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: June 7, 2006 08:30 AM Wednesday; Rod Welch

Doctor analysis of rising CA 15-3 likely cancer; planning treatment.

1...Summary/Objective
2...Comparison CT Test 060505 with PET Test 060414 Not Evident
3...CA 15-3 Rises to 59 Requires Close Scrutiny Plan Treatment
4...Treatment Plan Avoid Cancer Cascading Out of Control CA 15-3 59
5...Meetings Be Prepared Submit Analysis Theories to Guide Discussions
6...104+ Temperature Treatment Emergency Room Kaiser Walnut Creek
7...Registration for Admittance to Emergency Room Examination
8...Esophagitis Diagnosis Inquiry by Attending Physician
9...Radiation Treatment May Induce Esophagitis Leading to Pneumonia
10...Pneumonia May Occur with Esophagitis Symptoms from Radiation Treatment
11...Cruise Ship Crew Quarentined with Illness May Have Infected Millie
12...Took Marilyn Home
13...Xray Test Shows Penumonia Lower Left Lung Diagnosis
14...Penumonia Diagnosis Millie Admitted to Hospital


..............
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CONTACTS 

SUBJECTS
Cancer Relapse Bones Lymph Nodes Treatment Planning CA 15-3 Rising T

2103 -
2103 -    ..
2104 - Summary/Objective
2105 -
210501 - Follow up ref SDS 91 0000. ref SDS 89 0000.
210502 -
210503 -
210504 -
210505 -
210506 -
210508 -  ..
2106 -
2107 -
2108 - Progress
2109 -
210901 - Comparison CT Test 060505 with PET Test 060414 Not Evident
210902 -
210903 - Follow up ref SDS 91 4C6G, ref SDS 89 4C6G.
210904 -
210905 - Millie received ref DRT 1 0001 dated yesterday, 060606 from the
210906 - primary care physician responding to Millie's letter, ref DIP 6 0001
210907 - submitted on 060605, and asking for analysis of cancer relapse in
210908 - light of CA 15-3 rising to 59 on accelerating path. ref SDS 91 EB4J
210910 -  ..
210911 - The doctor says...
210912 -
210913 -    1.  Here is my response, ref DRT 1 0001, [...to your letter dated
210914 -        June 5, 2006, ref DIP 6 0001, requesting further analysis
210915 -        comparing the CT test on May 5th with the PET scan test on
210916 -        April 14, 2006, ref DIP 6 XK6O; and further asking for comments
210917 -        on implications of cancer relapse based on rising CA 15-3.
210918 -        ref DIP 6 Y67I].
210920 -  ..
210921 - For some reason the doctor does not respond to the request on 060605,
210922 - ref SDS 91 UQ5X, still pending from the letter on 060526 to analyse
210923 - rising CA 15-3 by obtaining further analysis of the CT test comparing
210924 - with the PET scan test on 060414, ref SDS 89 JD5K, as requested by the
210925 - analyst of PET scan test, reported on 060428. ref SDS 81 K64X
210926 -
210927 -            [On 060623 attention completing contrast study diverted by
210928 -            new symptoms of IBC rash. ref SDS 94 6X3N
210930 -  ..
210931 - During the meeting on 060428 the doctor tried to make a direct
210932 - examination using the computer in the examination room to compare the
210933 - CT and PET scan tests, but had problems using the system.  There
210934 - seemed to be a plan for the doctor to follow up when there was more
210935 - time after the meeting. ref SDS 81 L66H  Has the doctor done this
210936 - analysis?  If so, what was found?
210937 -
210938 -
210940 -  ..
210941 - CA 15-3 Rises to 59 Requires Close Scrutiny Plan Treatment
210942 - Treatment Plan Avoid Cancer Cascading Out of Control CA 15-3 59
210943 - Meetings Be Prepared Submit Analysis Theories to Guide Discussions
210944 -
210945 - Follow up ref SDS 91 EB4J.
210947 -  ..
210948 - Doctor's letter continues...
210949 -
210950 -    2.  Where might cancer be forming that is not captured by image
210951 -        tests, (bone or LN's) or might cancer have been captured, but
210952 -        simply overlooked in the review process (yes, imaging studies
210953 -        are not 100%)?  Can CA 15-3 rise continuously, and there be no
210954 -        cancer (No)? ref DRT 1 GX6H
210956 -  ..
210957 - "LN" seems like "lymph nodes," since this has been a common location
210958 - for cancer in patient history, beginning with surger on 020312, as
210959 - listed on 050812. ref SDS 60 TW6H
210961 -  ..
210962 - Extensive patient history shows swelled lymph nodes occurring with
210963 - rising CA 15-3.  There is no previous record in this case of rising CA
210964 - 15-3, swelled lymph nodes, and no identification by image testing, nor
210965 - patient awareness of swelling.
210967 -  ..
210968 - Can deminimus activity found in the PET scan test on 060416, and
210969 - reported on 060428, ref SDS 81 OX68, and more recently in the CT test
210970 - received on 060523 showing no evidence of cancer by size criteria,
210971 - ref SDS 86 014T, be sufficient to increase CA 15-3 from 28 in December
210972 - 2005, to 59 in May, 2006? (see the record on 060605, ref SDS 91 EB4J)
210973 - In other words, Can metastatic cancer be forming broadly throughout
210974 - the body with accumulated effect that increases CA 15-3 cancer marker,
210975 - even though there is no one location that is significant enough to be
210976 - identified by image testing?  Or, is it more likely that cancer is
210977 - occurring with elevated mass that has simply been missed by the image
210978 - tests?
210979 -
210980 -     [On 060711 doctor seemed to mention "total cancer burden" that can
210981 -     drive up cancer marker, without cancer being large enough to show
210982 -     up in image testing; IBC typically only appears in image testing
210983 -     as "thickened skin." ref SDS 95 YO6I
210985 -      ..
210986 -     [On 050711 research another case of IBC relapse; CA 15-3 above
210987 -     300, and no evidence of cancer in image tests. ref SDS 95 R34G
210989 -  ..
210990 - Should CT test on 060505 be correlated with the PET test on 060414 to
210991 - verify status of right axillary and left supraclavicular, per requests
210992 - pending above? ref SDS 0 EB9J
210994 -  ..
210995 - Millie had a bone scan test on 020613; results were submitted during
210996 - the meeting on 020628 and no problems were reported.  She had a brain
210997 - scan test about the same time, and no cancer was found, listed in the
210998 - study on 050812. ref SDS 60 KV4L
211000 -  ..
211001 - Bone scan on 040429 found no evidence of cancer, submitted during the
211002 - meeting on 040713, as listed in the study on 050812. ref SDS 60 YE9F
211004 -  ..
211005 - Currently, there are no signs of inflammation nor lumps in either
211006 - breast, suggesting of IBC relapse.
211008 -  ..
211009 - Should bone scan test, and full body PET test of head and lower
211010 - extremeties be performed to search for cancer in order to design a
211011 - treatment?
211013 -  ..
211014 - Doctor's letter continues...
211015 -
211016 -    3.  It is probably time to discuss a plan for our next round of
211017 -        chemo.  However, if you are not having symptoms from the cancer
211018 -        and there are no radiology images to correlate, it may be
211019 -        premature to start now.
211021 -  ..
211022 - Fortunately, Millie feels great.
211024 -  ..
211025 - Teatment plan should minimize risk of general and emergent metastic
211026 - cancer reaching critical mass that cascades out of control.
211027 -
211028 -
211030 -  ..
2111 -
2112 -
2113 - 1405
2114 -
211401 - Millie submitted ref DIT 1 0001 responding to the doctor's letter,
211402 - ref DRT 1 0001, per above. ref SDS 0 4C6G
211403 -
211404 -    1.  Thanks very much for your letter yesterday discussing
211405 -        rising CA 15-3. Into the mix, I had to come home from
211406 -        work today. About 1000 I felt very warm, then got the
211407 -        chills. I came home at 1300. My temp is 102.4. I will
211408 -        call Arlette for guidance on this.
211410 -         ..
211411 -    2.  Up until today, I have felt great. There are still no
211412 -        signs of lumps or inflammation that have signaled cancer
211413 -        previously with rising CA 15-3.
211415 -         ..
211416 -    3.  Treatment planning sounds attractive. I have to run now.
211418 -         ..
211419 -    4.  Thanks for your help.
211420 -
211421 -
211422 -
211423 -
211424 -
211425 -
211426 -
2115 -

SUBJECTS
104+ Temperature Emergency Room Treatment Diagnosis Pneumonia Treate

3703 -
3704 - 1409
370501 -  ..
370502 - 104+ Temperature Treatment Emergency Room Kaiser Walnut Creek
370503 -
370504 - Millie came home from work early today.
370506 -  ..
370507 - She reported feeling uncomfortable leaving for work this morning.
370509 -  ..
370510 - About 0800 to 0900 Millie began to feel warm, and then overheated.
370512 -  ..
370513 - About 1000 she got the chills, but continued working.  At about 1245
370514 - she was chilled and shaking, and so came home.
370516 -  ..
370517 - She arrived home still feeling chilled.  She was wobbly on her feet.
370519 -  ..
370520 - Her temperature is 102.4.
370522 -  ..
370523 - Marilyn reported that Millie seemed to catch a cold and did not feel
370524 - well the past few days of the cruise to Alaska.  When they returned on
370525 - Monday, 060605, ref SDS 90 0001, Millie seemed to be on the mend.  She
370526 - did not report any problems., and looked well.
370528 -  ..
370529 - Today, she seems to have relapsed.
370531 -  ..
370532 - Millie took two asprin to bring her temperature down.  She went to
370533 - bed.
370535 -  ..
370536 - Elevated temperature above 100.5 fits the parameter for calling Kaiser
370537 - when stage IV cancer patient has elevated temperature, reported
370538 - previously on 041202. ref SDS 44 IX9N  This happened again due to a
370539 - cat bite on 050212. ref SDS 48 5V8J
370540 -
370541 -    [On 070216 instructions call UCSF for emergency high fever
370542 -    spreading rash IBC cellulitis; conflicts with Kaiser instructions.
370543 -    ref SDS 98 UW9I
370545 -  ..
370546 - Called Kaiser Advice Nurse at the Oncology clinic...
370547 -
370548 -                       680 295 4030
370550 -  ..
370551 - Talked to Becky.
370553 -  ..
370554 - She said that since Millie is a stage IV cancer patient she should go
370555 - to the emergency room, even though she has been off treatment for 7
370556 - months, since 050916. ref SDS 62 407N
370557 -
370559 -  ..
3706 -
3707 -
3708 - 1422
3709 -
370901 - Temperature taken again.  It shows 104.2.
370902 -
370903 - Millie dressed, and we drove to Kaiser in Walnut Creek.
370905 -  ..
370906 - At the ER, Millie was seen very quickly by Doctor Geya (spelling???)
370907 - in the Emergency Room (ER).
370909 -  ..
370910 - The doctor made preliminary review of symptoms by asking Millie a
370911 - number of diagnostic questions.  This exercise yielded no specific
370912 - medical condition.  The doctor commented how well Millie looks for a
370913 - women of 70 with stage IV cancer.  The doctor indicated that, since
370914 - Millie is not currently being treated with chemotherapy, ordinarily
370915 - elevated temperature alone does not require ER treatment.
370917 -  ..
370918 - Reviewed recent patient history showing cancer marker CA 15-3 rising
370919 - to 59 and current considerations to begin treatment, presented earlier
370920 - today by the oncologist, per above. ref SDS 0 D45K  The doctor checked
370921 - Kaiser's computer, and evidently was able to verify cancer patient
370922 - Stage IV status.  He then decided to admit Millie for further
370923 - examination due to status of elevated temperature and evident relapse
370924 - of stage IV cancer, and as required by Kaiser policy, cited above,
370925 - ref SDS 0 H565, as further recommended by the Oncology Department
370926 - Advise Nurse, Becky, per above. ref SDS 0 LM9O
370927 -
370928 -        [On 060711 diagnosed IBC recurrence, ref SDS 95 025H, patient
370929 -        begins chemotherapy treatment on 060721. ref SDS 96 0001
370930 -
370931 -
370933 -  ..
3710 -
3711 -
3712 - 1450
3713 -
371301 - Registration for Admittance to Emergency Room Examination
371302 -
371303 - Christy took vitals and prepared additional admitting documents.
371304 -
371305 - Blood pressure normal, but pulse was 89, which is very high for
371306 - Millie, usually at 60.
371308 -  ..
371309 - Temperature showed 101.4.  Since we have had experience with incorrect
371310 - vital diagnostics using Kaiser equipment, and since 101.4 is a
371311 - significant drop from 104.2 in a short time, there was discussion to
371312 - take vitals again.  Christy did this a few minutes later and the
371313 - temperature was 102.2, which is a relief dropping from 104.2 earlier,
371314 - per above. ref SDS 0 044G
371315 -
371316 -
371318 -  ..
3714 -
3715 -
3716 - 1517
3717 -
371701 - Millie's good friend Marilyn is visiting from Chicago this week, and
371702 - so came to the hopsital with Millie.  Went to the waiting room and
371703 - briefed Marilyn on progress.
371704 -
371705 -
371707 -  ..
3718 -
3719 -
3720 - 1527
3721 -
372101 - Blood tests were taken by Cellia.  I explained patient history of
372102 - trauma to the left arm from a lot of blood draws the past few years.
372103 - We discussed using the port catheter to avoid this problem.  Cellia
372104 - said this would require calling a specialist.  She is not qualified to
372105 - draw blood from a port.  Cellia was careful finding a good vein, and
372106 - so this blood draw was completed without problems on the first
372107 - attempt.
372109 -  ..
372110 - Waiting for results.
372112 -  ..
372113 - An attendant came and processed payment.  Millie paid $50 co-pay with
372114 - credit card.
372115 -
372116 -
372117 -
372119 -  ..
3722 -
3723 -
3724 - 1609
3725 -
372501 - Millie admitted into an emergency room, waiting for examination.
372502 -
372503 - Attending physician. has not yet arrived...
372504 -
372507 -  ..
372508 - Nurse Zorgy talked to Millie initially, but was going off shift.
372510 -  ..
372511 - Andrea took over and did an outstanding job, beginning with entering a
372512 - work plan on the marking board.  This engaged the patient with the
372513 - medical team, as called out in Kaiser's Healthwise Handbook, reviewed
372514 - on 990625, ref SDS 4 4185, to avoid mixups in treatment and
372515 - communications, common in high pressure hospital work, reported in the
372516 - study on 990912. ref SDS 5 0001
372518 -  ..
372519 - Though she was constantly busy treating other patients, Adnrea was
372520 - attentive and timely providing assistance when requested.  She was
372521 - very helpful explaining the steps in the process and getting updates
372522 - from the doctor on progress of the work.  This avoided anxiety during
372523 - long lapses between treatment activity about being forgotten or
372524 - ignored.
372525 -
372526 -     [On 060615 letter to Kaiser commends nursing staff in the ER.
372527 -     ref SDS 93 TB4X
372529 -  ..
372530 - Went to the waiting room and briefed Marilyn again.
372531 -
372532 -
372534 -  ..
3726 -
3727 -
3728 - 1618
3729 -
372901 - Millie had another blood draw from port.
372902 -
372903 - James made the connection to the port, and said he has experience from
372904 - treating other cancer patients in the ER department.
372905 -
372906 -     [On 061027 follow up visit to ER there were problems connecting to
372907 -     the port catheter. ref SDS 97 OK4J
372909 -  ..
372910 - A second blood draw is a cross check on the first blood draw by
372911 - Cellia, ref SDS 0 YS6O, for quality control to avoid mis-diagnosis
372912 - from getting blood containers mixed up handling a lot of patients.
372913 - They are looking for both blood reports to read the same, and if there
372914 - are differences, they do another draw to break the tie.
372916 -  ..
372917 - IV connected to port to restore fluids.
372918 -
372919 -
372920 -
3730 -

SUBJECTS
Esophagitis Diagnosis Inquiry by Attending Physician Kaiser Computer

6103 -
6104 - 1715
610501 -  ..
610502 - Esophagitis Diagnosis Inquiry by Attending Physician
610503 - Radiation Treatment May Induce Esophagitis Leading to Pneumonia
610504 - Pneumonia May Occur with Esophagitis Symptoms from Radiation Treatment
610505 -
610506 - Millie was taken to the imaging department to get a chest xray.
610508 -  ..
610509 - The attending physician arrives. ref SDS 0 K64F  Since Millie was
610510 - taken for an xray, the doctor asked a series of questions to prepare
610511 - initial patient profile for diagnosis.
610513 -  ..
610514 - The doctor asked how Millie has been treated for esophagitis, and for
610515 - how long?  She seemed to indicate that esophagitis contributed or
610516 - otherwise compounds the pneumonia condition (diagnosed later, per
610517 - below. ref SDS 0 PT7S)
610518 -
610519 -            [On 060711 primary care physician reports patient has not
610520 -            been diagnosed with esophagitis on the basis of imaging
610521 -            tests, since patient reports only mild, occassional
610522 -            symptoms. ref SDS 95 JP6K
610524 -  ..
610525 - Correlations with cancer marker CA 15-3 rising to 59 on an
610526 - accelerating path, cited by primary care physician earlier today, per
610527 - above, ref SDS 0 4C6G, and for stage IV breast cancer patient were not
610528 - considered in this discussion of pneumonia and esphagatius symptoms.
610530 -  ..
610531 - There was discussion of patient history showing that Millie has not
610532 - been treated for esophagitis.
610534 -  ..
610535 - Esophagitis was cited in the PET scan test report for 060120, reviewed
610536 - in the record on 060126. ref SDS 71 DH4O  A letter to the doctor on
610537 - 060330 reports patient history of occassional symptoms consistant with
610538 - PET scan test findings of esophagitis. ref SDS 75 X93U  On 060428 a
610539 - report on follow up PET scan testing performed on 060414 did not
610540 - compare prior findings on esophagitis; patient reported mild
610541 - infrequent symptoms; treatment was deferred pending rise of symptoms.
610542 - ref SDS 81 PR9J
610543 -
610544 -     [On 060623 doctor unable to access computer to review test
610545 -     findings on esophagitis. ref SDS 94 463H
610547 -      ..
610548 -     [On 060623 medical chart says esophagitis not symptomatic,
610549 -     ref SDS 94 7M5H; there is no record of receiving the letter
610550 -     submitted today, 060320, listing symptoms, per above.
610551 -     ref SDS 75 X94Q
610553 -  ..
610554 - There is no record of Millie having been diagnosed with esophagitis.
610555 - The doctor was asked for the basis of inquiry in this matter?
610557 -  ..
610558 - The doctor said that Kaiser's computer shows Millie has been diagnosed
610559 - with esophagitis.
610560 -
610561 -     [On 060608 discussed with attending physician in Respiratory
610562 -     Department. ref SDS 92 MK3H
610563 -
610564 -     [On 060615 letter to Kaiser commends the doctor's excellent
610565 -     treatment, and team care in ER. ref SDS 93 TB9X
610567 -  ..
610568 - Following this meeting, research on the Internet found a study
610569 - reported on...
610570 -
610571 -               ClinicalTrials.gov
610572 -
610573 -              http://www.clinicaltrials.gov/ct/gui/show/NCT00081315;jsessionid=3C64D00452512704ACB772AF635CAC5D?order=40
610574 -
610575 -    ...which says in part...
610577 -     ..
610578 -    Subcutaneous Amifostine (Ethyolr) in the Prevention of
610579 -    Radiochemotherapy-Induced Esophagitis and Pneumonitis in Patients
610580 -    With Unresectable Non-Small Cell Lung Cancer
610581 -
610582 -       Note.. "pneumonitis" is an alternate name for pneumonia, per
610583 -       research below. ref SDS 0 NT3O
610585 -     ..
610586 -    Purpose
610588 -     ..
610589 -    The primary objective of this study is to assess the activity of
610590 -    subcutaneous (SC) amifostine on the incidence and severity of
610591 -    acute radiochemotherapy-induced esophagitis in patients with
610592 -    unresectable Stage IIIA or IIIB non-small cell lung cancer (NSCLC)
610593 -    receiving combined modality therapy.
610595 -     ..
610596 -    More Information
610597 -
610598 -        Study ID Numbers:  MI-CP079
610599 -        Last Updated:  March 9, 2006
610600 -        Record first received:  April 7, 2004
610601 -        ClinicalTrials.gov Identifier:  NCT00081315
610602 -        Health Authority: United States: Food and Drug Administration
610603 -        ClinicalTrials.gov processed this record on 2006-06-07
610605 -  ..
610606 - The study started November 2003, and seems to be underway, so no
610607 - results are reported.
610609 -  ..
610610 - This research indicates possible correlation between esophagitis and
610611 - pneumonia, and further that esophatatis may be induced by radiation
610612 - treatment.  Millie received radiation treatment for breast cancer to
610613 - the ches area during the period from 020708, reported on, ref SDS 14
610614 - 0001, including two (2) additional "booster" treatments. ref SDS 14
610615 - AN6I  Radiation treatment was concluded on 020910, reported on 020924.
610616 - ref SDS 16 0J7H  On 040402 reaction to radition treatment caused
610617 - redness of breast treated with radiation, that delayed start of
610618 - chemotherapy treatment by 2 weeks. ref SDS 32 8T5O
610619 -
610620 -
610622 -  ..
610623 - Cruise Ship Crew Quarentined with Illness May Have Infected Millie
610624 -
610625 - Marilyn was admitted in the treatment area, and joined the discussion
610626 - at this time.  She explained that Millie was not feeling well during
610627 - the vacation cruise to Alaska beginning about 5 days ago, which was
610628 - about 4 days into the trip that begain on 060526. ref SDS 88 0001
610630 -  ..
610631 - Marilyn related that the cruise line notified passengers that some
610632 - members of the crew had been quarentined with some form of illness,
610633 - which was not presented in the announcement.  Some areas of the ship
610634 - were placed off-limits, and passengers were asked to take precautions
610635 - entering common areas like dining rooms by wearing sanitary gloves.
610636 -
610637 -
610638 -
610640 -  ..
6107 -
6108 -
6109 - 1743
6110 -
611001 - Took Marilyn Home
611002 -
611003 - This was a long day.  Not clear how much longer this would continue,
611004 - so Marilyn discussed going home.
611005 -
611006 - While Millie was getting an xray, drove Marily home.  She called Pam
611007 - to let her know what has happened today.  Fed the cats.
611009 -  ..
611010 - Talked to James.  He will tell Millie that Marily was taken home.
611011 -
611012 -
611013 -
611015 -  ..
6111 -
6112 -
6113 - 1900
6114 -
611401 - Xray Test Shows Penumonia Lower Left Lung Diagnosis
611402 - Penumonia Diagnosis Millie Admitted to Hospital
611403 -
611404 -
611405 - Doctor Natchak examines Millie.
611407 -  ..
611408 - The doctor advised that initial diagnosis is pneumonia based on chest
611409 - xray and blood counts.  White blood cell count is up, indicating her
611410 - immune system is fighting an infection.  The xray found fluid in the
611411 - lower left lobe of the lungs, consistent with pneumonia, and possibly
611412 - related to esophagatis, discussed above. ref SDS 0 K66E
611413 -
611414 -        [On 060615 letter to Kaiser commends the doctor's excellent
611415 -        treatment, and team care in ER. ref SDS 93 TB9X
611417 -         ..
611418 -        [On 060711 follow up xray shows pneumonia resolved, lungs
611419 -        clear. ref SDS 95 FF3K
611421 -  ..
611422 - Research on the Internet defines pneumonia...
611423 -
611424 -              http://health.allrefer.com/health/pneumonia-info.html
611425 -
611426 -    Pneumonia is an inflammation of the lungs caused by an infection.
611427 -    Many different organisms can cause it, including bacteria, viruses,
611428 -    and fungi.
611430 -     ..
611431 -    Pneumonia is a common illness that affects millions of people each
611432 -    year in the United States.
611434 -     ..
611435 -    Pneumonia can range from very mild to very severe, even fatal.  The
611436 -    severity depends on the type of organism causing pneumonia as well
611437 -    as your age and underlying health.
611439 -     ..
611440 -    Alternate Names:
611441 -
611442 -        Bronchopneumonia,
611443 -        Community-Acquired Pneumonia,
611444 -        Pneumonitis
611446 -  ..
611447 - Doctor Natchak consulted with the ER admitting team, and they decided
611448 - that patient history in this case requires that Millie should stay in
611449 - the hospital for treatment.
611450 -
611451 -        [On 060615 letter to Kaiser commends the doctor's excellent
611452 -        treatment, and team care in ER. ref SDS 93 TB9X
611454 -  ..
611455 - Patient factors that require monitoring and control release to go
611456 - home are...
611457 -
611458 -        temperature
611459 -        blood counts come down - white blood cells
611460 -        oxygenation
611462 -  ..
611463 - Millie wants notice to the following...
611464 -
611483 -  ..
611484 - Purse and cell phone on dining room table, take upstairs, and plug
611485 - cell phone in to re-charge the battery.
611486 -
611487 -
611488 -         1.  Cell phone
611489 -
611490 -             Eye drops... Timinol
611491 -
611492 -                Andrea said that the hospital will provide eye drops
611494 -              ..
611495 -             Moisture Mary Kay with pink top
611497 -  ..
611498 - Decided to wait until tomorrow
611499 -
611501 -  ..
6116 -
6117 -
6118 - 1953
6119 -
611901 - Millie getting hungry.  Talked to doctor who was working on a computer
611902 - in the ER administration common area.  She said that Millie is cleared
611903 - to eat.  A nurse said that Millie can order a meal from the hospital
611904 - kitchen menu; or, we can bring in something she would like, for
611905 - example a hamburger and fries.  The doctor said there is no
611906 - restriction on eating.
611908 -  ..
611909 - Millie wanted a hamburger.
611911 -  ..
611912 - Went to the cafeteria and ordered a cheeseburger, fries, and a coke.
611913 -
611914 -
611916 -  ..
6120 -
6121 -
6122 - 2021
6123 -
612301 - We had a sort of picnik in the examination room of the Emergency
612302 - Room.
612304 -  ..
612305 - The nurse, Andrea, said it would likely be several more hours before
612306 - there is a room available for Millie in the hospital.  They plan to
612307 - move Millie to another room in the ER that is used for ER holdover
612308 - status.
612310 -  ..
612311 - Millie was getting cold, so Andrea brought her a blanket.
612312 -
612313 -
612314 -
612316 -  ..
6124 -
6125 -
6126 - 2042
6127 -
612701 - Andrea moved Millie into the "Yellow" area of ER.  She had been in the
612702 - "Blue" area room B12.
612704 -  ..
612705 - She said that Millie may be here for a few hours until a room is
612706 - available to admit Millie into the resperatory department of the main
612707 - hospital.
612708 -
612709 -     [On 060608 Millie was not moved into a permenant room until 0600
612710 -     the next day. ref SDS 92 PR5R
612712 -  ..
612713 - This room is bigger, and has a television.
612714 -
612716 -  ..
6128 -
6129 -
6130 - 2117
6131 -
613101 - Notified Millie's office that she will be out of the offfice for a few
613102 - days, per the list above. ref SDS 0 JX3I
613103 -
613104 -
613105 -
613106 -
613107 -
613108 -
613109 -
613110 -
613111 -
6132 -