CONTACTS 

SUBJECTS
Chemotherapy Taxol Avastin Bevacizamub VEGF Treatments Begin Today 2
Blood Tests Cause Big Welt on Right Forearm Difficulty Finding Vein
Flue Shot at Kaiser While Waiting for Blood Draw to Get Chemotherapy

0905 -
0905 -    ..
0906 - Summary/Objective
0907 -
090701 - Follow up ref SDS 33 0000. ref SDS 32 0000.
090702 -
090703 - Millie had blood drawn for test to get treatment, and an hour or so
090704 - later got a treatment.
090705 -
090706 -      [On 041104 Kaiser removed Millie from treatment due to finding
090707 -      pulmonary embolism in CT test the day before on 041103.
090708 -      ref SDS 34 RZ4I
090709 -
090710 -
090712 -  ..
0908 -
0909 -
0910 - Progress
0911 -
091101 - Millie had blood drawn here at the Chemotherapy Infusion clinic this
091102 - morning to evaluate getting the 7th treatment on Avastin Taxol
091103 - chemotherapy drug trial today.
091105 -  ..
091106 - While waiting to be called for a blood draw, Millie went downstairs
091107 - and got a flu shot.  She fits the profile of high risk patients who
091108 - are over 60 and suffering disease that requires flue shot treatments.
091110 -  ..
091111 - After getting blood drawn, Millie and I went to lunch at the Hickory
091112 - Pit, then returned for her treatment.
091113 -
091114 -
091116 -  ..
0912 -
0913 -
0914 - 1315
0915 -
091501 - Sherri is the nurse today.
091503 -  ..
091504 - Millie's weight is 140.4 today.
091506 -  ..
091507 - Millie asked to change meetings from Thursday to Friday.
091509 -  ..
091510 - Sherrie checked with Rosalie, and they made this change, so that
091511 - Millie's treatments will be on Friday starting on 041203.
091512 -
091513 -
091514 -
091515 -
091516 -
0916 -

SUBJECTS
Blood Tests White Cell Count Good 2nd Cycle 1st Treatment Chemothera
Urine Tests No Evident Problems
Blood Test Results Pass for Treatment

1305 -
130601 -  ..
130602 - Blood Counts Good Dose Chemotherapy Taxol Normal
130603 -
130604 - Follow up ref SDS 33 Q659, ref SDS 32 Q659.
130605 -
130606 - Millie requested report on blood test taken today?
130608 -  ..
130609 - Sheri submitted the report showing...
130610 -
130611 -    Patient   Provider  Category   View      FR Date   To Date
130617 -     ..
130618 -    Procedure              Results             Reference Range
130620 -     ..
130621 -    Log#: 510429501681      041021 11:54 Outpa WCR Req: RA Johnson, MD
130622 -
130623 -                  ** Walnut Creek Medical Center **
130625 -     ..
130626 -    @CBC
130627 -    WBC x 10-3               4.4 K/uL           3.5   -     12.5
130628 -    RBC x 10-6    L         3.58 M/uL           3.60  -      5.10
130629 -    Hemoglobin    L         11.3 g/dL          11.5   -     15.0
130630 -    Hematocrit    L         33.7 %             34.0   -     46.0
130631 -    MCV                       94 fL            80.0   -    100.0
130632 -    RDW                     15.6 %             11.9   -     14.3
130633 -    Plt x10-3                242 K/uL         140     -    400
130634 -     ..
130635 -    Neutrophils   L           43 %             50     -     70
130636 -    Lymphocytes               39 %             20     -     50
130637 -    Monocyte                   4 %              0     -     11
130638 -    Eosinophils    H          13 %              1     -      5
130639 -    Basophil                   1%               0     -      2
130640 -    Bands              No Report %              0     -      5
130641 -    Manual Diff?
130643 -     ..
130644 -    CA 15-3              NO REPORT             -<     -     39
130646 -     ..
130647 -    Seg Neutrophils  L No Report %             50     -     70
130649 -     ..
130650 -    DIFF Method
130651 -    Anisocytosis       No Report+
130652 -    Macrocytes         No Report+
130653 -    Plt estimate         Adequate
130654 -
130655 -
130656 -
130657 -
130658 -
130659 -
130660 -
130661 -
1307 -

SUBJECTS
CA 15-3 78 Smaller Rise than 10 Points Reported on 040318

1403 -
140401 -  ..
140402 - CA 15-3 Drops from 49 to Normal at 39, Lowest Reading Ever
140403 -
140404 - Follow up ref SDS 33 2N5J, ref SDS 32 2N5J.
140405 -
140406 - No test today.
140407 -
140408 -
140409 -
140410 -
140411 -
1405 -

SUBJECTS
Prepare for Treatment Connect Equipment for Port Catheter
Tagiment Dexatron Administered to Prevent Alergic Reaction to Taxol
Port Catheter Required 3 Tried to Connect Infusion Equipment Prepare

1705 -
1706 - 1107
170701 -  ..
170702 - Preparation for Treatment Required One (1) Attempt to Connect Port
170703 -
170704 - Follow up ref SDS 33 EB7J, ref SDS 32 EB7J.
170705 -
170706 - The port connection was done earlier this morning when Millie had
170707 - blood drawn, per above, ref SDS 33 407N, so the procedure did not have
170708 - to be done again.  Saves time and wear and tear on the patient.
170710 -       ..
170711 -      Interlink System Vented Paclitaxel set
170713 -  ..
170714 - Sherri brought Compazine pill for nausea.
170716 -  ..
170717 - Sherri flushed the port with Saline.
170718 -
170720 -  ..
1708 -
1709 -
1710 - 1413
1711 -
171101 - Tagamet and Decadron administered first today prior to Benadryl, and
171102 - prior to Taxol for prevention of allergic reaction.
171103 -
171105 -  ..
171106 - Vitals...
171107 -
171108 -    Blood pressure.. 144 83
171110 -     ..
171111 -    Pulse........... 69
171113 -     ..
171114 -    Temperature..... 98.4
171115 -
171117 -  ..
1712 -
1713 -
1714 - 1413
1715 -
171501 - Benadryl infusion started.
171502 -
171503 - Millie and I did not notice when Tagament and Decadron ended, and
171504 - Sheri started this treatment, and so commented to Sheri that today's
171505 - work seems to conflict with prior practice.  Sheri retrieved the
171506 - infusion bag and expressed concern because it has a different name,
171507 - which Sheri said is Benadryl.
171509 -  ..
171510 - Sheri apologized for confusion, and became somewhat emotional, because
171511 - she could not remember following the correct sequence of medications
171512 - in this instance.  She checked her chart, but noticed that all of the
171513 - entries were not listed.  Sheri consulted with the lead nurse, and
171514 - together they filled out the chart so the record shows the correct
171515 - procedure was followed, even though there is no assurance of that, and
171516 - further that it seems likely today that one or more steps was not
171517 - performed.
171519 -  ..
171520 - They apologized to Millie again, and said that in this case they don't
171521 - feel any damage has been done.  The lead nurse said they had a meeting
171522 - last week, and plans were announced to increase the ratio of nurses to
171523 - patients, either by sending some patients to another hospital, or by
171524 - adding more nurses to reduce confusion from one nurse handling many
171525 - patients with similar but different treatments that require precision
171526 - in the sequence and amount administered.
171528 -  ..
171529 - Previously, on 040402 Rosalie, the protocol nurse, explained that
171530 - Kaiser's work practices and records are audited to maintain a high
171531 - degree of precision for treatment. ref SDS 2 6E4K
171532 -
171533 -    [On 040416 case study illustrates advantages of audits to
171534 -    support vigilence avoiding errors and omissions in health care
171535 -    and medical practice. ref SDS 5 GN7J
171536 -
171537 -
171538 -
171540 -  ..
1716 -
1717 -
1718 - 1427
1719 -
171901 - Benadryl infusion completed.
171902 -
171903 - There was no alarm.
171904 -
171905 -
171906 -
171907 -
171908 -
171909 -
1720 -

SUBJECTS
Taxol Treatment Delayed 30 Minutes Because Lab Has Not Prepared Trea

1803 -
1804 - 1428
180501 -  ..
180502 - Taxol Dosage Normal Because Blood Counts Above Targets
180503 -
180504 - Follow up ref SDS 33 4N5M, ref SDS 32 4N5M.
180505 -
180506 - Sherri advised that Taxol is normal again today which is 90, up from
180507 - 65 2 weeks ago, because Millie's blood counts are all good.
180509 -  ..
180510 - Taxol is started by Shiri.
180511 -
180513 -  ..
1806 -
1807 -
1808 - 1440
1809 -
180901 - Vitals...
180902 -
180903 -    Blood pressure.. 170 94
180905 -     ..
180906 -    Pulse........... 62
180908 -     ..
180909 -    Temperature..... 97.9
180910 -
180912 -  ..
1810 -
1811 -
1812 - 1455
1813 -
181301 - Vitals...
181302 -
181303 -    Blood pressure.. 166 86
181305 -     ..
181306 -    Pulse........... 60
181308 -     ..
181309 -    Temperature..... 99.2
181310 -
181311 -
181313 -  ..
1814 -
1815 -
1816 - 1511
1817 -
181701 - Vitals...
181702 -
181703 -    Blood pressure.. 144 92
181705 -     ..
181706 -    Pulse........... 61
181708 -     ..
181709 -    Temperature..... 98.3
181710 -
181711 -
181713 -  ..
1818 -
1819 -
1820 - 1529
1821 -
182101 - Alarm sounds indicating Taxol completed.
182102 -
182103 - Does not seem to actually be complete.  Looks like there is more
182104 - treatment still in the infusion bag.
182105 -
182106 -
182108 -  ..
1822 -
1823 -
1824 - 1530
1825 -
182501 - Sherri resets equipment; notices there is still more treatment to
182502 - complete infusion, and so decides to wait until infusion is completed
182503 - for Taxol, and then will take vitals again.
182504 -
182506 -  ..
1826 -
1827 -
1828 - 1532
1829 -
182901 - Taxol completed.
182902 -
182903 - Vitals taken by Sherri...
182904 -
182905 -    Blood pressure.. 151 89
182907 -     ..
182908 -    Pulse........... 59
182910 -     ..
182911 -    Temperature..... 98.7
182912 -
182913 -
182914 -
182915 -
182916 -
182917 -
1830 -

SUBJECTS
Avastin Treatment Without Blood Pressure Testing

1903 -
1904 - 1540
190501 -  ..
190502 - Avastin Treatment Without Blood Pressure Testing
190503 -
190504 - Follow up ref SDS 33 PV4H, ref SDS 32 PV4H.
190505 -
190506 - Started.
190507 -
190509 -  ..
1906 -
1907 -
1908 - 1620
1909 -
190901 - Avasting completed.
190902 -
190903 -
190904 -
190905 -
1910 -

SUBJECTS
Tired Wobbly on Feet after Treatment In Asleep by 1900

2003 -
2004 - 1537
200501 -  ..
200502 - Alert Energetic After Treatment Marked Change from Prior Treatments
200503 -
200504 - Follow up ref SDS 33 F54N, ref SDS 32 F54N.
200505 -
200506 -
200507 -
200508 -
200509 -
200510 -
200511 -
2006 -