CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
1103 -
1103 - ..
1104 - Summary/Objective
1105 -
110501 - Follow up ref SDS 47 0000. ref SDS 45 0000.
110502 -
110503 -
110504 -
110505 -
110506 -
110507 -
110509 - ..
1106 -
1107 -
1108 - Background
1109 -
110901 - On 210607 1428 letter to Doctor Pellegrini references understandings
110902 - from the meeting today, on possible electrical nodes in right atrial
110903 - causing AFL episodes. ref SDS 24 5640
110905 - ..
110906 - On 210607 1428 letter to Doctor Pellegrini lists recurrent AFL
110907 - episodes in right atrial since last ablation on 201210. ref SDS 24
110908 - RF8H
110910 - ..
110911 - On 210824 0845 changed meeting scheduled to meet with Doctor
110912 - Pellegrini on 210825, to 210922 0930, because Kathy had meeting with
110913 - Doctor Hui in sacramento on 210825 1000. ref SDS 26 5M5I This
110914 - followed up letter to Doctor Pellegrini on 210629 1036. ref SDS 25
110915 - TV5L
110917 - ..
110918 - On 210921 0326 letter to Doctor Pellegrini sets agenda for meeting
110919 - today. ref SDS 27 TV5L
110921 - ..
110922 - On 210930 0646 letter to Doctor Pellegrini on results meeting at
110923 - VAMCSF in Cardiology on 210922 0930, ref SDS 29 W44O; ask about letter
110924 - saying another meeting in Cardiology on 210930, ref SDS 29 J463,
110925 - report dates of 5 AFL episodes. ref SDS 29 J534 Review variances in
110926 - blood pressure. ref SDS 29 J53O
110928 - ..
110929 - On 210930 1846 letter to Doctor Pellegrini in Cardiology reports
110930 - another AFL episode. ref SDS 30 BT5N Requests timeline for next
110931 - ablation. ref SDS 30 VU49
110933 - ..
110934 - On 211006 1100, while meeting with Doctor Pellegrini, she made
110935 - referral to Doctor Monto to follow up on ischemic colotis episodes.
110936 - ref SDS 33 6M9I
110938 - ..
110939 - On 211213 0800 video meeting with Doctor Yu - she ordered CT test and
110940 - lab to evaluate recovery from ischemic colotis. ref SDS 35 T17O
110941 -
110942 -
110943 -
110944 -
110946 - ..
1110 -
1111 -
1112 - Progress
1113 -
111301 - Submitted letter to Doctor Pellegrini at VAMCSF saying...
111302 -
111303 - 1. Subject: EXTERNAL] SECURE AFL Episodes Hiking Solved Pausing Tramadol, Elevated BP, LDL Resume Atorvastatin
111304 - Date: 2022-04-19, 14:08
111309 - ..
111310 - 2. Dear Doctor Pellegrini,
111312 - ..
111313 - 3. Attached are EKGs and Polar continual HR studies showing AFL on
111314 - 220329, 220331, 220402. These were consecutive hikes, with a
111315 - day off between each hike for the heart to calm down.
111316 - Metoprolol restored sinus after 2 hours on 220329. Took 5
111317 - hours on 220331. Did not take metoprolol for 3rd episode,
111318 - because was not aware until seeing overnight Polar HR results
111319 - the next morning. This was ongoing when study was started, but
111320 - escaped notice, because was in sinus during and at end of hike,
111321 - and for 30 minutes or so while writing up the record. AFL
111322 - lasted with some gaps for about 7 hours with sinus restored
111323 - about 0300, see Polar HR report.
111324 -
111326 - ..
111327 - 4. These episodes all occurred about mile 18. This suggested
111328 - common trigger. Guessed it might be Tramadol because took 2nd
111329 - pill on all 3 hikes at mile 18. Evidently 2nd Tramadol has an
111330 - additive effect that overloads the "system".
111332 - ..
111333 - References reporting in case study beginning on 220101 0635.
111334 - ref SDS 36 VSWP and ref SDS 36 WSQU and ref SDS 36 XPVY
111336 - ..
111337 - Letter to Doctor Pellegrini continues...
111339 - ..
111340 - 5. Good news - paused taking Tramadol for 10 days. This was very
111341 - difficult hiking with pain to see if AFL occurs without
111342 - Tramadol. There was no AFL on these 10 consecutive hikes.
111344 - ..
111345 - 6. On 200413, experimented taking 2 Tramadol pills again. No AFL
111346 - on 25 miles. Next day 16, then 20, 21 - no AFL. Guess whatever
111347 - builds up that triggers AFL was washed out of the body during
111348 - the 10 day pause. Nice to know we can pause hiking for a few
111349 - days, and then resume taking Tramadol for pain management
111350 - without triggering AFL. This will keep AF burden low, and
111351 - further shows the 4 ablations you performed to date, have
111352 - effectively treated AF issues, per your letter on 220402, see
111353 - below.
111354 -
111355 - [On 220426 1535 letter from Doctor Pellegrini explains low
111356 - AF burden requires no further cardiac ablation procedures
111357 - at this time. ref SDS 50 XP5H
111359 - ..
111360 - 7. Attached Labcorp blood test last week on 220415, reported LDL
111361 - 268, up from 213 for lab on 220126, increasing LDL 92 in VAMCSF
111362 - lab on 220110, and after pausing Atorvastatin on 220116, to
111363 - relieve side effects of peripheral neuropathy in both feet,
111364 - myopathy in left shoulder and left side neck, reported to the
111365 - team the past year, and discussed with Doctor Grunfeld on
111366 - 220127. [...ref SDS 39 TQ3O...]
111368 - ..
111369 - References blood test studies reported on 220415 1853. ref SDS 49 FH4J
111371 - ..
111372 - Letter to Doctor Pellegrini continues...
111373 -
111374 - 8. Side effects are now noticeably milder. Considering trying
111375 - Atorvastatin again possibly 5 mg every other day, instead of 10
111376 - mg every other day, as currently prescribed. Hoping this will
111377 - bring LDL below 120 - not ideal, but better than 270 range.
111378 -
111379 - [On 220506 1347 letter requests new prescription to take
111380 - Ezetimibe everyday, and plan for lab after new taking
111381 - Ezetimibe everyday for several weeks to test need for
111382 - adding Atorvastatin back to daily lipid medication regimen.
111383 - ref SDS 51 HA43
111385 - ..
111386 - 9. Was medically evaluated for IHD disability compensation
111387 - yesterday. Vitals were 162 93 64, or something like that.
111388 - This aligns with recent upward trend in daily vitals taken
111389 - after rising in the morning... 200101 0701, ref SDS 5 VD8N
111391 - ..
111392 - 10. Could this be related to LDL issue, so solving it will redress
111393 - BP?
111395 - ..
111396 - 11. We are scheduled to meet on 220810 1030. I'm fine with waiting
111397 - to discuss progress at that time.
111399 - ..
111400 - 12. Very grateful you worked on issues in CT test 220110. Turned
111401 - out they are old matters from prior studies that are likely
111402 - benign, and so should not have taken up your time. Your report
111403 - and coordination was helpful and kind.
111405 - ..
111406 - References Doctor Pellegrini's letter on 220402 2027. ref SDS 46 4182
111408 - ..
111409 - Letter to Doctor Pellegrini continues...
111410 -
111411 - 13. Best regards,
111413 - ..
111414 - 14. Rod
111415 - ...0144
111416 - 925 787 5641
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1115 -