CONTACTS 
0201 - Kaiser Medical Center              415 929 4000
020101 - Dr. George Matula, GP; =415 202 2220; Internal Medicine, 2nd Floor

SUBJECTS
Prostrate Cancer Testing
Sleep, Dizzyness, Chest Pains
Physical Exam on 940628

1005 -    ..
1006 - Summary/Objective
1007 -
100701 - Follow up ref SDS 3 0893.
100702 -
100703 - Had to wait an hour to see the doctor.
100704 -
100705 - Nothing apparent was discovered from preliminary exam.
100706 -
100707 - Will do hearing exam, and blood tests tomorrow, then need report from
100708 - George on results.
100709 -
100710 -     [On 940629 submitted letter requesting feedback. ref SDS 5 0001]
100711 -
100712 -     [On 990722 doctor said tests were normal, refused to submit
100713 -     written report. ref SDS 9 2409]
100714 -
100715 -  ..
1008 -
1009 -
1010 - Symptoms
1011 -
101101 - Dizziness
101102 -
101103 - About 3 weeks ago, I experienced a period of about a week where when I
101104 - layed down I would feel mildly dizzy.  The same would occur when I got
101105 - up.  As best I recall, this did not occur when I sat down, only when I
101106 - layed down, so I was changing the horizontal orientation of my head
101107 - relative to the ground.
101108 -
101109 - Seems to have lasted about a week or so, and has now gone away.
101110 -
101111 -     [On 940724 problem returned, notified George. ref SDS 10 0001]
101112 -
101113 -
101114 - Chest Pains
101115 -
101116 - We did not discuss this point.  Millie mentioned it when I later
101117 - called her to advise nothing apparent emerged from the exam.  So I am
101118 - setting it out here. I did indicate on a history form in advance of
101119 - the exam, having been hospitalized in 1976 with chest pains, so
101120 - presumably George had this information for the exam, although since he
101121 - noted the file folder he was given for me had incorrect documents,
101122 - possibly he was unaware of this matter.  He did not ask about it.
101123 -
101124 -
101125 - About every 3 months or so, sometimes more often, sometimes at greater
101126 - intervals (it is random), I will have chest pains.  These can be
101127 - relatively severe.  I believe this first occurred in 1976, at age 31.
101128 - I woke up in the morning about 6 am, and drove to the emergency room
101129 - at the hospital in Sacramento.  They kept me for about 2 days, I later
101130 - saw an internist, and he attributed it to a possible tension arising
101131 - from business situation, litigation etc.
101132 -
101133 - About 2 years later I recall a similar condition occurring, while
101134 - playing volleyball on the beach in Santa Cruz.  I was not hospitalized.
101135 - Just layed down for awhile.  It took several hours on that occasion
101136 - for the problem to cease.
101137 -
101138 - Within the past 5 years, a similar condition began occurring with the
101139 - frequency described above.  However, somewhere along the line I
101140 - learned the pressure can be relieved by forced burping, essentially
101141 - expelling the pressure.  This can take 5 - 30 minutes, before the
101142 - symptom is fully dissipated.  I have read in recent years that chest
101143 - pains similar to a heart problem can occur from indigestion. At this
101144 - time, based on the above record, I assume the difficulties described
101145 - here have been digestion disorders, rather than heart related.
101146 -
101147 -
101148 -
101149 -
101150 -
1012 -
1013 -
1014 - Administration
1015 -
101501 - The record of the dermatology exam, and diagnosis of rosacea were in
101502 - the medical record, so George was aware of that information.
101503 -
101504 - The Dr. said there were other documents on another patient, that were
101505 - incorrectly included in the file folder for my record, i.e., the
101506 - hospital's records were mixed up.
101507 -
101508 -
101509 -
101510 -
1016 -
1017 -
1018 - Analysis
1019 -
101901 - My weight was checked, and it looks like I am about 170.  Would like
101902 - to be closer to 155 - 160, but the 170 is better than I expected.
101903 -
101904 -
101905 -  ..
101906 - Sleep/Dizziness
101907 -
101908 - In connection with the dizziness, I explained having worked some long
101909 - hours lately (e.g., 36).  The Dr. indicated this is "pushing the
101910 - envelope."  He said the mind begins reacting a little when there is
101911 - not enough sleep.  This is consistent with the lecture on sleep
101912 - presented at the IBM conference, ref SDS 6 line 99.
101913 -
101914 - My hours are not much different than in past years. Maybe once a month
101915 - or so, when the need arises, or I am working on something interesting,
101916 - I just keep going.  Normally I get from 4 - 6 hours sleep.  After
101917 - working extended hours, I can sleep 10 to 12 hours.
101918 -
101919 - He checked my ears, and observed nothing indicating a disorder that
101920 - explains the dizziness.
101921 -
101922 - George checked my blood pressure, and said it is normal.
101923 -
101924 - He is a tennis player, so we chatted about the relative value of
101925 - tennis as an exercise regimens.  He sounds like a good player.
101926 -
101927 - George submitted a document for a hearing test at another location,
101928 - and another document specifying a variety of blood tests.
101929 -
101930 -      [On 990707 hearing test performed. ref SDS 7 0001]
101931 -
101932 -      [On 990718 requested results of tests. ref SDS 8 0001]
101933 -
101934 -
101935 -  ..
101936 - Prostrate Cancer
101937 -
101938 - I asked about prostrate PSA exam per discussion with Bill Palmer on
101939 - 940621. ref SDS 3 0893
101940 -
101941 - George said that condition is generally not evaluated until about age
101942 - 55.
101943 -
101944 - I requested that this test be performed.
101945 -
101946 - George checked "PSA" on the blood test document to schedule the test.
101947 -
101948 - After meeting with George, I went to the labatory for PSA tests.
101949 -
101950 - There was a long line, so I will come back tomorrow at 0700.
101951 -
101952 -     [On 990629 performed PSA blood test. ref SDS 5 0001]
101953 -
101954 -
101955 -
101956 - Physical Examination Required 20 Minutes
101957 -
101958 - This seemed like a cursory exam.  The entire discussion took about 20
101959 - minutes, and part of that was on POIMS.
101960 -
101961 - I asked if he knew of anyone interested in the biology of the brain
101962 - that relates to the distinction between "information" which essen-
101963 - tially is sensory, and "knowledge" which seems to be "processed"
101964 - information.
101965 -
101966 - George said his nephew is working in this area.
101967 -
101968 - I will submit the POIMS paper and ask him to pass it along to his
101969 - nephew for comments.
101970 -
101971 -
101972 -
101973 -
1020 -

SUBJECTS
Dermatology - face blemish, 920810
Rosacia, 940624

1105 -
110501 -  ..
110502 - Rosacea Prescrption Medication Received at Pharmacy
110503 -
110504 - While waiting to get a physical exam, per above, ref SDS 0 0001, went
110505 - to the pharmacy across the street on Geary, and picked up medication
110506 - prescription, per the record on 940624. ref SDS 4 0001
110507 -
110508 -
110509 - Received following document
110510 -
110511 -
110512 -     SFO Pharmacy #2 - Dermatology
110513 -
110514 - Claim Check #: 94175 02033 A
110515 - Welch, Rod                                   Your Prescription
110516 - 28Jun94                                      Drug Benefit
110517 - Mr. #:  05519189                             Saved You:    $29.95
110518 -
110519 -
110520 -                        Retail Price             Your Price
110521 -                                    ----------
110522 - Rx#  313 55257             8.05                     3.00
110523 - Rx#  313 55258            23.90                     3.00
110524 -
110525 -
110526 -                   Total Rx Price:                   6.00
110527 -
110528 -
110529 -  ..
110530 - Medication Instructions
110531 -
110532 - Received ref OF 1 0001, titled "Tetracyclines," that gives general
110533 - instructions about taking the medication for the full prescription
110534 - period. ref OF 1 0896
110535 -
110536 -      Take with full glass of water and on empty stomach, ref OF 1 0896
110537 -      [this instruction is also on the medication label.]
110538 -
110539 -      Medication can be taken up to 4 times a day. ref OF 1 2074
110540 -      [instruction on the prescription label says to take 3 times a
110541 -      day.]
110542 -
110543 -        [On 000124 possible conflict with Glucosamine and Chrondroitin.
110544 -        ref SDS 11 2655]
110545 -
110546 -      Avoid "too much" sunlight, ref OF 1 9077. [this is also on
110547 -      medication label]
110548 -
110549 -      Avoid antacids, calcium supplements, iron supplements and magne-
110550 -      sium-containing preparations. Allow at an hour's time between
110551 -      your tetracycline dose and any of these other drugs, ref OF 1
110552 -      6745
110553 -
110554 -      Possible Side Effects
110555 -
110556 -      Mild diarrhea, nausea, cramps or burning of stomach may occur
110557 -      during treatment as body adjusts to the medicine. Tetracyclines
110558 -      may sometimes cause temporary darkening or discoloration of the
110559 -      tongue. Itching of the rectum or genital areas or soreness of the
110560 -      mouth or tongue can occur while taking Tetracyclines.
110561 -
110562 -      Contact the doctor if these effects are severe or persistent..
110563 -      ref OF 1 9563
110564 -
110565 -
110566 -  ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Per understandings with Kory on 940624, ref SDS 4 0001, I am deferring
110902 - rosacea medication treatment, per above, ref SDS 0 0877, to evaluate
110903 - change in condition from changing my diet. Since the meeting on
110904 - Friday, 940624, the severe blister on my nose has cleared, and most of
110905 - the blemishes on my forehead have disappeared.
110906 -
110907 - Therefore, I will continue to defer taking medicines until the
110908 - condition fails to continue to abate or if it begins to increase in
110909 - severity.  I do not have a good sense about cause and effect yet.  I
110910 - am eating less and have stopped having liquids with caffeine, but am
110911 - not convinced this accounts for the apparent improvement reported so
110912 - far.  It may be just a natural cycle, rather than a change in the
110913 - condition.  To test that, need to continue on present course, before
110914 - beginning to take prescribed medicine.
110915 -
110916 -     [On 940629 submitted letter on progress. ref SDS 5 6381]
110917 -
110918 -
1110 -