CONTACTS 

SUBJECTS
Blood Test at Kaise to Test for White Blood Cell Count in preparation
Chemotherapy 4th Treatment Today Taxotere
White Blood Cell Count Low Requires Another Blood Test to Determine i
Nupogin Not Needed Because White Blood Cell Up from 3.2 to 10.1 from

0906 -
0906 -    ..
0907 - Summary/Objective
0908 -
090801 - Follow up ref SDS 3 0000.
090802 -
090803 - Anne is the nurse today.
090805 -  ..
090806 - She submitted results of the blood test on Saturday, 020629, and noted
090807 - that the primary care physician is concerned the white blood cell
090808 - count is too low again (see line showing WBC marked as "L" for low at
090809 - 3.2 K/uL which is below the target range of 3.5 - 12.5. ref SDS 0 GS4F
090824 -  ..
090825 -                           Regional Lab
090826 -
090827 -
090828 -     Alkaline Phos          47.0  U/L       (     47.0  -    137   )
090829 -     Bili, Tot Adult         0.4  mg/dl     (      0.2  -      1.2 )
090830 -    CA 15-3                Test in Lab
090831 -     AST (SGOT)       H     46.0  U/L       (     10.0  -     40   )
090833 -  ..
090834 -
090835 -    CBC
090836 -     WBC x 10-.3      L      3.2  K/uL      (      3.5  -     12.5 )
090837 -     RBC x 10-.6             3.94 M/uL      (      3.60 -      5.70)
090838 -     Hemoglobin             12.5  g/dL      (     11.5  -     15.0 )
090839 -     Hematocrit             37.4  %         (     34    -     46.0 )
090840 -     MCV                    95    fL        (     80    -    100   )
090841 -     RDW              H     14.5  %         (     11.9  -     14.3 )
090842 -     Plt x 10-.3           196    K/uL      (    140    -    400   )
090844 -  ..
090845 -
090846 -    ADIF            Test Cancelled
090847 -    MDIFR
090848 -     Seg Neutrophils  L     27    %         (     50    -     70   )
090849 -     Lymphocytes            40    %         (     20    -     50   )
090850 -     Monocytes        H     25    %         (      1    -     11   )
090851 -     Eosinophils             5    %         (      1    -      5   )
090852 -     Basophils        H      3    %         (      0    -      1   )
090853 -     Ovalocytes       *      1+
090854 -     Macrocytes       *      1+
090855 -     Microcytes       *      1+
090856 -     Schistocytes     *      1+
090857 -     PLT Estimates     Adequate
090858 -
090860 -  ..
090861 - Ann advised that even though blood counts are low again today,
090862 - ref SDS 0 RQ6J, the doctor decided to perform treatment today, rather
090863 - than incur a delay to allow more time for the white blood cells to
090864 - increase, as occurred on 020513. ref SDS 1 0001, because results of
090865 - the test on Saturday, also, indicate that white blood cells were
090866 - beginning to increase at an accelerated rate, and so the doctor
090867 - suspects that today the count is up enough to safely procede.
090868 -
090869 -     [On 021002 white blood cell count low again, but rising, so
090870 -     treatment was given. ref SDS 7 LY3G
090872 -  ..
090873 - We asked about the CA 15-3 cancer marker, which Doctor Johnson
090874 - discussed on 020628. ref SDS 4 QB22
090876 -  ..
090877 - Ann said those results have not yet been reported.
090878 -
090879 -     [On 020705 CA 15-3 has elevated slighty from 67 to 75. ref SDS 6
090880 -     UX6I
090882 -  ..
090883 - Ann took another blood sample, as the first step in treatment. It will
090884 - be tested and analyzed during the time Millie undergoes chemotherapy
090885 - today.
090887 -  ..
090888 - Results are expected in about an hour, before Millie completes
090889 - treatment.
090891 -  ..
090892 - If the results are favorable, Millie will not need to use Nupigen
090893 - during this next week to restore the white blood cells.  However, if
090894 - the white blood cell count is still low for the test today, Millie
090895 - will have to administer Nupigen this next week in order to maintain
090896 - the immune system by increasing the white blood cells, as was done
090897 - following the 2nd chemotherapy treatment on 020520. ref SDS 2 RF4M
090899 -  ..
090900 - Ann asked Millie if she took the Decadron medication today prescribed
090901 - by the primary care physician on 020628 that prepares the body for
090902 - chemotherapy treatment using the Taxotere drug? ref SDS 4 BZ5L
090904 -  ..
090905 - Millie explained having taken pills as prescribed the past two days,
090906 - but not not today, per instructions by Doctor Johnson and the
090907 - pharmacist. ref SDS 4 BZ5L
090909 -  ..
090910 - Ann clarified the instructions, explaining the medication is to
090911 - prepare for treatment, and needs to be taken the day before and on the
090912 - day of treatment, as well.  She asked Millie to go ahead and take the
090913 - medication now, along with another medication.  She brought a cup of
090914 - water for taking the medication.
090916 -  ..
090917 - Ann took Millie's pulse, 72, and blood pressure was 113 61.
090919 -  ..
090920 - She commended Millie on good general health, and noted that being in
090921 - shape with low blood pressure and a strong pulse is a big boost for
090922 - recovery from cancer and for tolerating the treatments.
090924 -  ..
090925 - After Ann drew blood for testing, per above, ref SDS 0 EN50, she
090926 - hooked up the initial phase of treatment that begins with about an
090927 - hour of an IV with Benadryl in advance of Taxotere.
090929 -  ..
090930 - Benadryl helps prevent allergies.  Taxotere can make people more
090931 - suceptible to allergies.
090932 -
090933 -
090934 -
090935 -
090937 -  ..
0910 -
0911 -
0912 - 1249
0913 -
091301 - Benadryl treatment completed.
091302 -
091304 -  ..
091305 - Taxotere IV started, following up the switch from AC on 020610.
091306 - ref SDS 3 MR5I
091307 -
091308 -
091309 -
091311 -  ..
0914 -
0915 -
0916 - 1406
0917 -
091701 - Ann brought good news with the results of the blood test...
091716 -  ..
091717 -                           Regional Lab
091718 -
091719 -   @CBC
091720 -     WBC x 10-.3            10.1  K/uL      (      3.5  -     12.5 )
091721 -     RBC x 10-.6      L      3.48 M/uL      (      3.60 -      5.10)
091722 -     Hemoglobin       L     12.5  g/dL      (     11.5  -     15.0 )
091723 -     Hematocrit       L     31.9  %         (     34    -     46.0 )
091724 -     MCV                    92    fL        (     80    -    100   )
091725 -     RDW              H     14.8  %         (     11.9  -     14.3 )
091726 -     Plt x 10-.3           258    K/uL      (    140    -    400   )
091727 -     Granulocytes     H     84    %         (     50    -     70   )
091728 -     Lymphocytes      L     11    %         (     20    -     50   )
091729 -     Monocytes               5    %         (      0    -     11   )
091730 -     Eosinophils             0    %         (      0    -      4   )
091731 -     Basophils               0    %         (      0    -      2   )
091732 -     Manual Diff?         Chemo
091734 -  ..
091735 -   @MDIF
091736 -     Diff Method        Auto Dif
091737 -
091739 -  ..
091740 - Ann pointed out the increase in White Blood Cells (WBC) from the
091741 - report on 020629 showing 3.2 K/uL, per above, ref SDS 0 GS4F, to 10.1
091742 - K/uL for the test taken today. ref SDS 0 GT9I  She advised this means
091743 - that Millie does not need to take Neupogen this next week per above
091744 - planning. ref SDS 0 HO7F  Millie was happy about this.
091745 -
091746 -
091748 -  ..
0918 -
0919 -
0920 - 1430
0921 -
092101 - Treatment was completed.  Ann removed the IV.  She reviewed the
092102 - schedule for Millie to meet with the doctor at Mt. Diabloe hospital on
092103 - 020708 to plan radiation treatment, and indicated it would likely
092104 - begin a few days after the initial consultation.
092105 -
092106 -     [On 020702 drove to Grass Valley to help Steve and Lilly move in
092107 -     to their new home. ref SDS 5 0001
092108 -
092109 -
092110 -
092111 -
092112 -
092113 -
092114 -
092115 -
092116 -
0922 -