THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: March 11, 2002 12:50 PM Monday; Rod Welch

Millie meets doctor about surgery tomorrow to remove cancer.

1...Summary/Objective
2...Schedule Surgery Breast Cancer 020312 1330
3...Meeting with Doctor Reilly-Paul Schedule Surgery 020312 1330
4...Chest Xray
5...Notify Family and Friends about Millie's Progress


..............
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CONTACTS 

SUBJECTS
Meeting Schedule Surgery Report Results of Biopsy
Living Arrangements So Millie is Not Alone
Anesthologist Called Millie to Prepare for Surgery Tomorrow
Radiologist Did Not Call to Prepare for Surgery Tomorrow

0706 -
0706 -    ..
0707 - Summary/Objective
0708 -
070801 - Follow up ref SDS 5 0000.
070802 -
070803 - Millie got a call from the anethesiologist this morning, and they
070804 - concluded the business on that matter to prepare for sugery tomorrow.
070806 -  ..
070807 - She had a call into the radiology department, but has not heard
070808 - anything, so we drove to the hospital.
070810 -  ..
0709 -
0710 -
0711 - 1323
0712 -
071201 - Walked to radiology, which is also called Medical Imagry, and asked
071202 - about meeting with the radiologist in connection with surgery
071203 - tomorrow.
071205 -  ..
071206 - The nurse said the computer shows that surgry is scheduled to take
071207 - place in the Martinez Kaiser hospital tomorrow, and that Millie had an
071208 - appointment with the department yesterday.
071210 -  ..
071211 - Millie recognized that is a mistake.
071213 -  ..
071214 - The nurse said she was not sure what was going on.  She suggested we
071215 - check with nuclear medicine next door.
071217 -  ..
071218 - We went into the nuclear medicine department.
071220 -  ..
071221 - The nurse in nuclear medicine said Millie will meet with this
071222 - department tomorrow at 0930.
071223 -
071224 -
071225 -
071226 -
071227 -
0713 -

SUBJECTS
EKG to Prepare for Surgery Tomorrow

0803 -
0804 - 1407
080501 -  ..
080502 - Walked to Cardiology Pulminary Department.
080504 -  ..
080505 - Millie got an EKG report.
080506 -
080508 -  ..
0806 -
0807 -
0808 - 1430
0809 -
080901 - We walked to the cafeteria and got something to eat to wait for the
080902 - meeting with Doctor Poly at 1545.
080904 -  ..
080905 - Millie called Vivien to say she wanted to purchase a book the
080906 - hospital sells on breast cancer.
080907 -
080908 -
080909 -
0810 -

SUBJECTS
Meeting with Surgeon and Prepare for Surgery Tomorrow

0903 -
090401 -  ..
090402 - Schedule Surgery Breast Cancer 020312 1330
090403 - Meeting with Doctor Reilly-Paul Schedule Surgery 020312 1330
090404 -
090405 -
0905 -
0906 - 1530
0907 -
090701 - We went to the surgery clinic.  Millie purchased the book on breast
090702 - cancer.
090704 -  ..
090705 - Pam arrived.
090707 -  ..
090708 - A nurse came out and took us to an examination room.  The nurse gave
090709 - Millie a yellow file folder with a lot of forms to fill out.
090710 -
090711 -     [On 020321 this yellow file folder was adequate for follow up
090712 -     surgery, was not necessary to fill out papers again. ref SDS 10
090713 -     0T9G
090715 -  ..
090716 - Millie gave the nurse the EKG report which she got earlier, per above.
090717 - ref SDS 0 5XFH
090719 -  ..
090720 - The nurse asked when the operation is scheduled?
090722 -  ..
090723 - Millie said it is supposed to be tomorrow, but we don't know the time.
090725 -  ..
090726 - The nurse said that is very fast to get an operation scheduled for a
090727 - patient diagnosed with breast cancer.  She indicated usually there is
090728 - a period of weeks even months.
090730 -  ..
090731 - The nurse took some vital signs, temperature, pulse, blood pressure,
090732 - etc.
090734 -  ..
090735 - Millie asked if the operation will be done here in Walnut Creek, or in
090736 - Martinez, as reported earlier by the nurse in radiology? ref SDS 0
090737 - OP7G
090739 -  ..
090740 - The attending nurse said to wait a minute.  She left the examination
090741 - room to investigate and returned a few minutes later.  The nurse said
090742 - the surgery will be performed in the Walnut Creek hospital; she said
090743 - there was a mixup in the records, but Millie should come here
090744 - tomorrow and not Martinez.
090746 -  ..
090747 - Millie asked some questions about filling out the forms in the folder
090748 - she had been given.  The nurse looked through the documents and said
090749 - it wasn't necessary to fill everything out.  She removed some of the
090750 - extraneous forms.
090752 -  ..
090753 - The nurse said not eat anything after midnight and not to drink
090754 - anything except a small amount of water after midnight in advance of
090755 - the operation tomorrow.
090756 -
090757 -
090758 -
090760 -  ..
0908 -
0909 -
0910 - 1615
0911 -
091101 - The surgeon came into the examination room and the nurse left.
091102 -
091103 - The doctor said that Millie will meet with nuclear medicine tomorrow
091104 - at 0930, per the notice above. ref SDS 0 CS8O  At that time, Millie
091105 - will be injected with radioactive material at the location of the
091106 - cancer in her breast.
091108 -  ..
091109 - The doctor advised that the operation is scheduled to take place at
091110 - 1330 tomorrow on 020312 in Walnut Creek, per the nurses instructions a
091111 - few mintues earlier. ref SDS 0 NW6J
091113 -  ..
091114 - The injection by nuclear medicine at 0930 gives the radioactive
091115 - material time to flow through the system from the cancerous area in
091116 - the left breast to connected lymph nodes under Millie's left arm.
091117 - This will map the lymphatic structures that drain the tissue in and
091118 - around the tumor site.
091120 -  ..
091121 - There is about a 12 hour period for the injection to be effective, so
091122 - having the operation at 1330 falls within this period of
091123 - effectiveness.
091125 -  ..
091126 - The doctor asked for background on discovery of the problem.
091128 -  ..
091129 - Millie related the explanation on 020306 when she and Pam met with the
091130 - surgeon. ref SDS 5 IW6N  Recent swelling under her left arm caused
091131 - some discomfort, and this led to seeking treatment on 020208.  At that
091132 - meeting, Doctor Jordon ordered immediate tests, ref SDS 1 0001,
091133 - however, Kaiser was not able to perform the biopsy test that disclosed
091134 - cancer until a month later on 020304, ref SDS 4 0001, as shown in the
091135 - record on 020214. ref SDS 3 JH4J
091136 -
091137 -     [On 020321 received results of biopsy taken on 020304, from Doctor
091138 -     Johnson. ref SDS 9 6Q6J
091140 -  ..
091141 - The surgeon explained that she will use a device that detects the
091142 - radioactive material injected at 0930 to identify which lymph nodes
091143 - may have been infected with cancer so she can remove only those that
091144 - are infected.
091146 -  ..
091147 - The doctor also plans to inject Millie during the operation with a
091148 - blue dye material, that will further assist in identifying lymph nodes
091149 - that are infected from the cancer tumor in the left breast.
091151 -  ..
091152 - The doctor said that previously all of a patient's lymph nodes would
091153 - be removed.  These two identification methods enable the doctor to
091154 - avoid a mass removal, and target only infected material.  This makes
091155 - recovery must faster because the operation is less invasive.
091157 -  ..
091158 - As a result of using the targeted identification methods for cancerous
091159 - lymph nodes, Millie will not have a drain tube under her arm, which
091160 - was explained in their prior visit.
091162 -  ..
091163 - The doctor said she will fit Millie with a tube top like bandage that
091164 - can be removed in two-three days following surgery.
091166 -  ..
091167 - The surgeoin advised that the blue dye she will inject into Millie's
091168 - cancerous area during the operation, per above, will cause urine to be
091169 - sort of blue-green for a few days following surgery.  This is nothing
091170 - to worry about.
091172 -  ..
091173 - The doctor said that after getting the injection tomorrow at 0930,
091174 - Millie will have a 2 hour wait until 1130 to be processed by the
091175 - surgery admitting department to prepare for the operation at 1330.
091177 -  ..
091178 - The actual surgery may not occur until after 1330, because there may
091179 - be a wait for the operating room, or for various team memebers to
091180 - complete other matters.
091182 -  ..
091183 - Millie mentioned again that the nurse in radiology said the Kaiser
091184 - computer shows the operation is to be performed in the Kaiser hospital
091185 - in Martinez tomorrow, but the surgeon's nurse just said that she
091186 - believes the operation will be in the Walnut Creek hospital.  Millie
091187 - asked for confirmation of the location for the operation.
091189 -  ..
091190 - The surgeon left the examination room.
091192 -  ..
091193 - She came back a few minutes later and confirmed the operation will be
091194 - in the Walnut Creek hospital.
091196 -  ..
091197 - The doctor gave Millie an examination with the stethescope.
091199 -  ..
091200 - She explained Millie needs to visit the Radiology (Medical Imagry) to
091201 - get a chest xray, and then Millie needs to go to the Laboratory and
091202 - have blood drawn.
091204 -  ..
091205 - Millie asked if the xray reflects additional findings or suspicions
091206 - about further medical problems?
091208 -  ..
091209 - The surgeon said the xray is standard for all patients undergoing the
091210 - operation that Millie is having.
091212 -  ..
091213 - The doctor advised that after the injection tomorrow at 1330 there
091214 - will be a two hour wait until Millie is processed at Surgery Admitting
091215 - at 1130 to get ready for surgery at 1330.
091217 -  ..
091218 - Surgery Admitting is on the second floor of the main hospital.
091220 -  ..
091221 - The doctor explained personal physical therapy Millie needs to perform
091222 - to prevent loss of range of motion due to adhesions from incisions and
091223 - removal of the lymph nodes under the arm.  She demonstrated how to
091224 - lift the arm, and to brush her hair with a vigorous motion to keep the
091225 - arm from freezing up.
091226 -
091227 -     [On 020312 a few hours after surgery, Millie was doing these
091228 -     exercises. ref SDS 6 7T6N
091230 -  ..
091231 - This concluded the meeting with the surgeon.
091233 -  ..
091234 - We went to the nurse workstation just outside the examination room.
091236 -  ..
091237 - The nurse called the Medical Imagry (radiolog) department and
091238 - scheduled the chest xray that Doctor Reilly-Paul requested for the
091239 - surgery tomorrow.  For some reason she had Millie talk to the station
091240 - nurse briefly on the phone.
091242 -  ..
091243 - The nurse then called the Laboratory and arranged for Millie to have a
091244 - blood sample drawn later today.
091246 -  ..
091247 - The nurse asked for Millie's yellow patient folder.
091249 -  ..
091250 - Millie handed the folder to the nurse, who then wrote in big letters
091251 - on the front cover....
091252 -
091253 -
091254 -                     W a l n u t    C r e e k
091255 -
091256 -
091257 - ...she said this will help the staff avoid further confusion about the
091258 - operation being performed here in  Walnut Creek rather than at the
091259 - hospital in Martinez.
091260 -
091261 -
091263 -  ..
091264 - Chest Xray
091265 -
091266 -
0913 -
0914 -
0915 - 1628
0916 -
091602 -  ..
091603 - We then went back to the Medical Imaging (radiology) Department.
091605 -  ..
091606 - There was a long line, but this went fairly quickly.  Millie was asked
091607 - to wait in the patient area and will be called.
091609 -  ..
091610 - This took 30 to 45 minutes before she was called.  Millie told Pam
091611 - that she could go on home, rather than wait around for an unknown
091612 - amount of time for the EKG and then the blood work up.  She asked if
091613 - Pam remembered where the Lab is located.
091615 -  ..
091616 - Pam recalled seeing that we walked past the Lab on the way to Medical
091617 - Imagry.
091619 -  ..
091620 - Pam asked about driving arrangements for tomorrow.  Should she pick us
091621 - up at 0845 for the meeting at 0930 with Nuclear Medicine?
091623 -  ..
091624 - Decided that Pam will meet us at Surgery Admitting at 1130 tomorrow.
091626 -  ..
091627 - Pam said good by.
091629 -  ..
091630 - About 10 minutes after Pam left, Millie's name was called for the EKG.
091631 - She was only gone about 10 minutes.  So we we waited nearly 45 minutes
091632 - for a 10 minute task.
091633 -
091634 -    [On 020312 Doctor Riley-Paull reported that the xray did not show
091635 -    any indications of problems. ref SDS 6 YA4F
091637 -     ..
091638 -    [On 020318 research shows Cat Scan testing is performed on the
091639 -    brain, chest and abdomen to assess potential for further cancer.
091640 -    ref SDS 8 VM5N
091642 -     ..
091643 -    [On 020321 Doctor Johnson ordered Cat Scan for the abdomen.
091644 -    ref SDS 9 6T5H
091645 -
091646 -
091648 -  ..
0917 -
0918 -
0919 - 1705
0920 -
092001 - After getting the xray, we walked back to the Laboratory to get the
092002 - blood tests requested by the surgeon.  The room was nearly empty.
092003 - Millie submitted her documents received from the doctor explaining the
092004 - tests to be taken, and in about 5 minutes, they called her to take the
092005 - blood.  This took about 10 minutes.
092006 -
092007 -
092009 -  ..
0921 -
0922 -
0923 - 1737
0924 -
092401 - When we returned, there was a message from a radiologist in the
092402 - Martinez Kaiser Hopsital saying he apologized for calling so late, but
092403 - wanted to talk about the surgery tomorrow.
092404 -
092405 -
092406 -
092407 -
092408 -
092409 -
092410 -
0925 -

SUBJECTS
Communication Notify Family Friends of Progress

1003 -
100401 -  ..
100402 - Notify Family and Friends about Millie's Progress
100403 -
100404 -
1005 -
1006 -
1007 - 2047
1008 -
100802 -  ..
100803 - Submitted ref DIT 1 0001 to family and friends explaining results of
100804 - planning today, and surgery that will occur tomorrow.
100805 -
100806 -      [On 020312 responses. ref SDS 6 N25G
100807 -
100808 -      [On 020313 more responses. ref SDS 7 SM4J
100809 -
100810 -
100811 -
100812 -
100813 -
100814 -
1009 -