THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: December 1, 2020 09:30 AM Tuesday; Rod Welch

VA Podiatry Doctor Tang examin blood blister little toes and treat calluses.

1...Summary/Objective


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CONTACTS 

SUBJECTS
VA EGD Procedure Stricture Lower Esophageal Sphincter Valve LESV 10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
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2503 -    ..
2504 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250501 - Follow up ref SDS 20 0000. ref SDS 19 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
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250509 -  ..
2506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2508 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2509 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250901 - On 201028 084602 after hiking through the Park this morning, blood                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250902 - blister on ring toe left foot still hurt, despite cushion dressing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250903 - applied this morning.  Stopped at Podiatry. ref SDS 19 4G4N  Anna made                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
250904 - examination.  She provided another type of dressing, and scheduled                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250905 - meeting with Doctor Tang today, for evaluating blood blister.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250906 - ref SDS 19 RS58                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250908 -  ..
250909 - On 201102 113002 Doctor Tang and Brittany treated calluses and blood                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250910 - blisters. ref SDS 20 A45G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250912 -  ..
250913 - On 201123 0825 letter to Doctor Tang reports new blood blisters on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250914 - little toes. ref SDS 21 IV6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250915 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250917 -  ..
250918 - Today, worked with Jaydean.  She is a 4th year medical student at a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
250919 - school in New York.  She getting on the job training working with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
250920 - Doctor Tang.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
250922 -  ..
250923 - Agenda...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250924 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250925 -    1.  Blood blister little toe right foot.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
250927 -  ..
250928 - Jaydean debrided this to remove underlying wound.  This was fairly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250929 - easy, because using hydrofera blue the past few days, has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250930 - significantly closed the wound.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250932 -  ..
250933 - Doctor Tang provided a tube cutout for protecting little toes.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250934 - also provided dressing, and demonsted how to apply to little toes to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250935 - prevent compounding injuries while hiking.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
250936 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250937 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250938 -    2.  Tailor's Bunions both feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
250940 -  ..
250941 - Jaydean shaved both.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250942 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250943 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250944 -    3.  Calluses big toes both feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250946 -  ..
250947 - Jaydean shaved both.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250949 -  ..
250950 - On 201126 1037 received in the mailbox package containing a tube of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
250951 - Urea 20. ref SDS 22 4G4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
250953 -  ..
250954 - Doctor Tang explained Urea 20 complements ammonium lactate 12%.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
250955 - said to first apply ammonium lactte over entire foot and toes.  Then                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250956 - apply Urea 20 to areas of calluses.  It will loosen the skin for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250957 - easier removal.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250959 -  ..
250960 - Doctor Tang also ordered prescription for new line of care with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250961 - Miconazole Nitrate 2%.  He explained it is applied topically and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250962 - inside socks to keep feet dry during long hikes.  This will reduce                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
250963 - pressues that cause blisters and calluses.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
250964 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250965 -            [On 201207 1549 received from VA Pharmacy prescription for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250966 -            Miconazole Nitrate 2% foot powder, with 6 refills.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250967 -            ref SDS 25 4G4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250969 -             ..
250970 -            [On 200101 0702 applied prior to hike and seemed effective.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
250971 -            ref SDS 13 RWYY                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250973 -  ..
250974 - The doctor changed the schedule setup on 201102 1130. ref SDS 20 3A39                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
250975 - He explained the hospital has changed policy to further reduce patient                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
250976 - visits to the hospital during current surge of coronavirus cases.  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
250977 - meeting scheduled on January 5th was moved to 210129 0930.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
250979 -  ..
250980 - The doctor said to keep him posted with email on progress of podiatry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250981 - problems.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
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2510 -