CONTACTS 

SUBJECTS
1st Treatment 1st Cycle Taxotere Xeloda Capacitibine Chemotherapy Tr

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 54 0000. ref SDS 52 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Angela is the nurse today.
040903 -  ..
040904 - We visited with Vivian from the pharmacy.
040906 -  ..
040907 - Vivian, asked about side effects and whether the dose should be
040908 - adjusted again.
040910 -  ..
040911 - Millie related discussions with the primary care physician earlier
040912 - today, when side effects were reported to be accelerating, ref SDS 55
040913 - DS5J, toward levels experienced previously on 050516. ref SDS 48 AQ6G
040915 -  ..
040916 - Vivian disclosed that Kaiser follows industry practice to start
040917 - patients with a maximum dose of chemotherapy, and then adjusts down to
040918 - a level the patient can tolerate.  She explained that tolerance for
040919 - chemothereapy varies widely between patients.  To get the biggest
040920 - health improvement, doctors strive for maximum strength.
040922 -  ..
040923 - Millie noted this strategy may have helped achieve a breakthrough
040924 - making substantial progress treating IBC, reported by the doctor on
040925 - 050520. ref SDS 49 025H
040927 -  ..
040928 - Vivian suggested generous use of balm on the feet, and wear socks at
040929 - night during sleep to enable the feet to regain moisture that helps
040930 - prevent pain and blisters. listed as side effects by Zan on 050415.
040931 - ref SDS 45 H44G  The documentation Zan subitted at that time, on
040932 - 050415, also, recommended vitiman B6, and balm, ref SDS 45 YG9V, cited
040933 - by Vivian today.
040934 -
040935 -     [On 050809 reduced problems from painful feet while walking, after
040936 -     implementing Vivian's guidance. ref SDS 56 6P7F
040938 -  ..
040939 - Vivian said Millie should consult further with the primary care
040940 - physician on adjusting the dosage to moderate side effects, as was
040941 - done this morning during the meeting with the doctor. ref SDS 55 EA8H
040942 -
040943 -
040944 -
040945 -
040946 -
040947 -
040948 -
040949 -
040950 -
0410 -

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

0805 -
080601 -  ..
080602 - Blood Counts Good Dose Chemotherapy Taxol Normal
080603 -
080604 - Follow up ref SDS 54 Q659, ref SDS 52 Q659.
080605 -
080606 - Millie had blood drawn this morning at 1100 by the Kaiser Chemotherapy
080607 - Clinic.  They left the connection to the port so that treatment this
080608 - afternoon is faster and easier.
080610 -  ..
080611 - Angela submitted the report showing...
080612 -
080613 -    Patient   Provider  Category   View      FR Date   To Date
080619 -     ..
080620 -    Procedure              Results             Reference Range
080622 -     ..
080623 -    Log#: 540521000022      050729 06:47 Outpa WCR Req: RA Johnson, MD
080624 -
080625 -                  ** Martinez Medical Offices **
080627 -     ..
080628 -    @CBC
080629 -    WBC x 10-3               5.4 K/uL           3.5   -     12.5
080630 -    RBC x 10-6    L         3.32 M/uL           3.60  -      5.10
080631 -    Hemoglobin    L         11.1 g/dL          11.5   -     15.0
080632 -    Hematocrit    L         32.2 %             34.0   -     46.0
080633 -    MCV                       97 fL            80.0   -    100.0
080634 -    RDW            H        19.2 %             11.9   -     14.3
080635 -    Plt x10-3              260   K/uL         140     -    400
080636 -     ..
080637 -    Neutrophils    H          82 %             50     -     70
080638 -    Lymphocytes               14 %             20     -     50
080639 -    Monocyte                   3 %              0     -     11
080640 -    Eosinophils                0 %              1     -      5
080641 -    Basophil                   1%               0     -      2
080642 -    Bands              No Report %              0     -      5
080643 -    Manual Diff?           Chemo
080645 -     ..
080646 -    CA 15-3        Test Remote Collect         -<     -     39
080648 -     ..
080649 -    Seg Neutrophils    No Report %             50     -     70
080651 -     ..
080652 -    DIFF Method         Auto Dif
080653 -    Anisocytosis       No Report+
080654 -    Macrocytes         No Report+
080655 -    Plt estimate         Adequate
080657 -     ..
080658 -    Alkaline Phos             44 U/L           38     -    126
080659 -    Bili, Tot Adult         <0.3 mg/dL        0.2     -    1.3
080660 -    Creatinine               0.7 mg/dL        0.6     -    1.2
080661 -    Phosphorus     Test Remote Collect
080662 -    Alt (SGPT)                38 U/L           11     -     66
080663 -    AST (SGOT)                46 U/L           11     -     66
080665 -     ..
080666 -    Cuomdin (Anticoag Ther WARFARIN
080667 -    PT, Patient             23.5 Sec         9.2           11.6
080668 -    PT, INR                  2.3 Ratio         2              3
080669 -
080670 -
080671 -
080672 -
080673 -
080674 -
0807 -

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

0903 -
090401 -  ..
090402 - CA 15-3 Drops from 54 to Below Normal at 37, Lowest Reading Ever
090403 -
090404 - Follow up ref SDS 54 2N5J, ref SDS 52 2N5J.
090405 -
090406 - Results is not available for CA 15-3 on the blood test today.  Angela
090407 - submitted results on the blood test for last week on 050701...
090408 -
090409 -    Log#: 540518200022      050701 06:43 Outpa WCR Req: RA Johnson, MD
090411 -  ..
090412 - Good news CA 15-3 has dropped to 37, two points below 39, and down
090413 - dramatically from 54 reported on 050611. ref SDS 51 554O  This is the
090414 - best reading Millie has ever had on this particular test in 4 years of
090415 - treatment.  She had a 39 on the test last year on 041007, ref SDS 34
090416 - 2N5J, but today is better.  There is indication of a significant
090417 - change in fortunes from the long climb that reated 105 on 050329.
090418 - ref SDS 44 PPRX
090419 -
090420 -
090421 -
090422 -
090423 -
090424 -
090425 -
090426 -
0905 -

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

1205 -
1206 - 1341
120701 -  ..
120702 - Preparation for Treatment Required One (1) Attempt to Connect Port
120703 -
120704 - Follow up ref SDS 54 EB7J, ref SDS 52 EB7J.
120705 -
120706 - Vitals taken by Shannon...
120707 -
120708 -    Blood preasure    133  74
120709 -    Pulse              84
120710 -    Temperature        99.3
120712 -  ..
120713 - Another nurse took admin with Angela to verify Millie's identification
120714 - and treatment.
120716 -  ..
120717 - Millie explained having taken Decadron tablets according to the
120718 - prescription to take two tablets twice a day, per instructions on
120719 - 050415. ref SDS 45 8U4O
120721 -  ..
120722 - Angela gave Millie a pill for Compazine 10 prior to treatment that
120723 - reduces nausea rather than as a drip treatment to avoid allergic
120724 - reaction.
120726 -  ..
120727 - Angela made installation, per above. ref SDS 54 Q659
120729 -       ..
120730 -      Interlink System Vented Paclitaxel set
120732 -  ..
120733 - Millie's blood counts are good, so there is no requirement to take
120734 - Nupigen again to strengthen the immune system.
120735 -
120736 -
120738 -  ..
1208 -
1209 -
1210 - 1552
1211 -
121101 - Benedryl started.
121102 -
121103 -
121105 -  ..
1212 -
1213 -
1214 - 1609
1215 -
121501 - Benedryl completed.  Equipment did not beep; Angela noticed the
121502 - container was empty, and so switched to Taxotere drip treatment.
121503 -
121504 -
121505 -
121506 -
121507 -
121508 -
121509 -
121510 -
1216 -

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

1504 -
1505 - 1611
150601 -  ..
150602 - Taxotere Full Dose Blood Counts Within Targets
150603 -
150604 - Follow up ref SDS 54 4N5M, ref SDS 52 4N5M.
150606 -  ..
150607 - Taxotere started.
150608 -
150609 -
150610 -
150611 -
150613 -  ..
1507 -
1508 - 1708
1509 -
150901 - Equipment beeped indicating treatment is over.
150902 -
150903 - Taxotere treatment completed.
150905 -  ..
150906 - Saline flush was run for a few minutes.
150908 -  ..
150909 - Angela did not remove the drip treatment tube from the port, and
150910 - apply Hepren to reduce clotting, and avoid infection, because this
150911 - was done earlier today when Millie got blood drawn in the lab.
150913 -  ..
150914 - Angela did not get vitals at the end of treatment, as was done last
150915 - time.
150916 -
150917 -   Temperature......... 97.6
150918 -   Pulse............... 145 77
150919 -   Blood Pressure...... 57
150920 -
150921 -
150922 -
150923 -
150925 -  ..
1510 -
1511 -
1512 - 1714
1513 -
151301 - We went to the Pharmacy and picked up the prescriptions for...
151302 -
151303 -            Xeloda
151305 -  ..
151306 - The co-payment on these drugs was approximatley $60.  The full price
151307 - was about $1,300, saving $1,240.
151308 -
151309 -
151310 -
151311 -
151312 -
151313 -
151314 -
151315 -
1514 -

SUBJECTS
Tired Wobbly on Feet after Treatment In Asleep by 1900
Tired Wobbly on Feet after Treatment Asleep by 1900 Not Today After

1704 -
1705 - 1537
170601 -  ..
170602 - Alert Energetic After Treatment Marked Change from Prior Treatments
170603 -
170604 - Follow up ref SDS 54 F54N, ref SDS 52 F54N.
170605 -
170606 - Millie seemed okay after treatment today.  No immediate wobbliness.
170607 - She was okay to drive, and seemed alert the rest of the day.
170609 -  ..
170610 - This seems unusual because Benedryal is part of the protocol for
170611 - Taxotere, per above. ref SDS 45 064F  Previously, when treated with
170612 - Bendryl and Taxotere, Millie has been noticably wobbly and unsteady
170613 - on her feet, and retired early to bed, reported on
170614 -
170615 -
170616 -
170617 -
170618 -
170619 -
170620 -
170621 -
170622 -
1707 -