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: July 21, 2006 12:16 PM Friday; Rod Welch

Doctor received request for strategy and available drugs for IBC.

1...Summary/Objective
2...Strategy Treating IBC on 3rd Relapse Post-surgery Mastectomy
3...Chemotherapy Drugs and Combinations Available Systemic Treatment IBC
4...Radiation Treatment Tumor Board Review Develop Strategy IBC Relapse
5...Tumor Board Review Develop Strategy IBC Relapse Treatment Radiation
6...Nupigen Prescribe with Capecitiabine Taxotere Following Prior Guidance


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CONTACTS 

SUBJECTS
Strategy Treatment 3rd-Relapse IBC Letter Asks Primary Care Physicia

0503 -
0503 -    ..
0504 - Summary/Objective
0505 -
050501 - Follow up ref SDS 5 0000, ref SDS 4 0000.
050502 -
050503 -
050504 -
050505 -
050506 -
050508 -  ..
0506 -
0507 -
0508 - Progress
0509 -
050901 - Strategy Treating IBC on 3rd Relapse Post-surgery Mastectomy
050902 -
050903 - Follow up ref SDS 5 21A6, ref SDS 4 K36G.
050904 -
050905 - Millie received ref DRT 1 0001 from primary care physician responding
050906 - to her letter, ref DIP 1 0001, yesterday requesting comments on
050907 - understandings and issues, ref SDS 5 21A6, that follows up discussions
050908 - during the meeting at Kaiser on 060711. ref SDS 4 K36G
050910 -  ..
050911 - Millie said to the doctor in her letter...
050912 -
050913 -        Since we are on the 3rd relapse, ref DIP 1 0001, can you look
050914 -        through our meeting on July 11th -- just the part about
050915 -        treatment. ref SDS 4 K36G
050917 -  ..
050918 - This part of the record reviews pending issues on...
050919 -
050920 -        a.  Systemic drug treatments............. ref SDS 4 FP9H
050921 -
050922 -            HDC in relation to coumadin and nupigen
050923 -
050924 -        b.  Surgery.............................. ref SDS 4 X54L
050926 -             ..
050927 -        c.  Radiation............................ ref SDS 4 Z26K
050929 -  ..
050930 - Today, the doctor responds saying...
050931 -
050932 -    1.  What has or has not been done, what has or has not been
050933 -        effective, what we can or cannot do again in the future.
050934 -        ref DRT 1 0Z6G
050936 -  ..
050937 - This is a circular response, reviewed on 040312, ref SDS 1 V05H,
050938 - repeating the question submitted to the doctor.
050939 -
050940 -
050941 -
050942 -
050943 -
0510 -

SUBJECTS
Chemotherapy Drugs Combinations Available Systemic Treatment IBC Sou

0803 -
080401 -  ..
080402 - Chemotherapy Drugs and Combinations Available Systemic Treatment IBC
080403 -
080404 - Follow up ref SDS 5 SL6G, ref SDS 4 PF3O.
080406 -  ..
080407 - Millie's letter to Kaiser said in part...
080408 -
080409 -        Key questions on treatment, ref SDS 4 KY4G, decisions are
080410 -        highlighted. ref DIP 1 GT6G
080411 -
080412 -        If you don't have time to address this, is there a department
080413 -        at Kaiser that does anlaysis, ref DIP 1 GT6K, to develop
080414 -        strategy tied to patient history? ref SDS 4 OV9J
080416 -  ..
080417 - The record of the meeting on 060711 asks for the source of drugs used
080418 - for chemotherapy treatment. ref SDS 4 QO7O
080420 -  ..
080421 - Today, the doctor responds saying...
080422 -
080423 -    2.  Currently our options alimited to a decreasing pool of
080424 -        chemotherapeutic agents. ref DRT 1 YS6M
080426 -  ..
080427 - For some reason the doctor does not submit the list of treatment drugs
080428 - in the "pool" that is decreasing, nor indicate the order of
080429 - prescribing drugs, requested in Millie's letter.
080430 -
080431 -          [On 060806 letter notifies Kaiser that disease progressing
080432 -          rapidly, requires change in treatment plan. ref SDS 6 OJ7S
080434 -           ..
080435 -          [On 060808 emergency meeting to review rise of IBC red rash,
080436 -          Kaiser deferred review of available treatments, because by
080437 -          the time of examination, IBC rash seemed to decline.
080438 -          ref SDS 7 YJ9J
080440 -  ..
080441 - Saying the pool of drugs is decreasing seems conflicting with the
080442 - record showing that since submitting an initial list on 041130, the
080443 - list has gotten steadily larger, reported on 060711. ref SDS 4 FP9H
080444 -
080445 -
080446 -
080447 -
080448 -
0805 -

SUBJECTS
Radiation Treatment Tumor Board Review Develop Strategy IBC Relapse

1103 -
110401 -  ..
110402 - Radiation Treatment Tumor Board Review Develop Strategy IBC Relapse
110403 - Tumor Board Review Develop Strategy IBC Relapse Treatment Radiation
110404 -
110405 - Follow up ref SDS 5 5S8F.
110406 -
110407 - Millie's letter to Kaiser said in part...
110409 -         ..
110410 -        Would the Tumor Board, ref SDS 4 Z26K, be of any help?
110411 -        ref DIP 1 TV7G
110413 -  ..
110414 - Background considering radiation treatment is reported in the record
110415 - on 060623. ref SDS 3 Z26K
110417 -  ..
110418 - Today, the doctor responds saying...
110419 -
110420 -        Tumor Board could offer no more. ref DRT 1 6S7G
110422 -  ..
110423 - Primary care physician submitted Millie's case to the Tumor Board
110424 - twice.  The last time, the Tumor Board made recommendations.  What is
110425 - the disposition of the recommendations?
110426 -
110427 -
110428 -
110429 -
110430 -
1105 -

SUBJECTS
Nupigen Prescribe with Capecitiabine Taxotere Following Prior Guidan

1403 -
140401 -  ..
140402 - Nupigen Prescribe with Capecitiabine Taxotere Following Prior Guidance
140403 -
140404 - Follow up ref SDS 5 185S.
140405 -
140406 - Millie's letter to Kaiser said in part...
140407 -
140408 -        I also notice that nupigen was prescribed initially when we
140409 -        started Xeloda and Taxotere. ref SDS 4 O16H  This was left
140410 -        undecided in the meeting with Zan, but it is really your call.
140411 -        ref DIP 1 GY8F
140413 -  ..
140414 - Today, the doctor responds saying...
140415 -
140416 -        Your white count will be closely followed.  Neupogen will be
140417 -        added if/when needed. ref DRT 1 FT7O
140419 -  ..
140420 - The doctor does not comment on patient history, reported on 060711.
140421 - ref SDS 4 UC3O
140422 -
140423 -
140424 -
140425 -
140426 -
140427 -
140428 -
140429 -
1405 -