CONTACTS
SUBJECTS
Treadmill Heart Stress Test Schedule 200103 0700 Chest Pain Elevated
2403 -
2403 - ..
2404 - Summary/Objective
2405 -
240501 - Follow up ref SDS H2 0000. ref SDS H0 0000.
240502 -
240503 -
240504 -
240505 -
240506 -
240508 - ..
2406 -
2407 -
2408 - Background
2409 -
240901 - On 191206 1425 letter to VAMCSF Cardiology Doctor Simpson, ref SDS A7
240902 - NE9N, notify possible afib symptoms. ref SDS A7 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 A8 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 A9
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 B3 AO7H
240920 - ..
240921 - On 191214 1138 letter to Doctor Simpson in Cardiology at VAMCSF,
240922 - ref SDS B1 NE9N, reports 8 weeks ago increased hiking route with steep
240923 - hills from 11 to 15 miles per day. ref SDS B1 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 B1 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 B1 MX64 Today,
240929 - before hiking felt chest swaying indicating afib. ref SDS B1 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 B1 368M Ask about medication to treat afib.
240933 - ref SDS B1 MY38 Offer to walk with Doctor Simpson to assist recovery
240934 - from hip surgery. ref SDS B1 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 B2 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 B4 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 B4 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 B4 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 B4 B658 HR 150 - should be 45 - 55. ref SDS B4 B662
240951 - Seems like bypass saphenous graft failed under elevated load wearing
240952 - elastic bandage on left knee. ref SDS B4 B665 Pause hiking until hear
240953 - from the doctor. ref SDS B4 B668
240955 - ..
240956 - On 191228 1416 at 1534 letter from Doctor Simpson notifies he will
240957 - order treadmill stress test. ref SDS B4 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 B4 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 B5 NE9N Further says to get care in the ER if chest pain
240967 - recurs at rest. ref SDS B5 NH77
240969 - ..
240970 - On 191229 1243 at 1256 letter to Doctor Simpson asks where and when to
240971 - get ECG test. ref SDS B5 YH8N Notifies so far chest pain has not
240972 - occurred at rest; has only occurred when hiking. ref SDS B5 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 B5 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 B5 LG4J Recommends notifying GI Clinic to delay EGD until
240981 - after resolution of current Cardiology issue. ref SDS B5 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 B5 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 B5 4R7J
240993 - ..
240994 - On 191229 1243 at 1700 letter thanks Doctor Simpson for advising ECG
240995 - not needed. ref SDS B5 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 B5 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 B5 UA47
241007 - ..
241008 - On 191230 0930 received call from Tina in Cardiology at VAMCSF
241009 - scheduled treadmill stress test on 200103, ref SDS B6 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 B6 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 B6 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 B6 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 B6 9W6F Reported mild chest pain at rest for 10 minutes, but
241027 - it resolved while writing the letter. ref SDS B6 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 B6 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 B6 578G Explained
241038 - background is reported in correspondence with Doctor Simpson in
241039 - Cardiology, and this has been copied to Lauren. ref SDS B6 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 B6 659K
241048 - ..
241049 - On 200227 0800 Lauren called. She will order Tramadol. ref SDS C9
241050 - NE9N Lauren will also order diclofenac topical medication to try
241051 - before ordering naproxen. ref SDS C9 016I She will call back in 2
241052 - weeks to evaluate results trying diclofenac. ref SDS C9 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 D6 955O
241060 - ..
241061 - On 200611 0730 Lauren called with VAMCSF Medical Practice following up
241062 - prior patient review on 200312 0823. ref SDS C8 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 C9 PQRQ Severe stomach pain occurring in the moment.
241066 - Dizziness, wobbly, staggering during hikes, fainting while working.
241067 - ref SDS E1 NE9N Lauren ordered examination in Urgent Care at VAMCSF.
241068 - ref SDS E1 H64G She wants EKG and labs to support the examination.
241069 - This was scheduled for today at 1400. ref SDS E1 H66H
241071 - ..
241072 - On 200811 0742 telecon Lauren Primary Care VAMCSF. ref SDS G4 NE9N
241074 - ..
241075 - On 200813 0824 letter to Lauren Primary Care VAMCSF confirm
241076 - understandings call on 200811. ref SDS G5 NE9N
241078 - ..
241079 - On 201117 0730 Lauren called and will have a nurse call to do opioid
241080 - screening survey. ref SDS H0 NE9N Lauren will ask Pain Clinic to call
241081 - with further ideas on pain management without NSAID and acetaminophen,
241082 - and without opioids. ref SDS H0 ML91
241084 - ..
241085 - On 201123 1528 Laura called with VA Primary Care to perform opioid
241086 - screen. ref SDS H2 NE9N
241088 - ..
241089 - On 201128 1049 received letter from Laura in Medical Practice Primary
241090 - Care, submitting Opioid screening consent form, which she prepared
241091 - during the telephone call on 201123. ref SDS 0 NE9N
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241098 -
241100 - ..
2412 -
2413 -
2414 - Progress
2415 -
241501 - Received letter from Laure in Medical Practice Primary Care saying...
241502 -
241503 - 1. Subject: RE: [EXTERNAL] Re: Opioid Consent Form
241504 - Date: 2020-11-27, 15:12
241508 - ..
241509 - 2. Oh I'm sorry Mr Welch. I thought you just wanted to see the
241510 - generic form for content. Here is the form for you
241511 - specifically. Let me know if you have any questions about it.
241513 - ..
241514 - This responds to the letter submitted to Laura requesting the consent
241515 - form she prepared and signed during the call on 201123 1528.
241516 - ref SDS H2 UB5K
241518 - ..
241519 - Thanks,
241521 - ..
241522 - Laura Goldbaum, RN
241523 -
241524 - Attachment: Welch.R0144consent.pdf
241526 - ..
241527 - The attached consent is entered in the record on the day the form was
241528 - prepared and signed by Laure, shown in the record on 201123 1528.
241529 - ref SDS H2 UB5K
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