CONTACTS
SUBJECTS
Meeting Doctor Examine Response Chemotherapy Taxotere Capecitiabine
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 80 0000. ref SDS 67 0000.
040502 -
040503 - Cancer marker CA 15-3 drops to 31, a dramatic improvement to Millie's
040504 - strongest recovery status in four (4) years. ref SDS 0 GJ5M Scheduled
040505 - continued testing for relapse, ref SDS 0 FV6L, with plans for PET scan
040506 - test near the end of January 2006. ref SDS 0 NL4N The doctor cited
040507 - findings of cancer in the biopsy on 040309 to support prognosis of
040508 - metastatic disease, which requires continuous testing for relapse.
040509 - ref SDS 0 LH7M Examination showed the surgical wound from the
040510 - mastectomy incision is healing without complications. ref SDS 0 025H
040511 - Discussion of DCIS was not followed up to test for disease in the
040512 - right breast; the doctor concurred with surgeon's analysis of test
040513 - results showing Millie has no evidence of disease (NED). ref SDS 0
040514 - KV9G The doctor called the Anticoagulant Clinic in Kaiser's Martinez
040515 - hospital, and notified that he has taken Millie off of Coumadin
040516 - treatments. ref SDS 0 RZ4I Millie is now completely off treatment due
040517 - to progress recovering from stage IV secondary IBC. ref SDS 0 AW5G
040518 - The doctor called the Pathology Department and requested again retest
040519 - of the biopsy on 040419 for status change, which will be needed in the
040520 - event of relapse to develop treatment plans. ref SDS 0 ZR6J Kaiser
040521 - has a new email system to support timely communications for the
040522 - doctor/patient partnership. ref SDS 0 FE4I
040523 -
040524 - [On 060217 PET scan test finds no evidence metastatic disease;
040525 - doctor describes swelling left axilla as post op localized edema.
040526 - ref SDS 96 T56K
040528 - ..
040529 - [On 060320 letter to primary care physician reports research
040530 - showing bandage should be worn during exercise; lymphedema may
040531 - have accelerated because exercise was performed without bandage
040532 - during exercise for several months prior to notce. ref SDS 97 EU40
040533 -
040535 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Agenda for Work Plan After Switching to Taxotere and Capecitabine
040902 -
040903 - Follow up ref SDS 80 MW6M, ref SDS 67 SM6M.
040904 -
040905 - This is the 1st review meeting after surgery on 051021, ref SDS 85
040906 - 0001, and following examination by the surgeon on 051027, when
040907 - Millie's status was reported "no evidence of disease (NED)".
040908 - ref SDS 89 M58G
040910 - ..
040911 - Millie listed an agenda on the marking board in the examination room
040912 - to guide discussions...
040913 -
040914 - 1. CA 15-3 cancer marker report............... ref SDS 0 GJ5M
040915 - 2. Breast exam recovering IBC................. ref SDS 0 025H
040916 - 3. Relapse testing program.................... ref SDS 0 SH4O
040917 - 4. Port flush schedule........................ ref SDS 0 SH5N
040918 - 5. Biopsy report final clear margins.......... ref SDS 0 UF4L
040919 - 6. DCIS right breast.......................... ref SDS 0 KV9G
040920 - 7. Hypercoagulable state work up.............. ref SDS 0 GW7G
040921 - 8. Surgeon's pre-op patient history........... ref SDS 0 355G
040922 - 9. Discomfort below right breast.............. ref SDS 0 6R6G
040923 - 10. Coumadin pause 5 days...................... ref SDS 0 RZ4I
040924 - 11. Treatment plan............................. ref SDS 0 AW5G
040925 - 12. Status change treatment options............ ref SDS 0 ZR6J
040926 - 13. Medical disability......................... ref SDS 0 J29L
040927 -
040928 -
040929 -
040930 -
040931 -
040932 -
040933 -
0410 -
SUBJECTS
CA 15-3 31 and 8 Points Below Normal 39 Stable for 4 Weeks Dramatic
1403 -
140401 - ..
140402 - CA 15-3 Cancer Marker 45 Stable for 3 Weeks
140403 -
140404 - Follow up ref SDS 80 087J, ref SDS 67 087J.
140405 -
140406 - The most recent blood test on 051116 shows CA 15-3 remained steady at
140407 - 31, after dropping from 45 on 051021 down to 34 on 051102, and then
140408 - dropping again to 30 on 051109, as shown in a report submitted by the
140409 - doctor today...
140411 - ..
140412 - Test Date Date Received
140413 - 051116......... 31............... 051121, ref SDS 0 087JL
140414 - 051109......... 30............... 051121, ref SDS 0 087JL
140415 - 051102......... 34............... 051121, ref SDS 0 087JL
140416 - 050909......... 45 H............. 051007, ref SDS 80 087JL
140417 - 050826......... 45 H............. 050913, ref SDS 67 087JL
140418 - 050819......... 45 H............. 050913, ref SDS 67 087JL
140419 - 050812......... 39 .............. 050819, ref SDS 60 3K6L
140420 - 050729......... 45 H............. 050819, ref SDS 60 EA5G
140421 - 050708......... 46 H............. 050729, ref SDS 58 087J
140422 - 050701......... 37 .............. 050708, ref SDS 55 2N5J
140423 - 050617......... 45 H............. 050729, ref SDS 58 087J
140424 - 050527......... 56 H............. 050610, ref SDS 54 087J
140425 - 050512......... 67 H............. 050520, ref SDS 53 087J
140426 - 050506......... 80 H............. 050520, ref SDS 53 087J
140427 - 050415.........105 H............. 050422, ref SDS 51 087J
140428 - 050325.........100 H............. 050329, ref SDS 49 087J
140429 - 050318.........101 H............. 050325, ref SDS 48 2N5J
140430 - 050304......... 88 H............. 050311, ref SDS 46 087J
140431 - 050225......... 95 H............. 050308, ref SDS 45 0001
140432 - 050211......... 78 H............. 050214, ref SDS 44 02BB
140433 - 050128......... 67 H............. 050204, ref SDS 43 087J
140434 - 041228......... 56 H............. 041230, ref SDS 42 087J
140435 - 041204......... 43 H............. 041210, ref SDS 41 087J
140436 - 041007......... 39............... 041104, ref SDS 38 087J
140437 - 040923......... 49 H............. 041005, ref SDS 37 087J
140438 - 040908......... 44 H............. 040909, ref SDS 36 087J
140439 - 040825......... 47 H............. 040812, ref SDS 36 087J
140440 - 040811......... 42 H............. 040812, ref SDS 35 087J
140441 - 040728......... 43 H............. 040729, ref SDS 33 2N5J
140442 - 040712......... 47 H............. 040713, ref SDS 32 087J
140443 - 040614......... 55 H............. 040615, ref SDS 31 PX6X
140444 - 040517......... 78 H............. 040601, ref SDS 29 2N5J
140445 - 040311......... 70 H............. 040318, ref SDS 24 SM6M
140446 - 040205......... 60 H............. 040211, ref SDS 22 SM6M
140447 - 031201......... 62 H............. 031205, ref SDS 21 SM6M
140448 - 030912......... 66 H............. 030915, ref SDS 20 SM6M
140449 - 030708......... 68 H............. 030710, ref SDS 19 SM6M
140450 - 030503......... 54 H............. 030508, ref SDS 18 SM6M
140451 - 030403......... 45 H............. 030508, ref SDS 18 SM6M
140452 - 030215......... 46 H............. 030220, ref SDS 17 5E6L
140453 - 030106......... 37 H............. 030109, ref SDS 16 SM6M
140454 - 021202......... 41 H?............ 021204, ref SDS 15 SP5G
140455 - 021111......... 36 H?............ 021113, ref SDS 14 Y65I
140456 - 021023......... 33 H?............ 021023, ref SDS 13 SQ5I
140457 - 020930......... 33 H?..29........ 021002, ref SDS 12 SQ5I
140458 - 020917......... 36 H?............ 020924, ref SDS 11 SQ5I
140459 - 020717......... 59 H?............ 020726, ref SDS 10 YN5K
140460 - 020629......... 75 H ............ 020705, ref SDS 9 UX6I
140461 - 020608........ 67 H ............ 020614, ref SDS 8 0001
140462 - 020603........ 108 H ............ 020607, ref SDS 7 X67F
140463 - 020511........ 117 H ............ 020603, ref SDS 6 PJ4J
140464 - 020419......... 81 H ............ 020430, ref SDS 4 7N5H
140465 - 020321......... 85 H ............ 020405, ref SDS 2 6T8K
140466 -
140467 -
140469 - ..
1405 -
1406 -
1407 - Analysis
1408 -
140801 - CA 15-3 31 Cancer Marker Drops Significantly Below Target Level
140802 -
140803 - Follow up ref SDS 80 GJ5M, ref SDS 67 GJ5M.
140804 -
140805 - The doctor was very pleased by 15 point drop in CA 15-3 to, at long
140806 - last, fall well below the target level of 39. This is the lowest
140807 - level Millie has tested in the entire four (4) year history of her
140808 - disease, and aligns with the surgeon's report on 051027 that Millie
140809 - has no evidence of disease (NED), ref SDS 89 M58G, based on test
140810 - results for the biopsy from the operation on 051021, which was
140811 - received on 051027, and showed Millie is disease free. ref SDS 89 616P
140812 - It also aligns with the PET scan test on 051005, and reported on
140813 - 051007. ref SDS 80 L66M
140815 - ..
140816 - There was discussion on what accounts for dramatic drop in CA 15-3,
140817 - when testing showed no evidence of disease, except for ductile
140818 - carcinoma in sutu (DCIS), found in the biopsy reported on 051027.
140819 - ref SDS 90 615K A primary caution is that no evidence of DCIS has
140820 - ever been reported in extensive imaging tests (PET and CT), reviewed
140821 - on 051027. ref SDS 90 HC3L
140823 - ..
140824 - The doctor today, seemed to indicate that DCIS would not drive CA 15-3
140825 - above 39 to 45. The doctor seemed to feel the breast tissue removed
140826 - must have had microscopic cancer cells for IBC disease, even though
140827 - this was not found by the biopsy, further discussed below. ref SDS 0
140828 - GV6K
140829 -
140830 - [...see below Millie is currently NED, with diagnosis of
140831 - metastatic cancer. ref SDS 0 GV6K
140833 - ..
140834 - The doctor approved continued CA 15-3 tests every 2 weeks, and for the
140835 - next month or so, with planning to then test monthly for signs of
140836 - relapse, and which will be supplemented by quarterly PET testing
140837 - beginning on 060115, per below. ref SDS 0 NL4N This vigorous
140838 - diagnostic regimen looking for early signs of relapse, fits planning
140839 - with the surgeon on 051027. ref SDS 89 L05O
140840 -
140841 -
140842 -
140843 -
140844 -
140845 -
1409 -
SUBJECTS
PET Scan Test Scheduled 060115 After Examination on 060106 Evaluate
2303 -
230401 - ..
230402 - PET Scan Test Report Shows Local Control with No Evidence of Cancer
230403 -
230404 - Follow up ref SDS 80 NL4N, ref SDS 67 NL4N.
230405 -
230406 - See discussion on rising CA 15-3, per above. ref SDS 0 GJ5M
230408 - ..
230409 - The doctor scheduled PET scan test for 060115, to follow up the test
230410 - on 051005, that was received on 051007. ref SDS 80 WJ6G
230412 - ..
230413 - This implements planning for quarterly image testing to supplement CA
230414 - 15-3 testing every 2 weeks for careful evaluation of patient status,
230415 - per above. ref SDS 0 FV6L
230416 -
230417 -
230418 -
230419 -
230420 -
2305 -
SUBJECTS
Axillary Right Left Lymph Nodes No Examination Patient Reports No Di
2903 -
290401 - ..
290402 - Examination Right Left Axillary No Evidence Lumps Lympadenopathy
290403 - Right Left Axillary Examination No Evidence Lumps Lympadenopathy
290404 -
290405 - Follow up ref SDS 80 MW8J, ref SDS 67 MW8J.
290406 -
290407 - See discussion of stable CA 15-3, per above. ref SDS 80 GJ5M
290409 - ..
290410 - There was no examination of axilla today.
290411 -
290412 - [On 060106 major swelling under left axilla diangosed as possible
290413 - lymphedema pending results of PET scan test. ref SDS 95 G55I
290415 - ..
290416 - [On 060217 PET scan test finds no evidence metastatic disease;
290417 - doctor observes significantly reduced swelling; describes swelling
290418 - as post op localized edema. ref SDS 96 T56K
290420 - ..
290421 - [On 060320 letter to primary care physician reports research
290422 - showing bandage should be worn during exercise; lymphedema may
290423 - have accelerated because exercise was performed without bandage
290424 - for several months prior to notce. ref SDS 97 EU40
290425 -
290426 -
290427 -
290428 -
290429 -
2905 -
SUBJECTS
Lumps in Neck Reported 040309 Currently Resolved Establish Stage IV
4403 -
440401 - ..
440402 - Prognosis Stage IV Metastatic Disease Currently in Remission
440403 - Palliation Mastectomy Surgery for Future Relapse Stage IV Cancer
440404 - Lumps in Neck Reported 040309 Establish Stage IV Metastatic Cancer
440405 -
440406 - Follow up ref SDS 80 8R6M, ref SDS 67 8R6M.
440407 -
440408 - There was no examination of the neck today. PET scan test report
440409 - received on 051007 found no evidence of cancer. ref SDS 80 GJ4S
440411 - ..
440412 - The doctor mentioned during discussion that Millie's history of
440413 - cancerous lumps in the neck, reported on 040309, ref SDS 24 0001,
440414 - requires treating Millie for stage IV metastatic disease, and for this
440415 - reason on 051007 Kaiser classified the mastectomy surgery on 051021
440416 - for future palliation, ref SDS 80 6A4N, even though at this time she
440417 - is NED, reported by the surgeon on 051027. ref SDS 90 M58G
440418 -
440419 - [...see below Millie is currently NED, with diagnosis of
440420 - metastatic cancer. ref SDS 0 GV6K
440422 - ..
440423 - Previously, on 040318 the doctor diagnosed metastatic cancer citing
440424 - positive biopsy on neck lumps. ref SDS 25 8R6M On 050324 review of
440425 - surgery options recognized prospect of similar diagnosis. ref SDS 48
440426 - YX4K At that time, on 050324 research indicates metastatic cancer
440427 - involving regional lymph nodes, may be operable to reduce chances of
440428 - relapse, which is different from "distant metastasis," that surgery
440429 - cannot cure, but may play a palliative role, ref SDS 48 O84N, further
440430 - explained from research on 050712. ref SDS 57 B65G More recently, on
440431 - 050923 the surgeon diagnosed metastatic cancer, ref SDS 73 VL4O, noted
440432 - previously on 050727 for presenting risk of microscopic cancer cells.
440433 - ref SDS 58 R34I
440434 -
440435 -
440436 -
440437 -
440438 -
440439 -
440440 -
4405 -
SUBJECTS
Examination Finds No Evidence of Disease NED Patient Recovering Mast
5903 -
590401 - ..
590402 - No Evidence of Disease NED Patient Recovering Mastectomy Surgery
590403 - Examination Left Breast Surgical Wound Mastectomy Incision Healing
590404 - DCIS Right Breast No Testing Scheduled Based on NED CA 15-3 Testing
590405 - Healing Surgical Wound Mastectomy Incision Examination Left Breast
590406 -
590407 - Follow up ref SDS 80 025H, ref SDS 67 025H.
590408 -
590409 - The doctor examined the incision wound from mastectomy surgery on
590410 - 051021, ref SDS 86 YG4R, and indicated the wound is healing normally
590411 - without complications, which extends findings by the surgeon a month
590412 - ago on 051027. ref SDS 89 RI6I
590413 -
590414 - [On 051202 examination by surgeon finds mastectomy incision
590415 - healing beautifully. ref SDS 94 025H
590417 - ..
590418 - [On 060217 PET scan test finds no evidence metastatic disease;
590419 - doctor describes swelling left axilla as post op localized edema.
590420 - ref SDS 96 T56K
590422 - ..
590423 - Millie asked for the pre-op patient history prepared by the surgeon,
590424 - and which was missing from the record prior to surgery on 051021,
590425 - ref SDS 86 DG6J, and then discussed with the surgeon a week later on
590426 - 051027. ref SDS 90 PO5J
590428 - ..
590429 - The doctor found the surgeon's post-op report on the computer, also,
590430 - discussed with the surgeon on 051027, ref SDS 90 O28G The doctor
590431 - printed a copy for Millie, which is entered in the record on 051021.
590432 - ref SDS 86 369L
590434 - ..
590435 - The doctor could not find the report on pre-op patient history.
590437 - ..
590438 - The doctor submitted the report on the biopsy performed on 051021, and
590439 - which was received from the surgeon on 051027, but was out of order.
590440 - ref SDS 90 P56F, and did not expressly state clear margins were
590441 - established. ref SDS 90 QY4M
590443 - ..
590444 - We reviewed analysis on the biopsy report from the record on 051027,
590445 - ref SDS 90 615K, concerning prospects for DCIS to occur in the right
590446 - breast, as found in the left breast. ref SDS 90 BA5G
590448 - ..
590449 - The doctor seemed to indicate today that DCIS in the right breast is
590450 - not a risk from findings of swelled lymph nodes in the right axillary,
590451 - reported in the record on 051007. ref SDS 80 OG5J
590453 - ..
590454 - No further testing was scheduled to evaluate DCIS in the right breast,
590455 - and prior analysis of swelled lymph nodes in the right axilla, also,
590456 - presented on 051007, ref SDS 80 1E8L, was indicated to be resolved
590457 - today by favorable biopsy report on removed tissue, and favorable CA
590458 - 15-3 testing, per above. ref SDS 0 GJ5M
590460 - ..
590461 - The doctor confirmed that Millie is NED, because extensive testing
590462 - with PET, biopsy, and CA 15-3 find no evidence of disease. The doctor
590463 - indicated that mastectomy surgery on the left breast performed on
590464 - 051021 may have removed microscopic cancer cells, which were missed by
590465 - biopsy tests, per above discussion on CA 15-3 results. ref SDS 0 GJ5M
590466 - This may relate to palliation for relapse due to microscopic cancer
590467 - cells that drive metastatic cancer, discussed above concerning prior
590468 - findings from a biopsy on the neck, ref SDS 0 LH7M, and citing
590469 - analysis on 051007. ref SDS 80 I482
590471 - ..
590472 - He hugged and congratulated Millie for strong response to treatment
590473 - recovering from stage IV cancer, per discussion above on metastatic
590474 - disease. ref SDS 0 LH7M
590476 - ..
590477 - On 051027 the surgeon advised that Millie would require being off
590478 - chemotherapy for 3 - 4 weeks after surgery on 051021. ref SDS 89 AO6N
590479 - This requirement has now been met, suggesting that if relapse occurs
590480 - now, Millie can get immediate treatment; however, the matter was not
590481 - expressly discussed today, since there is still no evidence of
590482 - disease, as shown by favorable CA 15-3 testing. ref SDS 0 GJ5M
590483 -
590484 - [On 051125 Millie reported slight seepage from the surgical
590485 - wound, only evident in stained clothing. ref SDS 91 025H Kaiser
590486 - was notified. ref SDS 91 LC7M
590488 - ..
590489 - [On 051129 Millie reported further slight seepage. ref SDS 92
590490 - 025H
590492 - ..
590493 - [On 051129 Diane at Kaiser called back; she contacted the
590494 - surgeon, and reported later than a meeting is scheduled for
590495 - 051202 to review the problem. ref SDS 92 JG7G
590497 - ..
590498 - [On 051202 surgeon examination to determine cause of slight
590499 - seepage; speculates may arise from drain tube system removed
590500 - today. ref SDS 94 XO8O
590502 - ..
590503 - Doctor scheduled follow up examination on 060106, per below.
590504 - ref SDS 0 PXXQ
590505 -
590506 -
590507 -
590508 -
590509 -
590510 -
5906 -
SUBJECTS
Stomach Muscle Pull Likely Discomfort New Below Right Breast No Trea
6203 -
620401 - ..
620402 - Discomfort Below Right Breast Likely Muscle Pull
620403 -
620404 - Follow up ref SDS 80 6R6G.
620405 -
620406 - Millie reported continued, mild discomfort occasionally occurs below
620407 - the right breast. The doctor found the spot, and again concluded this
620408 - is a minor muscle strain that can be treated with rest from heavy
620409 - lifting, and abrupt stretching.
620410 -
620411 -
620412 -
620413 -
620414 -
6205 -
SUBJECTS
Pulmonary Emboli Blood Clots Treatment Ended with Coumadin Mistake f
7903 -
790401 - ..
790402 - Kaiser Policy Cancer Patients with Pulmonary Emboli Treated for Life
790403 - Pulmonary Emboli Treatment with Coumadin Ended for Patient with IBC
790404 - Coumadin Treatment Stopped for Patient with Cancer and Pulmonary Emboli
790405 -
790406 - Follow up ref SDS 80 RZ4I, ref SDS 67-RZ4I.
790407 -
790408 - Millie explained instructions received on 051026 from the Coagulation
790409 - Treatment Clinic in Martinez, placing Millie back on Coumadin (also
790410 - called "Warfarin"), and asked if the doctor has talked to Gloria about
790411 - this? ref SDS 88 PO7J
790413 - ..
790414 - Today, the doctor indicated that Millie no longer requires Coumadin
790415 - (Warfarin) treatment for reasons presented during the meeting on
790416 - 051007, in that blood clots were reported on 041104 when Millie was
790417 - being treated with Avastin chemotherapy drugs, and pulmonary emboli is
790418 - a documented side effect of Avastin. ref SDS 80 XN7K During the
790419 - meeting today, the doctor called Gloria and left a message for the
790420 - Anticoagulant Clinic to end Coumadin Treatments for Millie.
790422 - ..
790423 - Previously, on 051025 Gloria called Millie and advised that Kaiser
790424 - policy requires the doctor to submit formal notice, when a cancer
790425 - patient, like Millie, is removed from treatment for pulmonary emboli,
790426 - and that the doctor did not do this to confirm the doctor's prior
790427 - order on 051007 ending Coumadin treatment. ref SDS 88 VN6V
790428 -
790429 - [On 060217 medical chart continues showing Warfarin 4 MG still
790430 - listed as patient current medication. ref SDS 96 1265
790432 - ..
790433 - [On 060428 medical chart continues showing Warfarin 4 MB, listed
790434 - as patient current medications. ref SDS 98 1265
790436 - ..
790437 - [On 060623 medical chart continues showing Warfarin 4 MB still
790438 - listed as patient current medication. ref SDS 99 1265
790440 - ..
790441 - [On 060714 oldest son hospitalized again with pulmonary emboli.
790442 - ref SDS A1 8S6I
790444 - ..
790445 - [On 060722 oldest son reports doctors performed tests and found
790446 - genetic cause of blood clots that will require continuing
790447 - treatment. ref SDS 90 3D9T
790449 - ..
790450 - [On 060722 research 10% pulmonary emboli patients have recurrence,
790451 - and 45% of those who suffer recurrence die, indicating high risk
790452 - that supports continuing treatments to avoid recurrence.
790453 - ref SDS A2 BI5J
790455 - ..
790456 - [On 060724 notified Kaiser of new information on family history of
790457 - blood clot problems. ref SDS A3 NL5Q
790459 - ..
790460 - [On 060726 letter from Arlette says Kaiser received notice and
790461 - forwarded to primary care physician. ref SDS A4 0001
790463 - ..
790464 - The doctor further explained that hypercoagulable state work up
790465 - recommended in the 2nd opinion from Doctor Bailey reviewed previously
790466 - on 051007, ref SDS 80 LN6O, and received from Doctor Bailey on 050922,
790467 - ref SDS 70 XD9X, is not required for the same reasoning that Coumadin
790468 - treatment is ended. This concludes action item from meeting with the
790469 - surgeon on 051027. ref SDS 89 6G6I
790470 -
790471 - [On 060724 notified Kaiser of new information on family history of
790472 - blood clot problems. ref SDS A3 NL5Q
790474 - ..
790475 - [On 060722 research 10% pulmonary emboli patients have recurrence,
790476 - and 45% of those who suffer recurrence die, indicating high risk
790477 - that supports continuing treatments to avoid recurrence.
790478 - ref SDS A2 BI5J
790480 - ..
790481 - [On 061002 Millie diagnosed with pulmonary emboli by CT test;
790482 - doctor prescribes Coumadin (Warfarin) treatments resumed.
790483 - ref SDS A5 MI5I
790484 -
790485 -
790486 -
790487 -
790488 -
790489 -
7905 -
SUBJECTS
Treatment Plan Testing for Relapse Patient NED Metastatic Cancer Tre
A303 -
A30401 - ..
A30402 - Treatment Plan Testing for Relapse Patient NED Metastatic Cancer
A30403 - Holiday Treatment Patient NED Test for Relapse Metastatic Cancer
A30404 -
A30405 - Follow up ref SDS 80 AW5G, ref SDS 67 AW5G.
A30406 -
A30407 - On 051027 surgeon reported successful mastectomy, and planned to
A30408 - notify the Oncology Department about continuing treatment of Millie.
A30409 - ref SDS 89 2562
A30411 - ..
A30412 - Since Millie is NED (no evidence of disease), per discussion of CA
A30413 - 15-3 above, ref SDS 0 GJ5M, citing favorable PET scan test on 051005,
A30414 - and reported on 051007, ref SDS 80 L66M, and further findings from
A30415 - examination, also, above, ref SDS 0 GV6K, the doctor advised that no
A30416 - treatment is required at this time. She will have a "treatment
A30417 - holiday" until disease progresses.
A30419 - ..
A30420 - Favorable response to treatment with Taxotere and capecitabine
A30421 - (Xeloda), presents opportunity for continuing this protocol, if
A30422 - disease relapses.
A30424 - ..
A30425 - Testing for relapse based on prognosis of metastatic cancer, per
A30426 - above, ref SDS 0 8R6M, is primary treatment concern going forward,
A30427 - also, planned above. ref SDS 0 FV6L
A30428 -
A30429 -
A30430 -
A30431 -
A30432 -
A30433 -
A305 -
SUBJECTS
Port Catheter Flush Scheduled by Kaiser to Maintain Chemo Treatment
A503 -
A50401 - ..
A50402 - Port Catheter Flush Scheduled by Kaiser to Maintain Chemo Treatment
A50403 -
A50404 - Follow up ref SDS 86 QW3M, ref SDS 90 918G.
A50405 -
A50406 - Since Millie is off treatment, she needs to have her port flushed, per
A50407 - planning on 051007, ref SDS 86 QW3M, and discussed with the surgeon on
A50408 - 051027. ref SDS 90 918G During the meeting today, the doctor provided
A50409 - a schedule of tasks, and this has included a visit to the chemo
A50410 - therapy clinic for a port flush on 051202 1030.
A50411 -
A50412 - [On 060106 port flush was performed in conjunction with follow up
A50413 - examination by the doctor. ref SDS 95 SH5N
A50414 -
A50415 -
A50416 -
A50417 -
A50418 -
A50419 -
A505 -
SUBJECTS
Status Test for Change ER PR HER2/neu from Negative to Positive Trea
A703 -
A70401 - ..
A70402 - Status Change Retest Biopsy 040419 Treatment Options
A70403 - Treatment Options Status Change Retest Biopsy 040419
A70404 -
A70405 - Follow up ref SDS 80 ZR6J.
A70407 - ..
A70408 - Millie related discussion with the surgeon on 051022 on retesting the
A70409 - biopsy taken 040419 for changing status to increase treatment options;
A70410 - the surgeon indicated having ordered the retest, but had still not
A70411 - received results, and so planned to inquire with the pathology
A70412 - laboratory on progress completing the assignment. ref SDS 86 NE9J
A70414 - ..
A70415 - On 051027 surgeon examined Millie and had not received results of
A70416 - retesting for status change; so, she planned to check with the
A70417 - pathology department on finding correct biopsy slide to test.
A70418 - ref SDS 89 964L
A70420 - ..
A70421 - Today, the primary care physician checked Kaiser's computer. He found
A70422 - there is an order on file for the Pathology Department to retest the
A70423 - biopsy on 040419 for status change, but there is no report on results
A70424 - of the retest.
A70426 - ..
A70427 - During the meeting, the doctor called the Pathology Department and
A70428 - left a message asking to expedite the order on retesting for status
A70429 - change.
A70431 - ..
A70432 - [On 051123 doctor called Millie and related information on
A70433 - Hercepton treatment, which could have indicated positive test
A70434 - results, but the call seems to have been a mistake, and so
A70435 - further follow up is required. ref SDS 91 OT5H
A70437 - ..
A70438 - [On 060711 primary care physician found status change report
A70439 - for the biopsy on 040419 was in Kaiser's computer in a location
A70440 - that required training and experience to access, and showed no
A70441 - change in status. ref SDS A0 SW7O
A70442 -
A70443 -
A70444 -
A70445 -
A705 -
SUBJECTS
Disability Patient No Evidence of Disease Approves Patient Can Retur
Disability Documents Prepared to Work Three (3) Days Per Week Cancer
AD04 -
AD0501 - ..
AD0502 - Disability Recovery from Cancer Millie Returning to Work
AD0503 -
AD0504 - Follow up ref SDS 80 J29L, ref SDS 71 0001.
AD0505 -
AD0506 - Millie advised she is planning to begin working in the first week in
AD0507 - December.
AD0509 - ..
AD0510 - The doctor indicated that the examination today indicates that
AD0511 - recovery from surgery and from cancer show substantial progress, based
AD0512 - on findings today that the patient shows no evidence of disease (NED,
AD0513 - per above, ref SDS 0 GJ5M, and that if this continues, he would
AD0514 - approve resuming normal activities.
AD0515 -
AD0516 - [On 051202 surgeon examination finds NED status continues, and
AD0517 - approves patient for return to work. ref SDS 94 LY99
AD0518 -
AD0519 -
AD0520 -
AD0521 -
AD0522 -
AD06 -
SUBJECTS
Doctor/Patient Partnership Communications Supported with Email Meeti
AH03 -
AH0401 - ..
AH0402 - Email Communications Facilitate Doctor/Patient Partnership
AH0403 - Doctor/Patient Partnership Communications Supported with Email
AH0404 -
AH0405 - Follow up ref SDS 80 OH9L.
AH0406 -
AH0407 - Background on 020402 doctor's staff advised there is not enough time
AH0408 - for the doctor to review the record for feedback to verify accuracy of
AH0409 - communications. ref SDS 3 2W4F The doctor commented on Kaiser's
AH0410 - efforts to implement requirements for communications in the Healthwise
AH0411 - Handbook, during a meeting on 020726. ref SDS 11 ST6F On 040504
AH0412 - discussed opportunity to improve productivity with Communication
AH0413 - Metrics. ref SDS 28 0001 On 040614 the doctor indicated that email
AH0414 - cannot be used for timely communication. ref SDS 31 NO6O On 041130
AH0415 - there was objection to providing written work plan. ref SDS 3 LG9F
AH0417 - ..
AH0418 - On 050520 the doctor began capturing a legible record on Kaiser's
AH0419 - computer, and disclosed Kaiser's plans to equip patient examination
AH0420 - rooms with ergonomic work stations for efficiently investing
AH0421 - intellectual capital. ref SDS 54 HX6J
AH0423 - ..
AH0424 - Today, the doctor advised that Kaiser has a new business system for
AH0425 - electronic transmission of communication to support the doctor/patient
AH0426 - partnership. This aligns with Kaiser's Healthwise Handbook calling
AH0427 - for effective communications, reviewed on 990625. ref SDS 1 4185
AH0428 -
AH0429 - [On 060106 Kaiser progress toward working intelligently; doctor
AH0430 - uses new Knowledge Management email system for submitting work
AH0431 - plan to patient drawn from electronic medical chart stored on
AH0432 - Kaiser's computer. ref SDS 95 FE4I
AH0434 - ..
AH0435 - [On 060106 Kaiser's internal email system still too inefficient
AH0436 - for clear, concise, complete communication, essential for
AH0437 - coordinating work with uniform distribution to involved parties in
AH0438 - time to be effective saving lives, time, and money. ref SDS 95
AH0439 - 1O8F
AH0441 - ..
AH0442 - [On 060217 Kaiser begins implementation; needs more experience and
AH0443 - expanded use of electronic communication to save time and money.
AH0444 - ref SDS 96 8V8M
AH0446 - ..
AH0447 - [On 060320 Kaiser electronic communication does not yet support
AH0448 - full communication; patient uses standard electronic communication
AH0449 - for feedback on issues in meeting on 060217. ref SDS 97 NL4H
AH0451 - ..
AH0452 - [On 060428 doctor begins making electronic distribution of
AH0453 - computer medical chart for collaboration with the patient.
AH0454 - ref SDS 98 FE4I
AH0456 - ..
AH0457 - [On 061218 cursory generalizations impede communication reduces
AH0458 - effectiveness doctor patient partnership causing poor health care.
AH0459 - ref SDS A6 VW7O
AH0460 -
AH0461 -
AH0572 -
AH0573 -
AH0574 -
AH0575 -
AH0576 -
AH0577 -
AH0578 -
AH0579 -
AH06 -