CONTACTS 

SUBJECTS
Surgery at 1230
Doctor's Comments Following Surgery
Meeting Schedule Surgery Report Results of Biopsy
Meeting with Surgeon and Prepare for Surgery Tomorrow

0806 -
0806 -    ..
0807 - Summary/Objective
0808 -
080801 - Follow up ref SDS 11 0001, ref SDS 7 0000.
080802 -
080803 - Surgery was performed this morning at the Kaiser hospital in Martinez;
080804 - and there is hope this procedure accomplished the objective of
080805 - obtaining "clear margins."  Follow up meeting is scheduled with
080806 - primary care physician on 020405 and with the surgeon on 020408, who
080807 - will disclose results.
080808 -
080809 -     [On 020408 the surgeon reports operation today achieved "clear
080810 -     margins." ref SDS 15 0001
080812 -      ..
080813 -     [On 020408 the surgeon plans follow up exmainations every three
080814 -     (3) months to monitor results of surgery. ref SDS 15 RK99
080815 -
080816 -
080817 -
080819 -  ..
0809 -
0810 -
0811 - Progress
0812 -
081201 - Admitting for Surgery
081202 -
081203 - Follow up ref SDS 7 Q68F.
081204 -
081205 - This morning Millie asked about submitting questions to the doctor,
081206 - which she received from her niece, Carol, who is a nurse.
081208 -      ..
081209 -     Discussed writing up the record of the meeting with the oncology
081210 -     doctor, and submitting to confirm understandings of treatment
081211 -     plan.  Will include Carol's questions and other questions that
081212 -     come to mind.
081213 -
081215 -  ..
081216 - We drove to the hospital taking Highway 242 to 4, then 4 past highway
081217 - 680 to Morrello.  Turn left on Morrello and go a block or two and
081218 - turned right on Muir.  Parked in the lot across from the Hacienda
081219 - building.
081221 -  ..
081222 - You have to walk through a lot of hallways to find the admitting room
081223 - for ambulatory surger.
081225 -  ..
081226 - We took the Yellow patient folder, as requested by Chris on 020321,
081227 - ref SDS 12 1G8O, but this was not requested by the admitting nurse.
081229 -  ..
081230 - Millie filled out a patient treatment permit, release and admissions
081231 - agreements.
081233 -  ..
081234 - Millie was not asked for her photograph nor for her Kaiser card. She
081235 - did not give these cards to me after the admissions process.
081237 -  ..
081238 - The nurse put the patient plastic ID bracelet on Millie's right hand.
081240 -  ..
081241 - The nurse asked Millie a series of questions about her address, place
081242 - of business, phone numbers and who pays for her Kaiser coverage.
081244 -  ..
081245 - The nurse then took us to an Ambulatory Patient Waiting room.
081246 -
081248 -  ..
0813 -
0814 -
0815 - 0650
0816 -
081601 - About 10 minutes later, the nurse came for Millie, and asked me to
081602 - remain in the waiting room.
081603 -
081604 -
081605 -
081606 -
0817 -

SUBJECTS
Surgery Breast Cancer Follow Up Today on 020327 Doctor Reily-Paull at

1003 -
100401 -  ..
100402 - Surgery from 0700 to 0900
100403 -
100404 - Follow up ref SDS 7 Q743.
100405 -
100406 - Was with Millie in pre-op room for only about 15 minutes.
100407 -
100408 - Pam arrived about 0730.  She saw Millie and wished her good luck just
100409 - as she was being taken to be prepared for surgery.
100411 -  ..
100412 - Following surgery, Millie advised that the staff provided a copy of
100413 - Millie's heart monitor performed during surgery.  They advised it
100414 - shows an irregular heart beat.
100416 -  ..
100417 - She was given a graph dated 020327 0838 showing...
100418 -
100419 -              HR........... 59
100420 -
100421 -              Pulse........ 60
100422 -
100423 -              NBP.......... 144/55 (84) 020328 0838
100425 -               ..
100426 -              SP02......... 100
100428 -               ..
100429 -              PERT......... 0.7
100431 -  ..
100432 - The graph shows a slight rise between the major rises that signify the
100433 - heart beat, thus indicating an "irregular" condition.
100435 -  ..
100436 - Millie wants to submit this to the primary care physician during the
100437 - meeting on 020405.
100438 -
100439 -     Posted this as a question under Treatment Planning and Evaluation
100440 -     in the record on 020321. ref SDS 13 535J
100441 -
100442 -        [On 020405 chart sumitted to primary care physician.
100443 -        ref SDS 14 RP6H
100445 -         ..
100446 -        [On 081105 Millie notified that primary care physician orders
100447 -        Muga test for heart damage prior to starting sunitinib clinical
100448 -        study that has some heart related side effects. ref SDS 16 WO72
100449 -
100450 -
100451 -
100452 -
100453 -
100454 -
1005 -

SUBJECTS
Doctor's Comments Following Surgery

1403 -
140401 -  ..
140402 - Surgery Completed, Discussion with Doctor on Results
140403 -
140404 - Follow up ref SDS 7 Q78M.
140405 -
140406 -
1405 -
1406 - 0900
1408 -    ..
140801 - The surgeon visited with Pam and I about results of the surgery.
140803 -  ..
140804 - The doctor is hopeful this surgery will achieve clear margins in the
140805 - pathology report, to correct problem with the initial surgery reported
140806 - on 020318. ref SDS 10 5V7I
140808 -  ..
140809 - The doctor said that Millie will be in recovery for about an hour
140810 - until 1445, then she will be moved to post-op which is the same room
140811 - where were with Millie for pre-op.  Millie will be processed for
140812 - release from post-op in about another hour.
140813 -
140814 -     [On 020405 the pathology report seems to indicate clear margins
140815 -     were accomplished, based on meeting with the primary care
140816 -     physician in Oncology. ref SDS 14 QV8I
140818 -      ..
140819 -     [On 020408 in follow up meeting the surgeon confirmed the second
140820 -     surgery met expectations. ref SDS 15 0001
140821 -
140822 -
140823 -
140824 -
140825 -
140826 -
140827 -
1409 -

SUBJECTS
Recovery 2 1/2 Hours Not One Hour

1603 -
1604 - 1000
160501 -  ..
160502 - Recovery Took 1 Hour
160503 -
160504 - Follow up ref SDS 7 H58I.
160505 -
160506 - Nurses came and got us about 1000.
160507 -
160508 -
160509 -
160510 -
1606 -

SUBJECTS
Post-op an Discharge

1803 -
180401 -  ..
180402 - Post-op Recovery and Discharge Instructions to Go Home
180403 -
180404 - Follow up ref SDS 7 H64L.
180405 -
1805 -
1806 - 1000
1808 -    ..
180801 - Millie did not have a breathing support.  Either it was not needed
180802 - for the operation, or the nurses removed it before we arrived in the
180803 - post-op room.
180805 -  ..
180806 - After 30 - 40 minutes, the nurse, J. Hay, in post-op began processing
180807 - Millie for release. Pam helped Millie dress.
180808 - ..
180809 - Got same instructions for home care that were given for the
180810 - operation on 020312. ref SDS 7 7Y63
180812 -  ..
180813 - Millie did not need a sling this time.
180815 -  ..
180816 - She was given ice bags and asked to keep the surgery incision area
180817 - iced on and off for from 24 to 48 hours.  This is different from the
180818 - first surgery.
180820 -  ..
180821 - She can remove the ace bandage tomorrow.
180823 -  ..
180824 - There were no restrictions on eating.
180826 -  ..
180827 - Meeting scheduled with Doctor Riley-Paull for 020408 1400 at Walnut
180828 - Creek clinic.
180830 -  ..
180831 - Millie felt the quality of care at the Martinez Kaiser hospital equal
180832 - to or better than service at the Walnut Creek hospital.  She was very
180833 - pleased with the level of care in this unit.
180834 -
180835 -
180836 -
180837 -
180838 -
180839 -
180840 -
180841 -
180842 -
180843 -
1809 -