Jesse’s HMO: KAISER PERMANENTE
Hospital: Los Angeles Medical Center
4867 W Sunset Blvd., @Vermont/Catalina, Los Angeles, CA 90027
Hospital: No DIRECT PHONES TO DOCTORS
323 783 4011 Main operator at Kaiser West Sunset
323 783 5941 Admitting at Kaiser West Sunset 1-800-954-8000 (toll free)
Cardiologist :DAVID JONATHAN MORRIS MD.. 1526 EDGEMONT
Primary: HWEI-JU ANNIE YU MD, 4950 Sunset
Wednesday, May 28, 14: Yesterday, Tuesday, Dr. Ji changed my next automatic ICD report transmission for June 5th to June 2nd. I believe this is so he can evaluate the leads’ function before possibly allowing September rather than June surgery to replace the damaged leads.
Sunday, May 25, 14: In May, 2009, I told my friend Toni Ann that I’d discovered that men have “cycles” because I seemed to gain weight on the 2nd week of each month and it would vanish near month’s end. Two years later I was hospitalized with Congestive Heart Failure (CHF). Now, as I reflect on 2 more CHF bouts in 2012 and 2014 I realize that the 2009 weight gain was also CHF, not a cycle. My abdomen, ankles and lungs filled with liquid my kidneys failed to eliminate because my heart’s reduced (ejection fraction, EF) function did not supply sufficient blood to the kidneys.
Saturday, May 24, 14: Results from the Kepler space telescope have led me to suppose that intelligent life is extremely rare in the universe and therefore my own life is something to be held on to for posterity. Yesterday, Friday, I asked Dr. Ji: “After speaking with Dr. Bek, I wonder if surgery can wait until September, when I return from 6 weeks in Boston. Please advise.” He responded with: “It all depends on how the problem with RA lead evolves. When do have another transmission (ICD reading automatically sent to the hospital monthly)?”
His responses made me realize that his main concern is that the ICD always be able to detect and respond if my heart freaks out. With defective leads such detection and response is not assured and is becoming less assured. Given recent ICD “emergency calls” with some low-end freak-outs it is dangerous to depend on my current leads for 6 weeks in Boston.
However, I have fully paid for my class at Harvard and worry that if Dr. Bek must sew my heart during surgery I will be in recovery when the class takes place and thereby forfeit at least some of my payment. Zennie, my ICD RN, does not like it, but says I can take the transmission device with me to Boston and fly back if a bad freak out happens or seek ER care in Boston. Medicare will pay 80% of the ER bill. Normally, my Medicaid (Medi-Cal in California) pays the other 20%, but works only in LA County. In any USA ER situation, however, it will also pay.
I await Dr. Ji’s response to this message: “Zennie says my next transmission is June 5. Dr. Bek suggested June 4-6, for surgery but if he must sew my heart or vein resultant of a puncture I think I'd be too long in recovery to attend a June 20th class in Boston. Zennie suggests I take the transmitter to Boston and manually send in monthly reports.”
Thursday, May 22, 14, Today, Kaiser Sunset Blvd. surgeon Dr. Bek discussed with me the dangers of my upcoming surgery. All three leads between my heart and ICD go through a single vein. If a second ICD were installed on my right side the two leads from that would also go through that vein. Five leads through one vein would be dangerous because it would likely cause all the space in the vein eventually to become clogged with new skin cells. The insulation on my leads has worn off, perhaps due to my chest exercises that squashed the leads, so the exposed wires interfere with my ICD’s heart problem detection and therapy delivery.
However, replacing the current leads risks being unable to distinguish between lead and vein or heart cells such that the surgeon might cut a hole in either vein, heart or both as the lead is lasered loose. A hole would require that the surgeon open my ribs to sew up the hole. There is a 20 percent chance of this and last year about 3-5 of Dr. Bek’s 15 similar surgeries required such sewing. Outpatient surgery should be June 6 or so, but sewing would require significantly more in-hospital recovery time and might jeopardize my June 20 class at Harvard.
Saturday, May 17: Perhaps 20 surgeries behind me, given probability, I am figuring that mistakes, resistant bacteria or something else must soon have my number. The upcoming opening to replace my ICD and replace old leads to it is said to be dangerous and I must have a special talk with Dr. Bek, the specialist surgeon, to discuss the danger.
Medications: Wednesday, May 28, 14
Atorvastatin (LIPITOR) 40 mg Oral Tab
Take 1 tablet by mouth daily to lower cholesterol and keep arteries open
Potassium Chloride (K-TAB) 10 mEq Oral SR Tab
Take 1 tablet by mouth daily
Furosemide (LASIX) 40 mg Oral Tab
Take 1 tablet by mouth 2 times a day (Diuretic). Take extra tab for swelling and weight gain 2 lbs over 24 hours and call care manager.
Digoxin (DIGOX) 125 mcg Oral Tab
Take 1 tablet by mouth daily
ALPRAZolam (XANAX) 0.5 mg Oral Tab
TAKE 1 TABLET ORALLY DURING HOUR OF SLEEP AS NEEDED TO HELP YOU SLEEP
Fluticasone (FLONASE) 50 mcg/actuation Nasl SpSn
SHAKE GENTLY AND INHALE 1 OR 2 SPRAYS IN EACH NOSTRIL DAILY
Carvedilol (COREG) 25 mg Oral Tab
TAKE 2 TABLETS IN THE MORNING AND TAKE ONE & ONE-HALF TABLETS IN THE EVENING (SPECIAL ORDER ITEM: ALLOW 3 WORKING DAYS)
Dabigatran Etexilate (PRADAXA) 150 mg Oral Cap
TAKE 1 TABLET ORALLY TWICE DAILY
Famotidine (PEPCID) 20 mg Oral Tab
TAKE 1 TABLET ORALLY 2 TIMES DAILY AS NEEDED FOR HEARTBURN OR UPSET STOMACH
Lisinopril (PRINIVIL/ZESTRIL) 10 mg Oral Tab
1 TAB PO DAILY
Psyllium (KONSYL/METAMUCIL S/T) Oral Powd
MIX 1 TBSP (15 ML) IN 8 OUNCES OF LIQUID AND DRINK PO DAILY . increase each week to three times daily.
Vardenafil (LEVITRA) 20 mg Oral Tab
TAKE 1 TABLET ORALLY 1 HOUR BEFORE SEXUAL ACTIVITY DO NOT EXCEED 1 DOSE IN 24 HOURS
================
Hospital: Los Angeles Medical Center
4867 W Sunset Blvd., @Vermont/Catalina, Los Angeles, CA 90027
Hospital: No DIRECT PHONES TO DOCTORS
323 783 4011 Main operator at Kaiser West Sunset
323 783 5941 Admitting at Kaiser West Sunset 1-800-954-8000 (toll free)
Cardiologist :DAVID JONATHAN MORRIS MD.. 1526 EDGEMONT
Primary: HWEI-JU ANNIE YU MD, 4950 Sunset
Wednesday, May 28, 14: Yesterday, Tuesday, Dr. Ji changed my next automatic ICD report transmission for June 5th to June 2nd. I believe this is so he can evaluate the leads’ function before possibly allowing September rather than June surgery to replace the damaged leads.
Sunday, May 25, 14: In May, 2009, I told my friend Toni Ann that I’d discovered that men have “cycles” because I seemed to gain weight on the 2nd week of each month and it would vanish near month’s end. Two years later I was hospitalized with Congestive Heart Failure (CHF). Now, as I reflect on 2 more CHF bouts in 2012 and 2014 I realize that the 2009 weight gain was also CHF, not a cycle. My abdomen, ankles and lungs filled with liquid my kidneys failed to eliminate because my heart’s reduced (ejection fraction, EF) function did not supply sufficient blood to the kidneys.
Saturday, May 24, 14: Results from the Kepler space telescope have led me to suppose that intelligent life is extremely rare in the universe and therefore my own life is something to be held on to for posterity. Yesterday, Friday, I asked Dr. Ji: “After speaking with Dr. Bek, I wonder if surgery can wait until September, when I return from 6 weeks in Boston. Please advise.” He responded with: “It all depends on how the problem with RA lead evolves. When do have another transmission (ICD reading automatically sent to the hospital monthly)?”
His responses made me realize that his main concern is that the ICD always be able to detect and respond if my heart freaks out. With defective leads such detection and response is not assured and is becoming less assured. Given recent ICD “emergency calls” with some low-end freak-outs it is dangerous to depend on my current leads for 6 weeks in Boston.
However, I have fully paid for my class at Harvard and worry that if Dr. Bek must sew my heart during surgery I will be in recovery when the class takes place and thereby forfeit at least some of my payment. Zennie, my ICD RN, does not like it, but says I can take the transmission device with me to Boston and fly back if a bad freak out happens or seek ER care in Boston. Medicare will pay 80% of the ER bill. Normally, my Medicaid (Medi-Cal in California) pays the other 20%, but works only in LA County. In any USA ER situation, however, it will also pay.
I await Dr. Ji’s response to this message: “Zennie says my next transmission is June 5. Dr. Bek suggested June 4-6, for surgery but if he must sew my heart or vein resultant of a puncture I think I'd be too long in recovery to attend a June 20th class in Boston. Zennie suggests I take the transmitter to Boston and manually send in monthly reports.”
Thursday, May 22, 14, Today, Kaiser Sunset Blvd. surgeon Dr. Bek discussed with me the dangers of my upcoming surgery. All three leads between my heart and ICD go through a single vein. If a second ICD were installed on my right side the two leads from that would also go through that vein. Five leads through one vein would be dangerous because it would likely cause all the space in the vein eventually to become clogged with new skin cells. The insulation on my leads has worn off, perhaps due to my chest exercises that squashed the leads, so the exposed wires interfere with my ICD’s heart problem detection and therapy delivery.
However, replacing the current leads risks being unable to distinguish between lead and vein or heart cells such that the surgeon might cut a hole in either vein, heart or both as the lead is lasered loose. A hole would require that the surgeon open my ribs to sew up the hole. There is a 20 percent chance of this and last year about 3-5 of Dr. Bek’s 15 similar surgeries required such sewing. Outpatient surgery should be June 6 or so, but sewing would require significantly more in-hospital recovery time and might jeopardize my June 20 class at Harvard.
Saturday, May 17: Perhaps 20 surgeries behind me, given probability, I am figuring that mistakes, resistant bacteria or something else must soon have my number. The upcoming opening to replace my ICD and replace old leads to it is said to be dangerous and I must have a special talk with Dr. Bek, the specialist surgeon, to discuss the danger.
Medications: Wednesday, May 28, 14
Atorvastatin (LIPITOR) 40 mg Oral Tab
Take 1 tablet by mouth daily to lower cholesterol and keep arteries open
Potassium Chloride (K-TAB) 10 mEq Oral SR Tab
Take 1 tablet by mouth daily
Furosemide (LASIX) 40 mg Oral Tab
Take 1 tablet by mouth 2 times a day (Diuretic). Take extra tab for swelling and weight gain 2 lbs over 24 hours and call care manager.
Digoxin (DIGOX) 125 mcg Oral Tab
Take 1 tablet by mouth daily
ALPRAZolam (XANAX) 0.5 mg Oral Tab
TAKE 1 TABLET ORALLY DURING HOUR OF SLEEP AS NEEDED TO HELP YOU SLEEP
Fluticasone (FLONASE) 50 mcg/actuation Nasl SpSn
SHAKE GENTLY AND INHALE 1 OR 2 SPRAYS IN EACH NOSTRIL DAILY
Carvedilol (COREG) 25 mg Oral Tab
TAKE 2 TABLETS IN THE MORNING AND TAKE ONE & ONE-HALF TABLETS IN THE EVENING (SPECIAL ORDER ITEM: ALLOW 3 WORKING DAYS)
Dabigatran Etexilate (PRADAXA) 150 mg Oral Cap
TAKE 1 TABLET ORALLY TWICE DAILY
Famotidine (PEPCID) 20 mg Oral Tab
TAKE 1 TABLET ORALLY 2 TIMES DAILY AS NEEDED FOR HEARTBURN OR UPSET STOMACH
Lisinopril (PRINIVIL/ZESTRIL) 10 mg Oral Tab
1 TAB PO DAILY
Psyllium (KONSYL/METAMUCIL S/T) Oral Powd
MIX 1 TBSP (15 ML) IN 8 OUNCES OF LIQUID AND DRINK PO DAILY . increase each week to three times daily.
Vardenafil (LEVITRA) 20 mg Oral Tab
TAKE 1 TABLET ORALLY 1 HOUR BEFORE SEXUAL ACTIVITY DO NOT EXCEED 1 DOSE IN 24 HOURS
================