CONTACTS 

SUBJECTS
2nd Opinion #3 Background Planning Strategy Treatment IBC Relapse Af
2nd Opinion #3 Planning Strategy Treatment IBC Relapse After Mastect

0504 -
0504 -    ..
0505 - Summary/Objective
0506 -
050601 - Follow up ref SDS 19 0000. ref SDS 17 0000.
050602 -
050603 - Develop request for input on options for treating IBC 3rd relapse.
050604 -
050605 -
050606 -
050607 -
050609 -  ..
0507 -
0508 -
0509 - Background
0510 -
051001 - Planning for 1st support opinion was developed on 041002. ref SDS 3
051002 - RI5I
051004 -  ..
051005 - Entitlement to a 2nd opinion is also listed on 041002, ref SDS 3 FA8O,
051006 - and Kaiser reported on 050727 that IBC is a rare disease; most
051007 - practitioners have limited experience. ref SDS 15 QJ3Q
051008 -
051009 -    This first support opinion cited case studies....
051010 -
051011 -        1.  Lump left arm.................... 040517, ref SDS 1 OW3I
051013 -             ..
051014 -        2.  IBC discovery treatment.......... 040517, ref SDS 1 2F4G
051016 -  ..
051017 - Letter prepared requesting 2nd opinion on 041002. ref SDS 3 K138
051019 -  ..
051020 - There is patient history communicating with Stanford Medical Center on
051021 - arranging 2nd opinions, reported on 041008, ref SDS 5 0001, and
051022 - followed up on with the Medical Center requesting medical records,
051023 - telecon on 041011. ref SDS 6 U186
051025 -  ..
051026 - Requested medical records from Kaiser business office, on 041007.
051027 - ref SDS 4 GI9F
051029 -  ..
051030 - Received medical records for 2nd opinion, reported on 041014.
051031 - ref SDS 7 0001
051032 -
051033 -        [On 060810 head nurse in Oncology ordered and assembled packed
051034 -        of documents for 2nd opinion #3. ref SDS 34 U76O
051035 -
051036 -        [On 061011 commend Kaiser and Arlette for extra work providing
051037 -        a packet of documents to facilitate 2nd opinion review by UCSF,
051038 -        reducing the cost by 30%. ref SDS 36 QY4I
051040 -      ..
051041 -     Medical records organized for submission to obtain 2nd opinions.
051042 -     ref SDS 7 PF7I
051044 -      ..
051045 -     Errors omissions in medical records. ref SDS 7 T49J
051047 -  ..
051048 - Commended work on 2nd opinion at Stanford, 051108. ref SDS 26 FR5J,
051050 -  ..
051051 - Commended work on 2nd opinion at UCSF, 051108. ref SDS 26 SJ5H
051052 -
051054 -  ..
051055 - Planning for 2nd support opinion, 050811. ref SDS 19 0001
051057 -      ..
051058 -     Case study for 2nd support opinion reported 050812. ref SDS 20
051059 -     0001
051061 -  ..
051062 - On 050819 letter to UCSF requesting 2nd opinion to backup Kaiser's
051063 - analysis. ref SDS 21 0001  On 050823 UCSF responded with referral to
051064 - surgeons in Berkeley. ref SDS 22 AI8N
051066 -  ..
051067 - On 050823 scheduled meetings with three (3) surgeons. ref SDS 22 0001
051069 -  ..
051070 - On 050907 problems with Business Office getting medical records again.
051071 - ref SDS 23 11D8
051073 -  ..
051074 - Objective is to prepare a letter requesting 2nd opinions, similar to
051075 - the letter on 041002. ref SDS 3 K138
051077 -  ..
051078 - Referral opportunitues are listed in the record meeting with the
051079 - surgeon on 050727. ref SDS 15 LA3I
051080 -
051081 -
051082 -
051083 -
0511 -
0512 -
051201 -
0513 -

SUBJECTS
2nd Opinion #3 Planning Organizations Doctors Solicit Support for Pl

0703 -
0704 - Planning
070501 -  ..
070502 - Organizations and Doctors Who May Provide 2nd Opinion
070503 -
070504 - This current project need not address issues of payment at this time,
070505 - since UCSF and Stanford have both offered follow up consultation.....
070506 -
070507 -             UCSF........................... 041117, ref SDS 9 OV3T
070508 -             Stanford....................... 041209, ref SDS 10 HS6L
070510 -  ..
070511 - Doctors who submitted 2nd opinions in 2005, might be able comment
070512 - constructively at this time.
070513 -
070514 -             Grissom........................ 050920. ref SDS 24 XL4V
070515 -             Bailey......................... 050923. ref SDS 25 2Y6W
070517 -  ..
070518 - There is a source for 2nd opinion listed in research from the meeting
070519 - with the surgeon on 050324. ref SDS 13 F36O  This, however, was not
070520 - responsive.
070521 -
070522 -
070523 -
070524 -
0706 -

SUBJECTS
2nd Opinion #3 Scope to Assist Kaiser Develop Strategy Planning Trea

0903 -
0904 - Requirements
090501 -  ..
090502 - Reason for 2nd Opinion Support Kaiser Develop Treatment Strategy
090503 -
090504 - Follow up ref SDS 19 IS6F.
090505 -
090506 - Need letters to doctors requesting 2nd opinions, ref SDS 0 6C4S, for
090507 - following reason...
090508 -
090509 -    1.  On 060711 Millie officially diagonsed relapsed. ref SDS 27 025H
090510 -
090511 -        At that time, on 060711 a number of treatment scenarios and the
090512 -        need for a strategy was discussed. ref SDS 27 K36G
090514 -         ..
090515 -        Specific issues are...
090516 -
090517 -        a.  Drugs available, including combinations.
090518 -
090519 -            There has been an expanding list of drugs to try, but no
090520 -            comprehensive listing, and coherent strategy. ref SDS 27
090521 -            QO8V
090523 -             ..
090524 -        b.  Order of trying drugs and combinations. ref SDS 27 E13L
090525 -
090526 -            What effect does cancer mutation have on choosing
090527 -            treatment, including starting with prior successful drugs
090528 -            (Taxotere and capecitabine), in light of prospect that
090529 -            current cancer survived prior treatment and so may be
090530 -            resistant. ref SDS 27 R04K
090531 -
090532 -                [On 090106 2nd opinion research with Doctor Stritter
090533 -                considers mutation problem again. ref SDS 38 UL7G
090535 -             ..
090536 -        c.  High dose chemotherapy (HDC) strategy and determining dose
090537 -            in relation to tolerance for side effects. ref SDS 27 KY4G
090539 -             ..
090540 -        d.  Surgery - perform previously postponed bread reconstruction
090541 -            to avoid wound from further more expansive surgery to
090542 -            remove infected skin. ref SDS 27 X54L
090544 -             ..
090545 -        e.  Radiation treatment of supraclavicular, and of left breast
090546 -            relapse area. ref SDS 27 Z26K
090548 -         ..
090549 -    2.  On 060720 Millie asked the doctor for a strategy. ref SDS 29
090550 -        21A6
090552 -         ..
090553 -        The doctor submitted a response today on 060721 that says in
090554 -        part...
090555 -
090556 -           "What has or has not been done, what has or has not been
090557 -           effective, what we can or cannot do again in the future,"
090558 -           ref SDS 30 YU46; and said "Currently our options [are]
090559 -           limited to a decreasing pool of chemotherapeutic agents."
090560 -           ref SDS 30 H45G
090562 -         ..
090563 -        This response "begs the question" and is unsatisfying for a
090564 -        strategy to guide work plans, indicating that limited time
090565 -        prevents sufficient analysis and communication with the
090566 -        patient.
090567 -
090568 -            [On 060725 UCSF request 2nd opinion. ref SDS 32 QR6P
090570 -             ..
090571 -            [On 060809 schedule meeting with Doctor Benz at UCSF on
090572 -            060821. ref SDS 33 YK6N
090574 -             ..
090575 -            [On 061006 Millie dissatisfied with poor quality of
090576 -            correspondence from primary care physician, failing to
090577 -            answer patient questions, and failing to explain reasoning
090578 -            and background in patient history that supports diagnosis
090579 -            and treatment decisions. ref SDS 35 GW3J
090581 -             ..
090582 -            [On 061218 doctor repeats generalization about using
090583 -            single agent treatments to avoid exhausing drugs to
090584 -            treat Millie, without listing available drugs for IBC,
090585 -            and conflicting with patient history prescribing
090586 -            double-agent treatments. ref SDS 37 JU7J
090587 -
090588 -
090589 -
090590 -
090591 -
090592 -
090593 -
090594 -
090595 -
0906 -