THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
S U M M A R Y
DIARY: February 27, 2004 04:45 PM Friday;
Meeting at Kaiser to examine new lump on Millie's neck biopsy ordered.
2...CT Scan Test Schedule to Include Neck
3...Medical Test Conflicts Under Review Pending Repair to Kaiser Computers
4...Computer Access Doctor Cannot Find CT Test Files Kaiser System Down
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Pea-like Cluster and Firmness Indicates Cancerous Lumps Not Present
Lymph Node Swelling on Left Side of Neck No Indication of Cancer
Examination Follow Up Lymph Node Neck New Lump Left Side Shows Treatm
Biopsy Ordered Lymph Node Neck New Lump Left Side Examination Follow
0906 - ..
0907 - Summary/Objective
090801 - Follow up ref SDS 4 WP7L.
090803 - The doctor examined the patient and found there seemed to be slight
090804 - reduction in swelling of lymph node following treatment ordered on
090805 - 040211. ref SDS 4 WP7L
090807 - ..
090808 - The doctor ordered examination by head and neck specialist to take a
090809 - biopsy. There is heightened concern about relapse of cancer, because
090810 - the new swelled lymph node is on the left side of the neck which is
090811 - the same side as the original tumor in the left breast. This will be
090812 - performed next week.
090814 - ..
090815 - On 030508 a request for biopsy was not performed on a growing lump
090816 - under the left arm causing discomfort, also, on the same side as
090817 - cancer in the left breast, and which was periodically inflammed with a
090818 - red rash. ref SDS 1 7C98
090820 - [On 040303 examination by head and neck specialist; found 3 or
090821 - 4 lumps; took a biopsy and ordered surgery. ref SDS 5 VF77
090823 - ..
090824 - [On 040309 pathology report on biopsy shows cancer cells.
090825 - ref SDS 6 HD5N
090827 - ..
090828 - [On 040318 clinical examination shows slight increase in size
090829 - and firmness of lumps in the neck, ref SDS 7 565L; CT test
090830 - results confirm pathology report on biopsy that found lumps are
090831 - cancer. ref SDS 7 GJ69
090833 - ..
090834 - [On 040517 Millie diagnosed with inflammatory breast cancer,
090835 - ref SDS 8 7D6F, research indicates that swelled lymph nodes in
090836 - the neck above the collar bone are symptoms of IBC. ref SDS 8
090837 - M67I
090839 - ..
090840 - These results can be reviewed in conjunction with CA 15-3 pattern of
090841 - test results to assess patient status, previously described as
090842 - "stable" on 031205. ref SDS 3 WS9J
Find CT Test Report Lost Cannot Find Analysis Nor Report in Medical
CT Scan Findings Show 2 New 1 CM Masses in Area of Prior Surgery for
CT Scan Findings Show 1 CM Masses Increased to 1.5 CM 50% Growth
CT Scan Test Ordered to Follow Up Report on 031205 to Look for Evide
Mistake CT Test Report Conflicts Cancer Growth 50% Lost Cannot Find
250801 - ..
250802 - CT Scan Test Schedule to Include Neck
250803 - Medical Test Conflicts Under Review Pending Repair to Kaiser Computers
250805 - Follow up ref SDS 4 LK5L, ref SDS 3 LK5L.
250807 - The doctor ordered another CT test, and expanded the scope to include
250808 - the neck. The last CT test was on 031205. ref SDS 3 LK5L
250810 - [On 040309 pathology reports finds evidence of cancer in cells
250811 - from biopsy on the neck. ref SDS 6 HD59
250813 - ..
250814 - [On 040318 CT test results show recurrence of cancer in the neck,
250815 - which aligns with pathology report on 040309. ref SDS 7 LK5L
250817 - ..
250818 - Millie asked about the CT test report on 031031, which the doctor
250819 - submitted a month later during the meeting on 031205; it says nothing
250820 - about 2 lymph nodes that increased 50% in the previous CT tests,
250821 - reported on 030710. ref SDS 3 GJ69 Does this mean rapidly growing
250822 - cancerous nodes disappeared? Is this expected when the patient is not
250823 - getting treatment; might there be an error in reporting?
250825 - ..
250826 - The doctor did not recall details of the medical reports. He looked
250827 - through the medical chart, and could not find the tests, nor any
250828 - mention of this matter in notes for the meeting on 031205. The doctor
250829 - indicated that sometimes in the rush of seeing a lot of patients, and
250830 - attending staff meetings everything doesn't get written down, and,
250831 - also, cryptic handwriting can wind up being a sribble that is hard to
250832 - make out what was originally intended.
250834 - ..
250835 - [On 041018 Doctor Benz advises that doctor notes of meetings
250836 - with patients are useful for 2nd opinion review, because
250837 - legibility is too poor to read. ref SDS 10 EN63
250841 - ..
250842 - Computer Access Doctor Cannot Find CT Test Files Kaiser System Down
250844 - The doctor tried to access the files on Kaiser's computer for Millie's
250845 - CT tests on 030710 and on 031031. After a few minutes, he said that
250846 - Kaiser's computers are down today, so he cannot pull up the test scans
250847 - and reports to check things out. The doctor will investigate and
250848 - report on disposition of this matter.
250850 - ..
250851 - [On 040318 prior CT tests could not be found in Kaiser's
250852 - computer nor in the medical chart, ref SDS 7 8T8K, to resolve
250853 - conflicts on expanding axillary lymphadenopathy, ref SDS 7
250854 - ZE5O; new CT tests and a biopsy report showing regional
250855 - metastatic disease in the neck change focus from diagnosis to
250856 - planning for treatment. ref SDS 7 H28F
250858 - ..
250859 - [On 040517 Millie diagnosed with inflammatory breast cancer,
250860 - ref SDS 8 7D6F, research indicates swelled lymph nodes in the
250861 - neck and swelled lymph nodes under the arm are symptoms of IBC.
250862 - ref SDS 8 M67I
250864 - ..
250865 - [On 040812 doctor could not find reports on prior tests for
250866 - comparison and trend analysis; explains conflicts in test
250867 - reports reflects general laxity for precision measurements
250868 - because medical practice does not have the diligence for
250869 - accuracy that is common to engineering work. ref SDS 9 T761
250871 - ..
250872 - [On 060126 medical analyst cannot find report for PET scan test
250873 - on 051005 for comparison and trend analysis from results of new
250874 - test on 060120. ref SDS 11 LC7N