CONTACTS
SUBJECTS
VA EGD Procedure Stricture Lower Esophageal Sphincter Valve LESV 10
2503 -
2503 - ..
2504 - Summary/Objective
2505 -
250501 - Follow up
250502 -
250503 - Follow up ref SDS D9 0001, ref SDS D9 0000. ref SDS C8 0000.
250504 -
250505 -
250506 -
250508 - ..
2506 -
2507 -
2508 - Progress
2509 -
250901 - EGD and Colonoscopy Diagrams
250902 -
250903 - Follow up ref SDS D9 ZB9N.
250904 -
250905 - After procedure on 200707 0930 during the meeting after EGD and
250906 - colonoscopy, Doctor Lee explained the colonoscopy procedure verified
250907 - diagnosis of ischemic colitis. ref SDS D9 ZB9N
250909 - ..
250910 - He wrote "shallow errosion" in LESV for EGD procedure. Is that
250911 - correct, reported on 200707 0930. ref SDS D9 FH7M
250913 - ..
250914 - What is the name of the finding in the colon tissue?
250916 - ..
250917 - This morning Doctor Lee explained he wrote "errosion"
250918 -
250919 -
250920 - B = biopsy sites
250921 -
250922 - ------------------------------------------
250923 - / B B \
250924 - / x x \
250925 - | -------------------------------- x |
250926 - | / \ |
250927 - | | shallow errosion / | |
250928 - | | ischemic / | |
250929 - | | colitis | |
250930 - | | | |
250931 - | | | |
250932 - | | | B |
250933 - | | | |
250934 - shallow errosion | |
250935 - ischemic |x | | |
250936 - colitis |xx | | |
250937 - |x ---- | |
250938 - | ---- / |
250939 - | | ----------------- |
250940 - | | / B /
250941 - | | / /
250942 - | | | ---------------
250943 - | | | /
250944 - | B | | |
250945 - | | | B |
250946 - | |
250947 - | |
250948 -
250949 -
250951 - ..
250952 - Doctor Lee seemed to say stomach pain during hike, may be caused by
250953 - dehydration during hikes over 3 hours in temperatures > 80. The
250954 - 14-mile hike yesterday was 4 hours and temperature was 83, reported in
250955 - case study on 200101 0702. ref SDS B9 FD4L He indicated dehydration
250956 - can be identified by dark colored urine. Suggested increasing
250957 - hydration during hikes on hot days.
250959 - ..
250960 - Have had no episodes of dark color urine.
250962 - ..
250963 - This morning, the doctor emphasized benefits of drinking water or
250964 - softdrink twice during long hikes when the temperature is elevated.
250966 - ..
250967 - Doctor Lee further said the pathologist found colitis at 4 of the 6
250968 - biopsy sites, so it is more pervasive than merely the 1 site with
250969 - inflammation found by the CT test at VAMCSF on 200611 1400.
250970 - ref SDS D1 NH6J and attributed this to ischemic and/or to NSAID pain
250971 - medication. Doctor Lee said this would indicate side effects of
250972 - naproxen.
250973 -
250974 - [On 200716 1048 letter notifies VA cardiology Doctor
250975 - Simpson and Doctor Pellegrini of biopsy findings.
250976 - ref SDS E1 SN32
250978 - ..
250979 - This record shows naproxen causing adverse effects - colitis, and
250980 - also lesions on left knee using diclofenac topical naproxen, reported
250981 - on
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250985 -
250987 - ..
250988 - Schedule Next Procedure and Post Procedure Review
250989 -
250990 - Follow up ref SDS C8 XF6X, ref SDS C3 XF6X.
250992 - ..
250993 - Continuing schedule for EGD is...
250994 -
250995 - Sep 08 2020 0930 Sac GI procedure 5 Building 645 1st Floor
250996 - Nov 03 2020 0830 Sac GI procedure 5 Building 645 1st Floor
250997 - Jan 05 2020 0830 Sac GI procedure 5 Building 645 1st Floor
250999 - ..
251000 - Asked the doctor about extending schedule through 2021, planned in the
251001 - record on 200707 0930. ref SDS D9 HH3N
251003 - ..
251004 - Doctor Lee will notify Jessica to schedule EGD' every 2 months for
251005 - rest of 2021.
251006 -
251007 -
251009 - ..
251010 - Stroke Counter Claim Defend VA Pension Claim Refund
251011 -
251012 - Told Doctor Lee have inquired about making claim against VA from
251013 - stroke episode on 160617 1637. ref SDS 74 5F6F Preliminary inquiry
251014 - was made yesterday on 200715 0939. ref SDS E0 4M9K
251016 - ..
251017 - The doctor appreciated the heads up on the context for the possible
251018 - claim, to oppose the VA claim.
251019 -
251020 -
251021 -
251023 - ..
2511 -
2512 -
2513 - 1609
2514 -
251401 - Doctor Lee Letter on Biopsy Results from Colonoscopy 200707
251402 -
251403 - Follow up ref SDS D9 ZB9N.
251404 -
251405 - Later in the afternoon, received the doctor's letter in the US
251406 - Mail, saying...
251407 -
251408 - Department of Veterans Affairs
251409 - VA Northern California Health Care System (VANCHCS)
251410 - Sacramento VA Medical Center
251411 - 10535 Hospital Way, Mather, CA 65655
251413 - ..
251414 - In Reply Refer to: Sacramento VAMC
251415 - Gastroenterology (111/SAC)
251416 -
251418 - ..
251419 - Mr Rodney C Welch
251420 - 1158 St Matthew PL #103
251421 - Concord, CA 94518
251422 -
251423 - 14 July 2020
251425 - ..
251426 - Dear Mr Welch:
251428 - ..
251429 - You had a colonoscopy at the Sacramento VAMC on 7 July 2020.
251430 - The biopsies from your colon showed damage limited to the right
251431 - side and left upper parts of the colon, matching the June 2020
251432 - CT findings. I believe these changes may be due to a
251433 - combination of your very strenuous hikes in hot weather, the
251434 - reduced heart pumping function, and the chemical side-effects
251435 - of the naproxyn you are taking to control your musculoskeletal
251436 - pain. There was NO cancer, NO precancerous changes, and NO
251437 - polyps.
251439 - ..
251440 - The abdominal discomfort you experienced appears to match with
251441 - the colon damage, and should serve as a warning for you to
251442 - temporarily reduce the vigor of your hikes and avoid
251443 - dehydration.
251445 - ..
251446 - As we discussed last week, I suggest carrying a water bottle
251447 - and scheduling water breaks in your hikes to reduce the risk
251448 - of dehydration. Accitionally, given the pathology report
251449 - conclusions, please reduce your use of naproxyn by at least
251450 - 50%. Naproxyn can cause colon inflammation as well as kidney
251451 - damage, especially if you are dehydrated.
251453 - ..
251454 - Truly yours,
251455 -
251457 - ..
251458 - Randall E Lee, MD, FACP
251459 - Gastroenterologist, VA NCHCS
251460 - 916 366 5339
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