which then caused                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042927 - degenerative arthritis for the past 46 years.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042928 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042929 -            [On 190101 0730 on 7 mile hike, at about mile 4.5 pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042930 -            level 1 across knee below knee cap lasted to end of hike -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042931 -            very unusual, after prior PRP injections to left knee feel                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042932 -            no pain hiking, running, sprinting, for several months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042933 -            ref SDS 63 RXVT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042934 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042936 -   
042938 -               ..
042939 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042940 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042942 -  ..
042943 - Pain increased as this lateral injection occurred to about level 6                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042944 - over 5 - 10 seconds.  Was more difficult to tolerate.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042945 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042947 -  ..
042948 - Two injections were made on the medial side of left knee about 1"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042949 - apart...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042951 -               ..
042953 -   
042954 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042956 -  ..
042957 - These were both pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042958 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042960 -  ..
042961 - After injecting both knees, Doctor Tucker injected PRP into both                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042962 - feet...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042964 -         ..
042965 -        Right Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042966 -        
042967 -        Follow up ref SDS 24 0108.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042968 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042969 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042970 -        Between little toe and ring toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042971 -        Between ring toe and middle toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042972 -        Between middle and long toe..................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042973 -        Between long toe and big toe.................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042975 -         ..
042976 -        Tailor's bunion................................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042978 -  ..
042979 - Pain increases as PRP is injected to level 8+, and so challenging to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042980 - tolerate.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042981 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042983 -   
042984 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042986 -               ..
042987 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042988 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042994 -         ..
042995 -        Total right foot...............................  5      5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042997 -         ..
042998 -        Left Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042999 -        
043000 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043001 -        Between little toe and ring toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043002 -        Between ring toe and middle toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043003 -        Between middle and long toe..................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043004 -        Between long toe and big toe.................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043006 -         ..
043007 -        Tailor's Bunion................................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043011 -   
043012 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043013 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043015 -   
043016 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043018 -  ..
043019 - Pain increases as PRP is injected to level 8+, and so challenging to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043020 - tolerate.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043021 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043023 -         ..
043024 -        Total right foot...............................  5      5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043025 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043027 -         ..
043028 -        Right Shoulder........................................  0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043029 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043031 -         ..
043032 -        Left Shoulder.........................................  0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043033 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043035 -         ..
043036 -        Total injections...................................... 15                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043037 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043039 -  ..
043040 - How long wait before doing pushups?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043042 -  ..
043043 - Doctor Tucker said treating shoulders takes a lot of PRP.  There was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043044 - not enough for injecting the shoulders today.  She feels rest will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043045 - heal evident tendon and ligament strains.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043047 -  ..
043048 - Doctor Tucker discussed injecting "ozone" at each injection site in 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043049 - weeks, saying this could extend effectiveness of PRP.   Current plan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043050 - is for Doctor Edwards to perform follow on PRP in about 3 weeks at VA,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043051 - planned in the meeting at the VA on 190327 0915. ref SDS 70 913K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043052 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043053 -            [...below on 190403 1000 doctor's Progress Notes recommend                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043054 -            adding ozone to PRP injections 2 weeks after getting PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043055 -            treatment x3. ref SDS 0 N13O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
043057 -             ..
043058 -            [On 190414 2007 letter asks Doctor Tucker to call and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043059 -            clarify proposed ozone treatment. ref SDS 80 HX55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043061 -  ..
043062 - After treatment research found reporting that ozone treatments are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043063 - "illegal"...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043064 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043065 -        Naturopathic Diaries                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043066 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043067 -        Ozone therapy in naturopathic medicine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043068 -        Posted on 22 May 2016                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043069 -        Author Britt Hermes   164 Comments                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043070 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043071 -              https://www.naturopathicdiaries.com/ozone-therapy-in-naturopathic-medicine/                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043073 -  ..
043074 - This reviewer says in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043076 -         ..
043077 -        The California Naturopathic Doctors Act, passed in 2003 and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043078 -        amended in 2013, does not permit the use of any gas. Thus, it                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043079 -        is illegal to administer ozone to patients.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043080 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043082 -         ..
043083 -        Wikipedia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043085 -         ..
043086 -        Ozone therapy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043087 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043088 -              https://en.wikipedia.org/wiki/Ozone_therapy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043090 -         ..
043091 -        Ozone can also be introduced via autohemotherapy, in which                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043092 -        blood is drawn from the patient, exposed to ozone and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043093 -        re-injected into the patient.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043095 -         ..
043096 -        More recent reviews have highlighted that different routes of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043097 -        administration may result in different therapeutic and side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043098 -        effect profiles,[11] though a statistically robust meta                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
043099 -        analysis of available research has not been performed to date.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043101 -         ..
043102 -        In April 2016, the FDA prohibited the medical use of ozone,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043103 -        "In any medical condition for which there is no proof of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043104 -        safety and effectiveness", stating "Ozone is a toxic gas with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043105 -        no known useful medical application in specific, adjunctive,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043106 -        or preventive therapy. In order for ozone to be effective as a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043107 -        germicide, it must be present in a concentration far greater                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043108 -        than that which can be safely tolerated by man and animals.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043110 -         ..
043111 -        Serious complications reported from the use of this therapy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043112 -        include the development of hepatitis and also include five                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043113 -        reported fatalities.[20] There is some concern about an                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
043114 -        association with heart attacks after autohemotherapy,[21]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043115 -        though this association has been contested as well.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043116 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043117 -            [On 190414 2007 letter to Doctor Tucker asks about risks of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043118 -            complications getting ozone therapy. ref SDS 81 HX66                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043119 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043120 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043138 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043141 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043142 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043143 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043144 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043145 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043146 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0432 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050401 -  ..
050402 - Progress Notes Doctor Tucker PRP Procedure on 190403                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050403 - 
050404 - Received letter from Doctor Tucker transmitting her Progress Notes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050405 - for the procedure today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050407 -            [On 190405 0909 submitted comments on progress notes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050408 -            ref SDS 77 OQ51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050410 -             ..
050411 -            [On 190412 0931 received revised progress notes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050412 -            ref SDS 79 GJ3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050414 -  ..
050415 - Stored Doctor Tucker's Progress Notes in...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050417 -              F:\05\00003\SM\CC\AGMJ\20190403-100000\PRP_G_Tucker_revised.docx                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050420 -         ..
050421 -    1.  Gloria Tucker MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050422 -        Diplomatic American College of Sports Medicine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050423 -        250 Bel Marin Keys Boulevard, Building G Suite 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050424 -        Novato, CA 94949                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050425 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050427 -         ..
050428 -        Rod Welch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050430 -         ..
050431 -    2.  Date....................................... 2019 04 03                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050433 -         ..
050434 -    3.  S:  Return visit for multiple complaints.  He notes that he is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050435 -        having pain in his bilateral shoulders when he does push-ups.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050436 -        He has been doing push-ups for many years 5 sets of 20, until                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050437 -        recently.  On August 10, 2018, he resumed pushups to build                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050438 -        strength for ascending Half Dome cables - limited to 3 sets of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050439 -        20 reps.  There were no injuries at this level.  After Half                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050440 -        Dome on September 12, 2018, he increased to 4 sets of 20 reps.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050441 -        He had to stop pushups on February 25, 2019, because right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050442 -        elbow was popping (not swelled) and both shoulders pain level                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050443 -        8.  Shoulders felt mushy, as having no power doing a pushup.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050445 -         ..
050446 -    4.  In addition, he notes the sensation of jitteriness or anxiety                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050447 -        in his bilateral legs after hiking long distances (15+ miles).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050448 -        This has only been occurring in the last few months.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050449 -        reports that he hydrates himself well after the hike.  He has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050450 -        no history of magnesium or iron deficiency.  This does respond                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050451 -        to medication such as tramadol.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050453 -         ..
050454 -    5.  While hiking, after about 1 mile he experiences "burning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050455 -        sensation" bottom right foot from above heel toward ring toe.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050456 -        This can last from .25 to 1+ miles, then subsides.  May recur                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050457 -        after a few miles, but after 7 or 8 miles does not recur for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050458 -        rest of hike.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050460 -         ..
050461 -    6.  About 8 years ago, he suffered severe (i.e., pins and needles,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050462 -        swelling, numbness - cannot feel the ground) peripheral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050463 -        neuropathy (PN) mainly in right foot, but some in left foot,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050464 -        and caused by statin medication (Rosuvastatin).  Doctor reduced                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050465 -        dose and PN did not recur, until 4 or 5 months ago.  Now very                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050466 -        mild PN occurs, as mere swelling of right foot and only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050467 -        occasionally, rather than with every hike.  Lasts only a mile                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050468 -        or so, then subsides and does not recur.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050470 -         ..
050471 -    7.  He would  like to be treated in left foot with PRP for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050472 -        recurrent metatarsalgia due to his extensive long distance                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050473 -        running. He has had PRP in his Bilateral feet many times with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050474 -        good results.  However, the only last 3-4 months.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050475 -        attempted adding Supartz before his PRP, to prolong the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050476 -        effects of the PRP, without benefit.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050478 -  ..
050479 - Did not get "running" changed to hiking, cited in the letter to the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050480 - team on 190405 0909. ref SDS 77 WW6O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
050482 -  ..
050483 - This doesn't make sense because Supartz only applied to knees, never                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050484 - to feet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050486 -  ..
050487 - Progress notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050488 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050489 -    8.  On examination:  Left shoulder: Range of motion is full,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050490 -        however he does have a painful arc from 60 to 120 degrees on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050491 -        abduction.  No evidence of discomfort on internal rotation or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050492 -        external rotation.  Negative O'Brien test.  He is distinctly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050493 -        tender along his greater tuberosity, the insertion site of his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050494 -        infraspinatus, and teres minor, and at his coracoid.  He has a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050495 -        negative lift-off test.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050497 -         ..
050498 -    9.  Left foot:  He has good fat pads in the region of his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050499 -        metatarsals on the left.  He is tender between his metatarsal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050500 -        heads 1 and 2, 2 and 3, 3 and 4, and 4 and 5.  He is also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050501 -        tender at his tailor's bunion.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050503 -         ..
050504 -   10.  Plan: Case discussed at length.  Left shoulder: Rotator cuff                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050505 -        tendinosis, no tear.  Next I think he would respond well to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050506 -        PRP.  I would back off his exercise regimen for 1 month and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050507 -        then steadily begin again.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050509 -  ..
050510 - Finding no rotator cuff tear, aligns with understandings during the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050511 - meeting, per above. ref SDS 0 FG8N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050513 -  ..
050514 - Progress notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050515 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050516 -   11.  Knee pain:  Needs frequent treatments with PRP and failed PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050517 -        plus hyaluronidase.  I would suggest adding ozone 2 weeks after                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050518 -        his PRP treatment x3.  Symptoms consistent with restless leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050519 -        syndrome, I would suggest checking levels of magnesium,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050520 -        potassium, sodium, iron, TIBC, and ferritin.  Afterwards I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050521 -        would treat with magnesium malate.  I also would like him to be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050522 -        hydrated during his hike not just after and well-hydrated                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050523 -        before.  Lastly I will treat his left foot at the MTPs today                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050524 -        with PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050526 -  ..
050527 - What does "...PRP treatment x3" mean"?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050529 -  ..
050530 - Add ozone to PRP knee injections 2 weeks later aligns with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050531 - understandings during the meeting, per above, ref SDS 0 UW8L, - will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050532 - discuss with Doctor Edwards at VA, in relation to getting additional                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050533 - PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050535 -  ..
050536 - Ozone therapy reported as alternative medical care, reviewed above.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050537 - ref SDS 0 EW4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050538 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050539 -            [On 190414 2007 letter asks Doctor Tucker to call and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050540 -            clarify proposed ozone treatment. ref SDS 80 HX55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050542 -  ..
050543 - Progress notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050544 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050545 -   12.  In light of his history of responding to PRP, but it lasting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050546 -        only 3 months.  And his hiking 3,500 miles per year - nearly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050547 -        300 miles per month with 11 - 20+ mile daily hikes, I believe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050548 -        he will continue to need PRP every 3 months as long as he                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050549 -        continues this hiking regimen.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050551 -  ..
050552 - This review reflects request a few days later in a letter to the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050553 - doctor on 190405 0909. ref SDS 77 WW9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050554 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050555 -            [On 190414 2007 letter asks Doctor Tucker to consider                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050556 -            amending progress notes with context on benefits of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050557 -            getting PRP treatments every 3 months that regress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050558 -            atherosclerosis plaques to improve cardiovascular                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050559 -            health. ref SDS 81 HK3X                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050561 -             ..
050562 -            [On 190414 2145 letter to Doctor Tucker presents treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050563 -            achalasia once per month with EGD dilation, presents                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050564 -            similar approach for PRP treatments every 3 - 6 months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050565 -            ref SDS 82 FA6H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050567 -  ..
050568 - Progress notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050569 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050570 -        Gloria Tucker MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050571 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050573 -         ..
050574 -        Rod Welch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050575 -        April 3, 2019                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050577 -         ..
050578 -   13.  Procedure: I aspirated 60 cc of blood from his left brachium,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050579 -        and spun this down to 3 cc of PRP.  I activated this with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050580 -        calcium chloride and buffered this with sodium bicarbonate.  I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050581 -        then injected his metatarsal heads 1 through 5 in his left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050582 -        foot as well as his left tailor's bunion.  He tolerated the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050583 -        procedure well.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050585 -         ..
050586 -        Gloria Tucker MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050588 -  ..
050589 - Does spinning 60 cc down to 3 cc of PRP represent a 2-spin high (5-9                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050590 - times baseline) concentration of PRP, which is a change from using                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050591 - 1-spin low (3 times baseline) concentration of platelets for prior                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050592 - procedures that yielded 6 and 7 cc of PRP?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
050594 -  ..
050595 - What contrifuge equipment was used today?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
050596 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050597 -            [On 190412 0931 letter to Doctor Tucker requests amend                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050598 -            Progress Notes to report centrifuge equipment - whether                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050599 -            1-spin or 2-spin high-platelet-concentration process.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050600 -            ref SDS 78 SL30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050602 -  ..
050603 - Actually, 3 cc of PRP is only for the feet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050604 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050605 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050606 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050607 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050608 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050609 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050610 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050611 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050612 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050613 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0507 -