EMAIL DETAILS

I did. can go either way. We can cancel the tube tomorrow but I don't think he will take in enough calories to not have it. If you want to give him an opportunity let me know and can cancel tube. Don't think he's going until 10

Howard D. Krein MD, PhD
Assistant Professor
Div. of Facial Plastics and Reconstructive Surgery
Dept. of Otolaryngology/ Head and Surgery
Thomas Jefferson University
215-955-6760<tel:215-955-6760>


On May 3, 2015, at 11:11 PM, Hunter Biden <hbiden@rosemontseneca.com<mailto:hbiden@rosemontseneca.com>> wrote:

See below- what do you guys think- I tend to agree.

RHB
202.333.1880

Begin forwarded message:

From: "Yung,W K Alfred" <wyung@mdanderson.org<mailto:wyung@mdanderson.org>>
Date: May 3, 2015 at 11:06:03 PM EDT
To: "'hbiden@rosemontseneca.com<mailto:hbiden@rosemontseneca.com>'" <hbiden@rosemontseneca.com<mailto:hbiden@rosemontseneca.com>>
Cc: "'halliebiden@gmail.com<mailto:halliebiden@gmail.com>'" <halliebiden@gmail.com<mailto:halliebiden@gmail.com>>, "'howard.krein@jefferson.edu<mailto:howard.krein@jefferson.edu>'" <howard.krein@jefferson.edu<mailto:howard.krein@jefferson.edu>>
Subject: Re: Beau

I agree and I do think it is good for Beau to get out of the ICU. Physically, he does not need intensive monitoring any more, and it will be good psychologically too. A cheerful upbeat environment with good PT/OT will be best. Do you think Walter Reed meet the bill? Would distance from family, the kids a factor? Medical and rehab services wise Walter Reed certainly is excellent.
I am ambivalent re putting a stomach tube in now before he move to Walter Reed, it could be a psychological downer for him. I think we should him first, see a change of environment with more stimulation will get him eat better and avoid the tube. I think we should remove the nose tube first, give him a reason that he must eat without the irritation of the nose tube. Walter Reed can put in the stomach tube when it is needed.
Al

W. K. Alfred Yung, MD
From my BlackBerry

----- Original Message -----
From: Hunter Biden [mailto:hbiden@rosemontseneca.com]
Sent: Sunday, May 03, 2015 04:12 PM
To: Yung,W K Alfred
Cc: halliebiden@gmail.com<mailto:halliebiden@gmail.com> <halliebiden@gmail.com<mailto:halliebiden@gmail.com>>; howard.krein@jefferson.edu<mailto:howard.krein@jefferson.edu> <howard.krein@jefferson.edu<mailto:howard.krein@jefferson.edu>>
Subject: Re: Beau

Thanks Al. Sorry I missed connecting with you on Friday. Hallie and I and I believe everyone else are in agreement that Beau needs to get out of ICU and into an environment where he can really begin rehabilitation and also get rest when he needs it. I think Walter Reed is the best place for that- but I wanted to make sure you agreed. He is still not eating unless Hallie or I force him to and despite a huge improvement he still is very very weak and only opens his eyes when you ask him to. Also there is the question of the direct feeding tube to the stomach (sorry I don't remember the technical term for that). If the procedure is what Howard explained I think he should do it until he begins to actually eat without being asked to. We were hoping to get him moved to Walter Reed by Tuesday so let us know asap if you think it's a good plan. Thanks, Hunter

RHB
202.333.1880

On May 3, 2015, at 6:47 PM, Yung,W K Alfred <wyung@mdanderson.org<mailto:wyung@mdanderson.org>> wrote:

Howard sent me a great picture Friday of Beau checking emails. Hope he can get more calories and protein in and get less tired.
I will be in Phoenix the next 2 days. I will check with Jon re the decadron tapering tomorrow. I like to wait till he get stronger before making the next move. But we may not want to wait too long.
Al

W. K. Alfred Yung, MD
From my BlackBerry

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