CONTACTS
SUBJECTS
Treadmill Heart Stress Test Schedule 200103 0700 Chest Pain Elevated
2403 -
2403 - ..
2404 - Summary/Objective
2405 -
240501 - Follow up ref SDS E2 0000. ref SDS E1 0000.
240502 -
240503 -
240504 -
240505 - [On 200615 0902 letter to Jessica referencing call with
240506 - Frank, and Gracie's letter on contacting Jessica about
240507 - scheduling prep for colonoscopy. ref SDS E4 NE9N
240508 -
240509 -
240510 -
240511 -
240513 - ..
2406 -
2407 -
2408 - Background
2409 -
240901 - On 191206 1425 letter to VAMCSF Cardiology Doctor Simpson, ref SDS A5
240902 - NE9N, notify possible afib symptoms. ref SDS A5 N874
240904 - ..
240905 - On 191207 0927 Doctor Simpson to order ECG [...electrocariogram...]
240906 - Zio test for AFib, after he returns to work following several weeks
240907 - out of the office. ref SDS A6 NE9N
240909 - ..
240910 - On 191213 0849 call from Tina - scheduled install Zio equipment for
240911 - heart monitoring test; meeting room 2A16 on 191216 1230. ref SDS A7
240912 - NE9N
240914 - ..
240915 - On 191216 1220 Exmeralda in Cardiology at VAMCSF installed Zio XT
240916 - heart monitor on left chest; she added 2 plastic tapes to secure the
240917 - unit against fall off in shower and perspiration during hiking.
240918 - ref SDS B1 AO7H
240920 - ..
240921 - On 191214 1138 letter to Doctor Simpson in Cardiology at VAMCSF,
240922 - ref SDS A9 NE9N, reports 8 weeks ago increased hiking route with steep
240923 - hills from 11 to 15 miles per day. ref SDS A9 MX58 About a week ago
240924 - increased hiking to 20+ miles per day in order to improve weight
240925 - control and to raise lipids toward HDL 80. ref SDS A9 MX61 Weight
240926 - increased after pausing hiking due to orthopedic pain left knee and
240927 - both feet, which was solved after receiving oxycodone and gabapentin,
240928 - and applying elastic bandage to left knee. ref SDS A9 MX64 Today,
240929 - before hiking felt chest swaying indicating afib. ref SDS A9 MY30
240930 - Research indicates walking can aid recovery from afib; during hike
240931 - today, will reduce level of effort back to 15 miles per day, and avoid
240932 - steeper hills. ref SDS A9 368M Ask about medication to treat afib.
240933 - ref SDS A9 MY38 Offer to walk with Doctor Simpson to assist recovery
240934 - from hip surgery. ref SDS A9 MY41
240936 - ..
240937 - On 191214 1138 at 1324 letter from Doctor Simpson in Cardiology at
240938 - VAMCSF says to do hiking that has led to symptoms. ref SDS B0 0K4L
240940 - ..
240941 - On 191228 1416 letter to Doctor Simpson notify Zio log reports chest
240942 - pain hiking with elastic bandage on left knee. ref SDS B2 NE9N 1st
240943 - episode hiking 12 miles through Golden Gate Park on 191220, chest pain
240944 - mild lasted on ly .25 miles. Occurred again next day hiking 20 miles
240945 - up Crystal Ranch Road. ref SDS B2 B652 Occurred next day on 191222, so
240946 - stopped at mile .75 and removed elastic bandage from left leg, pain
240947 - ended for rest of 20 mile hike and on subsequent hikes 20 mile past 6
240948 - days. ref SDS B2 B655 Today on 191228, chest pain occurred hiking up
240949 - mild hills without elastic bandage on left leg, so ended hike at 7
240950 - miles. ref SDS B2 B658 HR 150 - should be 45 - 55. ref SDS B2 B662
240951 - Seems like bypass saphenous graft failed under elevated load wearing
240952 - elastic bandage on left knee. ref SDS B2 B665 Pause hiking until hear
240953 - from the doctor. ref SDS B2 B668
240955 - ..
240956 - On 191228 1416 at 1534 letter from Doctor Simpson notifies he will
240957 - order treadmill stress test. ref SDS B2 RK6L
240959 - ..
240960 - On 191228 1416 at 1537 letter to Doctor Simpson notifies will submit
240961 - Zio XT device with afib data on Monday, 191230. ref SDS B2 WO6F
240963 - ..
240964 - On 191229 1243 received letter from Doctor Simpson notifies need to
240965 - get ECG test at VAMCSF before they can schedule treadmill stress test.
240966 - ref SDS B3 NE9N Further says to get care in the ER if chest pain
240967 - recurs at rest. ref SDS B3 NH77
240969 - ..
240970 - On 191229 1243 at 1256 letter to Doctor Simpson asks where and when to
240971 - get ECG test. ref SDS B3 YH8N Notifies so far chest pain has not
240972 - occurred at rest; has only occurred when hiking. ref SDS B3 YA48
240973 - Notifies of EGD procedure in GI Clinic at VAMC Sacramento on 200107,
240974 - and getting MRI studies on feet and knees at VAMCSF on 200109.
240975 - ref SDS B3 YA51
240977 - ..
240978 - On 191229 1243 at 1420 received letter from Doctor Simpson advising
240979 - ECG is done on 2nd floor building 203, and to arrive about 1000.
240980 - ref SDS B3 LG4J Recommends notifying GI Clinic to delay EGD until
240981 - after resolution of current Cardiology issue. ref SDS B3 6H6G
240983 - ..
240984 - On 191229 1243 at 1538 received letter from Doctor Simpson advising
240985 - ECG was done in this case at the end of Oct, so do not need a new one;
240986 - next step is for VA to schedule stress test. ref SDS B3 E17N
240988 - ..
240989 - On 191229 1243 at 1619 sent letter to Jessica on notifying Doctor Lee
240990 - to delay next EGD scheduled on 200107 0730 for a month until 200204
240991 - 0730. ref SDS B3 4R7J
240993 - ..
240994 - On 191229 1243 at 1700 letter thanks Doctor Simpson for advising ECG
240995 - not needed. ref SDS B3 M48J
240997 - ..
240998 - On 191229 1243 at 1946 letter notifies Doctor Simpson that feet
240999 - elevated on footrest seem swelled. Cellphone reports HR 38. That is
241000 - low for me. Don't feel dizzy or light headed; seems like afib event,
241001 - with chest swaying back and forth. ref SDS B3 MH6N
241003 - ..
241004 - On 191229 1243 at 1946 letter notifies Doctor Simpson Zio device was
241005 - mailed to company a day early on 191229. ref SDS B3 UA47
241007 - ..
241008 - On 191230 0930 received call from Tina in Cardiology at VAMCSF
241009 - scheduled treadmill stress test on 200103, ref SDS B4 NE9N, report
241010 - first at 0700 to ASU on 3rd floor Building 200 for IV, then go to
241011 - Neuclear Medicine on ground floor building 203. ref SDS B4 GE5K
241013 - ..
241014 - On 191230 0930 at 0938 received letter from Doctor Simpson in
241015 - Cardiology explaining symptoms reported last night are okay, since not
241016 - dizzy, until after stress test. ref SDS B4 GF3G
241018 - ..
241019 - On 191230 0930 at 0949 received letter Tina in Cardiology confirming
241020 - schedule for stress test on 200103 0700, and submitting instructions
241021 - to prepare for the test. ref SDS B4 Q76I
241023 - ..
241024 - On 191230 0930 at 1021 letter to Doctor Simpson in Cardiology at
241025 - VAMCSF reporting stress test has been scheduled on 200301 0700.
241026 - ref SDS B4 9W6F Reported mild chest pain at rest for 10 minutes, but
241027 - it resolved while writing the letter. ref SDS B4 JY39
241029 - ..
241030 - On 191230 0930 at 1114 received letter from Lauren, NP and PCP in this
241031 - case; she concurs patient should go to ER if chest pain persists at
241032 - rest, and should have a driver. ref SDS B4 2S4N
241034 - ..
241035 - On 191230 0930 at 1117 received call from Aladin who is Lauren's
241036 - assistent in Medical Practice; he indicated Lauren asked him to call
241037 - and get background on chest pain issue. ref SDS B4 578G Explained
241038 - background is reported in correspondence with Doctor Simpson in
241039 - Cardiology, and this has been copied to Lauren. ref SDS B4 5W6J
241041 - ..
241042 - On 191230 0930 at 1135 responded to Lauren citing call from her
241043 - assistent, Aladin, and reporting background on current issue is
241044 - reported in correspondence with Doctor Simpson in Cardiology, who is
241045 - directing the work, and that Lauren has been copied on all
241046 - correspondence. ref SDS B4 659K
241048 - ..
241049 - On 200227 0800 Lauren called. She will order Tramadol. ref SDS C7
241050 - NE9N Lauren will also order diclofenac topical medication to try
241051 - before ordering naproxen. ref SDS C7 016I She will call back in 2
241052 - weeks to evaluate results trying diclofenac. ref SDS C7 626M
241054 - ..
241055 - On 200312 082309 Lauren called. She does not want to take
241056 - responsibility for ordering naproxen, because it impacts apixaban that
241057 - is a blood thinner to prevent strokes that could occur, while in
241058 - atrial fibrillation. ref SDS D4 955O
241060 - ..
241061 - On 200611 0730 Lauren called with VAMCSF Medical Practice following up
241062 - prior patient review on 200312 0823. ref SDS C6 NE9N During call
241063 - today, explained pausing metoprolol, apixaban and clopidogrel due to
241064 - adverse side effects, reported this morning in case study on 200101
241065 - 0702. ref SDS C7 PQRQ Severe stomach pain occurring in the moment.
241066 - Dizziness, wobbly, staggering during hikes, fainting while working.
241067 - ref SDS C8 NE9N Lauren ordered examination in Urgent Care at VAMCSF.
241068 - ref SDS C8 H64G She wants EKG and labs to support the examination.
241069 - This was scheduled for today at 1400. ref SDS C8 H66H
241070 -
241071 -
241072 -
241073 -
241074 -
241076 - ..
2411 -
2412 -
2413 - Progress
2414 -
241401 - Earlier this morning about 0540 nurse did blood draw for another lab.
241402 -
241403 - Did 10 laps around the ward.
241405 - ..
241406 - Met with Katherine Sanders, resident in surgery.
241408 - ..
241409 - The surgeon team is concerned there is infection in the colon. GI
241410 - team will visit later today, for evaluation toward doing a
241411 - colonoscopy.
241412 -
241413 -
241415 - ..
2415 -
2416 -
2417 - 0810
2418 -
241801 - Doctor Cleveland visits. He is with the Medicine Department - senior
241802 - resident.
241804 - ..
241805 - Doctor Cleveland did another examination of stomach.
241807 - ..
241808 - The doctor said GI people may come by. Could do colonoscopy next
241809 - month with Doctor Lee in Sacramento, during regularly scheduled
241810 - meeting on 200707.
241811 -
241812 -
241814 - ..
2419 -
2420 -
2421 - 0822
2422 -
242201 - Chris stopped by. He is a 4th year medical student.
242202 -
242203 - Seems very knowledgable. Did another examination.
242204 -
242205 -
242206 -
242207 -
242209 - ..
2423 -
2424 -
2425 - 0911
2426 -
242601 - Shao visited to provide medications.
242602 -
242603 - She will ask the doctor to visit for scheduling medications.
242604 -
242605 -
242606 -
242608 - ..
2427 -
2428 -
2429 - 0930
2430 -
243001 - Doctor Pellegrini visits.
243002 -
243003 - She feels colitis (inflammation/infection in colon) could not be
243004 - caused by side effects of Metoprolol, clopidogrel, apixaban. It is
243005 - just a coincidence that symptoms of colitus align with some side
243006 - effects of these three (3) medications. She wants to continue
243007 - metoprolol, clopidogrel, apixaban to test if symptoms continue after
243008 - treatment for colitis.
243010 - ..
243011 - Agreed to continue these medicaitons.
243013 - ..
243014 - The doctor seemed to say Apixaban can be stopped within 3 months
243015 - after the last ablation on 200511.
243017 - ..
243018 - She will recommend to the Medicine team they do a CT test of the
243019 - chest to verify the ablation procedure did not injure the esophagus.
243021 - ..
243022 - The doctor notified Shao to provide medications this morning...
243023 -
243024 - metoprolol
243025 - clopidogrel
243026 - apixaban
243027 -
243028 -
243030 - ..
2431 -
2432 -
2433 - 0945
2434 -
243401 - Shao brought medications...
243402 -
243403 - metoprolol
243404 - clopidogrel
243405 - apixaban
243407 - ..
243408 - She explained how to identify the P wave, just before the high,
243409 - prominent QRS wave.
243410 -
243411 -
243412 -
243414 - ..
2435 -
2436 -
2437 - 1006
2438 -
243801 - Doctor Lopez visits, with Doctor Cleveland and Chris.
243802 -
243803 - The doctor said the ER team gave a treatment with antibiotics last
243804 - night through the IV with...
243806 - ..
243807 - Ciprofloxacin
243809 - ..
243810 - The medicine team is not prescribing any new treatment at this time,
243811 - until more results are available from pending lab results.
243813 - ..
243814 - WBC has come down to 14, from 17 yesterday.
243816 - ..
243817 - Temperature is normal this morning, after being elevated yesterday.
243819 - ..
243820 - Doctor Cleveland said to contact him through the nurse, if anything
243821 - further is needed.
243822 -
243824 - ..
2439 -
2440 -
2441 - 1048
2442 -
244201 - Call from Marvin in Pharmacy.
244202 -
244203 - Reviewed medications and protocols.
244205 - ..
244206 - He had most of the information from prior reveiw in the hospital on
244207 - 200121 0552. ref SDS C1 Q56G
244209 - ..
244210 - He verified the list of daily medications and the times when they are
244211 - taken.
244212 -
244213 -
244215 - ..
2443 -
2444 -
2445 - 1126
2446 -
244601 - Talked to Shao. She understands patient should not do laps for
244602 - exercise, at least until after results of tests are available from
244603 - the lab to establish the patient does not have any infectious
244604 - diseases.
244605 -
244606 -
244608 - ..
2447 -
2448 -
2449 - 1130
2450 -
245001 - Doctor Cleveland and Chris came by.
245002 -
245003 - They expect to get test results later today, or tomorrow. If results
245004 - are negative for disease, then patient can walk around the ward.
245005 - Will need to wear protective mask.
245006 -
245007 - [...below on 200612 0700 at 1211 Shao came in and said
245008 - tests are negative, so patient can walk the halls.
245009 - ref SDS 0 XD8J
245010 -
245012 - ..
2451 -
2452 -
2453 - 1146
2454 -
245401 - Received call from Paul.
245402 -
245403 - He is the Pharmacist, and called to confirm understandings with Marvin
245404 - in the earlier call, per above. ref SDS 0 UT3P
245405 -
245406 -
245408 - ..
2455 -
2456 -
2457 - 1211
2458 -
245801 - Shao came in and said all tests have come in "negative," so patient
245802 - can walk the halls. Should wear a mask, per planning above.
245803 - ref SDS 0 HZ6F
245804 -
245805 -
245806 -
245808 - ..
2459 -
2460 -
2461 - 1317
2462 -
246201 - Shao brought medication for bloating stomach. It is chewable.
246202 -
246203 - Simethacone
246205 - ..
246206 - This worked very well.
246207 -
246208 -
246210 - ..
2463 -
2464 -
2465 - 1426
2466 -
246601 - Chris visited to ask when colonoscopy was given.
246602 -
246603 - This was on 100305 1000. ref SDS 7 PG6G
246605 - ..
246606 - Chris said the VA will notify Doctor Lee about doing a colonoscopy
246607 - during the next procedure on 200707.
246608 -
246609 -
246610 -
246611 -
246612 -
246614 - ..
2467 -
2468 -
2469 - 1527
2470 -
247001 - Sent letter to Gracie and Danis in GI Clinic at VAMC in Sacramento,
247002 - and saying...
247003 -
247004 - 1. Subject: Ask Doctor Lee Perform Colonoscopy July 7
247005 - Date: 2020-06-12, 15:33
247010 - ..
247011 - 2. Gracie, Danis,
247013 - ..
247014 - 3. I am being treated for lower stomach pain, in the hospital at
247015 - VA Medical Center in San Francisco. CT tests show inflammation
247016 - in the colon. Other tests are negative for infection. The
247017 - Medicine team proposes a colonoscopy. Told them I prefer to
247018 - have Doctor Lee do the procedure. One of the residents, said
247019 - the team will notify Doctor Lee to do a colonoscopy. This
247020 - letter is a "heads up" for the doctor.
247021 -
247022 - [...below on 200612 0700 at 2014 received letter from
247023 - Gracie saying to check with Jessica on scheduling prep for
247024 - colonoscopy. ref SDS 0 Y44N
247026 - ..
247027 - [On 200615 0902 letter referencing Gracie's letter on
247028 - contacting Jessica about scheduling prep for colonoscopy.
247029 - ref SDS E4 NE9N
247031 - ..
247032 - 4. Doctor Lee did a colonoscopy on 2010 03 05, so we are out 10
247033 - years. Hopefully, Doctor Lee can do a colonoscopy with the
247034 - next EGD scheduled on July 7. He can review progress notes for
247035 - my care here in San Francisco, beginning yesterday in the ER,
247036 - and today.
247038 - ..
247039 - 5. If there is not enough time to do both EGD and colonoscopy,
247040 - then the doctor might consider doing only colonoscopy, since
247041 - swallowing is going pretty well.
247043 - ..
247044 - 6. Thanks for your help. See you next month.
247046 - ..
247047 - 7. Best regards,
247049 - ..
247050 - 8. Rod
247051 -
247052 -
247053 -
247055 - ..
2471 -
2472 -
2473 - 1545
2474 -
247401 - Doctor David Nagle visited from GI Department.
247402 -
247403 - The doctor was familiar with the record having EGD with Doctor
247404 - Kaltenbach, attending (actually, Doctor Patel performed the work) on
247405 - 180627 1300. ref SDS 66 9G4K
247407 - ..
247408 - He explained that since testing today, has been negative for
247409 - infection, the next line of care is to do a colonoscopy to look for
247410 - causes of symptoms.
247412 - ..
247413 - The question is whether to do the procedure immediately, while I am in
247414 - the hospital, or can this wait until the EGD with Doctor Lee scheduled
247415 - on 200707? Doctor Nagle said this can wait until 200707, but will
247416 - further review tests and CT to confirm his impression.
247418 - ..
247419 - Showed Doctor Nagel the letter to Gracie and Danis on notifying Doctor
247420 - Lee to schedule colonoscopy with EGD on 200707, per above. ref SDS 0
247421 - HD68
247423 - ..
247424 - The doctor said he is okay with the letter.
247425 -
247426 -
247427 -
247428 -
247429 -
247430 -
247432 - ..
2475 -
2476 -
2477 - 1614
2478 -
247801 - Called GI Clinic at VAMC in Sacramento.
247802 -
247803 - Frank answered. He said Gracie and Danis have already left for the
247804 - day.
247806 - ..
247807 - He will notify Doctor Lee about adding colonoscopy to EGD scheduled
247808 - on 200707 0930.
247809 -
247810 - [On 200615 0902 letter to Jessica referencing call with
247811 - Frank, and Gracie's letter on contacting Jessica about
247812 - scheduling prep for colonoscopy. ref SDS E4 NE9N
247813 -
247814 -
247815 -
247817 - ..
2479 -
2480 -
2481 - 1621
2482 -
248201 - Roberto here for vitals...
248202 -
248203 - BP 122 73
248204 - HR 70
248205 - Temp 98.1
248206 -
248207 -
248209 - ..
2483 -
2484 -
2485 - 1634
2486 -
248601 - Doctor Monto visited...
248602 -
248603 - Alexander Monto, MD
248604 - Professor of Clinical Medicine, UCSF
248605 - Director of Liver Clinic, SF VA Health Care System
248606 - Gastrointerology Section (111)
248607 - 4150 Clement Street
248608 - San Francisco, CA 94121
248609 - 415 750 2160
248611 - ..
248612 - The doctor has reviewed CT radiology study performed in ER yesterday
248613 - on 200611 1400. ref SDS E2 QM70 and other diagnostics. He explained
248614 - medical investigations indicate diagnosis of...
248615 -
248616 - ischemic colitis
248618 - ..
248619 - After the meeting research found...
248620 -
248621 - [On 200613 0519 at 1135 discharge instruction progress
248622 - notes cite vasodilation and 4 heart procedures as causing
248623 - reduced blood flow to heart causing ischemic colitis.
248624 - ref SDS E3 PP9T
248626 - ..
248627 - Overview
248628 -
248629 - https://www.mayoclinic.org/diseases-conditions/ischemic-colitis/symptoms-causes/syc-20374001#:~:text=Ischemic%20colitis%20occurs%20when%20blood%20flow%20to%20part%20of%20the,and%20may%20damage%20your%20colon.
248631 - ..
248632 - Ischemic colitis occurs when blood flow to part of the large
248633 - intestine (colon) is reduced, usually due to narrowed or
248634 - blocked blood vessels (arteries). The diminished blood flow
248635 - doesn't provide enough oxygen for the cells in your digestive
248636 - system.
248638 - ..
248639 - Ischemic colitis can cause pain and may damage your colon. Any
248640 - part of the colon can be affected, but ischemic colitis
248641 - usually causes pain on the left side of the belly area
248642 - (abdomen).
248644 - ..
248645 - Ischemic colitis can be misdiagnosed because it can easily be
248646 - confused with other digestive problems. You may need
248647 - medication to treat ischemic colitis or prevent infection, or
248648 - you may need surgery if your colon has been damaged.
248649 - Sometimes, however, ischemic colitis heals on its own.
248650 -
248652 - ..
248653 - Doctor Monto noted bloated, tight stomach signals ischemic colotis.
248655 - ..
248656 - Doctor Monto noted that long term atrial fibrillation can be a
248657 - significant trigger of ischemic colitis. Since symptoms first
248658 - occurred in December, and were resolved by ablation treatment within 5
248659 - months on 200511 0546, ref SDS D7 244I, there is low liklihood that AF
248660 - drove systoms of ischemic colotis in this case.
248662 - ..
248663 - The doctor seemed to say "narrowed or blocked blood vessles" likely do
248664 - not occur in this case from atherosclerosis, since IVUS
248665 - catheterization angiogram found blood vessels are fully open, reported
248666 - on 200124 0705. ref SDS C2 ME8G He feels dehydration during long (3+
248667 - hour) hikes may have caused narrowed or blocked blood vessels
248668 - impacting the digestive system. This has not occurred previously,
248669 - because the coronary system was not weakened by multiple procedures on
248670 - the heart. This year the patient has had 4 significant heart
248671 - procedures...
248673 - ..
248674 - IVUS angiogram.................. 200124 0705, ref SDS C2 V544
248675 - stent........................... 200128 0730, ref SDS C3 HQ9O
248676 - ablation left atrial............ 200430 0700, ref SDS D6 2O8O
248677 - ablation right atrial........... 200511 0546, ref SDS D7 244I
248679 - ..
248680 - Additionally, the patient underwent EGD dilation with conscious
248681 - sedation on 200529 0930. ref SDS D8 0001
248682 -
248684 - ..
248685 - He feels this level of treatment trauma in combination with
248686 - dehydration could trigger ischemic colitis. The doctor recommends
248687 - rest for the body to fully recover from coronary treatment trauma.
248689 - ..
248690 - Did not discuss possible cause of reduced blood flow to the large
248691 - intestine (colon) might be explained in this case by vasodilation that
248692 - re-directs blood to leg muscles during hiking, cited in research on
248693 - 180602 1806. ref SDS 63 O842 Another study expressly proposes
248694 - intestine as first source of blood for vasodilation during exercise.
248695 - ref SDS 63 GH5G
248696 -
248697 - [On 200613 0519 at 1135 discharge instruction progress
248698 - notes cite vasodilation and 4 heart procedures as causing
248699 - reduced blood flow to heart causing ischemic colitis.
248700 - ref SDS E3 PP9T
248702 - ..
248703 - [On 200101 0702 Polar overnight heart monitor reports HR
248704 - 49, showing heart getting stronger recovering from ablation
248705 - procedures. ref SDS B9 RUTX
248707 - ..
248708 - He wants to do colonoscopy Monday. The doctor seemed to say that the
248709 - colonoscopy procedure is not likely to have any affect on healing
248710 - ischemic colitis, i.e., will not resolve stomach pain. Thinks there
248711 - is good chance they won't find anything to treat, because WBC and
248712 - temperature both dropped today, indicating colon is healing by itself.
248713 - He thinks this illness may recover without express treatment.
248715 - ..
248716 - The doctor feels hiking in high heat without hydrating can cause blood
248717 - vessels around the colon to contract, failing to deliver oxygen and
248718 - nutrients.
248720 - ..
248721 - We will observe patient recovery tomorrow, and decide on discharge or
248722 - stay over to Sunday, to prepare for colonoscopy Monday, 200615.
248724 - ..
248725 - Thanked the doctor for excellent case review. It was helpful and fun
248726 - like being a student in his class at UCSF hearing a lecture on complex
248727 - and arcane medical conditions.
248728 -
248729 -
248730 -
248731 -
248733 - ..
2488 -
2489 -
2490 - 1721
2491 -
249101 - Shao brought Metoprolol 12.5 grams and Pantoprazole, half hour before
249102 - dinner.
249103 -
249104 -
249106 - ..
2492 -
2493 -
2494 - 1817
2495 -
249501 - Keyboard fell off the gurney. Landed on face of keys. Many keys
249502 - jammed. Now fail to function, so keyboard is broke.
249504 - ..
249505 - Have to work with native c23 keyboard, which is extremely
249506 - inefficient.
249507 -
249508 -
249510 - ..
2496 -
2497 -
2498 - 1959
2499 -
249901 - Yeshi arrived on shift change taking over for Shao, as the night
249902 - nurse.
249903 -
249904 -
249906 - ..
2500 -
2501 -
2502 - 2014
2503 -
250301 - Received letter from Gracie at GI Clinic with VAMC in Sacramento and
250302 - saying...
250303 -
250304 - 1. Subject: Re: Ask Doctor Lee Perform Colonoscopy July 7
250305 - Date: 2020-06-12 19:16
250309 - ..
250310 - 2. Hi Rod,
250311 -
250312 - Hope youre feeling better as youre reading this. You need
250313 - your golytely prep and bisacodyl for Dr. Lee to be able to do
250314 - colonoscopy. I suggest you call Jessica on Monday so she can
250315 - order them for you and have it mailed together with your pre-
250316 - procedure instructions. Dr. Lee should be able to do both
250317 - procedures the same day as long as youre prepped . Take care
250318 - and see you soon. Have a good night and God bless. Give my
250319 - regards to Cathy.
250321 - ..
250322 - 3. Gracie
250324 - ..
250325 - Gracie responds to the letter sent earlier today, per above.
250326 - ref SDS 0 HD68
250327 -
250328 - [On 200615 0902 letter referencing Gracie's letter on
250329 - contacting Jessica about scheduling prep for colonoscopy.
250330 - ref SDS E4 NE9N
250331 -
250332 -
250333 -
250334 -
250335 -
250337 - ..
2504 -
2505 -
2506 - 2052
2507 -
250701 - Yeshi here to provide nighttime medications...
250702 -
250703 - famotidine
250704 - apixaban
250705 - simethicone to suppress bloating
250706 - melatonin for sleep
250708 - ..
250709 - He asked about me.
250711 - ..
250712 - Explained growing up in California. Serving in the Army during
250713 - Vietnam. Entered construction. Years on legal support resolving
250714 - contracting disputes. Developing computer software technology.
250715 - Medical management in health care. Last 20 years got interested in
250716 - hiking, including hiking Half Dome.
250718 - ..
250719 - Yeshi said he loves hiking. He grew up in Nepal. His family has a
250720 - long tradition of hiking the Himalaya mountains. He has not hiked
250721 - Everest. Yeshi immigrated to the US. He settled in Colorado, where
250722 - he hikes the Rocky Mountains. He has traveled throughout the country
250723 - hiking in national parks.
250724 -
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250726 -
250727 -
250728 -
250729 -
250730 -
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250736 -
2508 -