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: January 4, 2005 03:30 PM Tuesday; Rod Welch

Millie 1st cycle 1st treatment AC at Kaiser to recover from IBC.

1...Summary/Objective
2...Blood Counts Good Dose Chemotherapy Taxol Normal
3...CA 15-3 Not Test Today
4...Preparation for Treatment Required One (1) Attempt to Connect Port
5...AC Andrimiacin Cytoxin Full Dose Because Blook Counts Above Targets
6...Alert Energetic After Treatment Marked Change from Prior Treatments


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CONTACTS 

SUBJECTS
Chemotherapy Taxol Avastin Bevacizamub VEGF Treatments Begin Today 2
Blood Tests Cause Big Welt on Right Forearm Difficulty Finding Vein
08 02 04 02 CPKG 040518fc 040518fg                     **Not Found**       07
Flue Shot at Kaiser While Waiting for Blood Draw to Get Chemotherapy
Blood Test Results Pass for Treatment

0907 -
0907 -    ..
0908 - Summary/Objective
0909 -
090901 - Follow up ref SDS 34 0000. ref SDS 33 0000.
090902 -
090903 - Treatments started today after an 11 week interruption in treatment
090904 - for increasing symptoms of IBC relapse.  Treatment today was
090905 - professional, with minimal side effects.
090906 -
090907 -
090908 -
090909 -
090910 -
090912 -  ..
0910 -
0911 -
0912 - Progress
0913 -
091301 - Laurie is the nurse today.
091302 -
091303 - Kaiser resumed treatment today.  The last treatment was on 041021.
091304 - ref SDS 34 EB7J  Treatments were ended because a CT test on 041103
091305 - diagnosed pulmonary embolism, which is a side effect of bevacizumab
091306 - (Avastin) that was part of a clinical study drug trial initially
091307 - prescribed as the best treatment for Millie's cancer, as reported on
091308 - 041104. ref SDS 35 LP7F
091310 -  ..
091311 - Rosalie visited Millie in the Chemotherapy Infusion clinic and seemed
091312 - to indicate that planning on 041130 to delay treatment in order for
091313 - Kaiser to find a chemotherapy drug trial, ref SDS 36 028N, and
091314 - subsequently deciding on 041210 to qualify Millie for a trial protocol
091315 - that requires four (4) treatments of AC by getting two (2) more
091316 - treatments, ref SDS 37 CF9F, and thereafter scheduled by the doctor
091317 - during the meeting on 041230, ref SDS 38 028N, may not be possible
091318 - afterall.
091320 -  ..
091321 - Rosalie will research qualifications for the protocol and update the
091322 - doctor on her findings.
091323 -
091324 -     [On 050204 Protocol Nurse says Millie cannot qualify for trial
091325 -     with capecitabine. ref SDS 40 JF4M
091327 -  ..
091328 - Laurie advised today that the doctor's Chemotherapy Order prescribes
091329 - Millie to receive four (4) treatments with AC.
091331 -  ..
091332 - This conflicts with planning a few days ago during the meeting at
091333 - Kaiser on 041230 to prescribe 2 treatments of AC in order for Millie
091334 - to qualify for the new trial protocol. ref SDS 38 XQ41  Adding 4
091335 - treatments of AC reported today seems further to conflict with
091336 - guidance on 041230 that more than 4 treatments of AC increases risk of
091337 - cumulative heart damage. ref SDS 38 XQ84
091339 -  ..
091340 - Millie plans to discuss cost and scheduling issues during the next
091341 - meeting with the doctor.
091342 -
091343 -        [On 050311 Kaiser schedules MUGA test to assess cumulative
091344 -        damage to heart from continued treatments with AC beyond fourth
091345 -        cycle. ref SDS 41 J544
091347 -         ..
091348 -        [On 050328 Millie at Kaiser for MUGA test. ref SDS 42 0Y6I
091350 -         ..
091351 -        [On 050422 MUGA test report shows no evidence heart damage.
091352 -        ref SDS 43 UG4H
091353 -
091354 -
091355 -
091356 -
091357 -
0914 -

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 34 Q659, ref SDS 33 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 Not Test Today
140403 -
140404 - Follow up ref SDS 34 2N5J, ref SDS 33 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 34 EB7J, ref SDS 33 EB7J.
170706 -  ..
170707 - Decadron 10, compazine, 10, anzimet 100 MG given in pill form prior to
170708 - treatment for avoiding nausea rather than as a drip treatment to avoid
170709 - allergic reaction, as applied during the Taxol and Avastin treatment
170710 - on the trial protocol.
170712 -       ..
170713 -      Interlink System Vented Paclitaxel set
170714 -
170715 -
170716 -
170717 -
170718 -
170719 -
1708 -

SUBJECTS
Taxol Treatment Delayed 30 Minutes Because Lab Has Not Prepared Trea
AC Adriamycin Cytoxin Treatment Begun Today on New Regimine Replacin
AC Adriamycin Cytoxin Treatment Begun Today on New Regimine Replacin

2005 -
2006 - 1539
200701 -  ..
200702 - AC Andrimiacin Cytoxin Full Dose Because Blook Counts Above Targets
200703 -
200704 - Follow up ref SDS 34 4N5M, ref SDS 33 4N5M.
200705 -
200706 - Andrimiacin started.
200708 -  ..
200709 - Dose on AC 98 and Cytoxin is 984 MG.
200711 -  ..
200712 - Urine will be red or orange.  White cell count can drop, which places
200713 - patient at risk.
200715 -  ..
200716 - If temperature goes over 100.5, call Kaiser
200717 -
200719 -  ..
2008 -
2009 -
2010 - 1606
2011 -
201101 - Cytoxin started.
201102 -
201104 -  ..
201105 - Laurie advised that Millie has prescription.
201107 -  ..
201108 - Picked up prescription for Anzemet.
201109 -
201110 -
201112 -  ..
201113 - Decadron can cause restlessness, difficult to sleep.
201114 -
201115 -
201116 -
201118 -  ..
2012 -
2013 -
2014 - 1651
2015 -
201501 - Cytoxin completed.
201502 -
201503 -
201504 -
201505 -
201506 -
201507 -
201508 -
201509 -
2016 -

SUBJECTS
Tired Wobbly on Feet after Treatment In Asleep by 1900

2103 -
2104 - 1537
210501 -  ..
210502 - Alert Energetic After Treatment Marked Change from Prior Treatments
210503 -
210504 - Follow up ref SDS 34 F54N, ref SDS 33 F54N.
210505 -
210506 - There seems to be less effect being tired and wobbly from treatment
210507 - with AC.
210509 -  ..
210510 - Possibly because Benadryl is not part of the protocol for AC
210511 - chemotherapy.
210512 -
210513 -
210514 -
210515 -
210516 -
210517 -
210518 -
210519 -
210520 -
2106 -