CONTACTS 

SUBJECTS
11th Cycle Treatment Taxotere Xeloda Capacitibine Chemotherapy Treat

0503 -
0503 -    ..
0504 - Summary/Objective
0505 -
050501 - Follow up ref SDS 85 0000. ref SDS 84 0000.
050502 -
050503 - Millie's blood count good again today for treatment. ref SDS 0 P560
050504 - No significant side effects reported. ref SDS 0 QU8K  Vitals show
050505 - patient stable. ref SDS 0 AW4L  Patient alert and energy level good
050506 - treatment. ref SDS 0 F54N  Nadine and the Kaiser Infusion Clinic team
050507 - did an excellent job today.
050508 -
050509 -
050510 -
050512 -  ..
0506 -
0507 -
0508 - Progress
0509 -
050901 - Treatment Delayed 5 Days to Reset Standard Schedule
050902 -
050903 - Follow up ref SDS 85 407N.
050904 -
050905 - Received treatment to begin 11th cycle overall of chemotherapy with
050906 - Taxotere and Xeloda prescribed by the primary care physician on
050907 - 060825, ref SDS 87 KT7J, for the 3rd cycle of treatment for 3rd
050908 - relapse of IBC, Scheduling and treatment were reviewed by the backup
050909 - doctor on 060808 due to rising IBC symptoms after 1st cycle, and
050910 - decision was made to continue treatment plan with Taxotere and Xeloda.
050911 - ref SDS 83 N96O  The 1st cycle (9th overall) was performed on schedule
050912 - at Kaiser on 060721. ref SDS 79 407N  The second cycle of treatment on
050913 - 060814 was delayed 4 days to accomdate Kaiser's schedule, reported on
050914 - 060810. ref SDS 84 0001
050916 -  ..
050917 - Work today was further deferred for another 4 days in order to
050918 - reinstate the original schedule of treatment on Friday, shown by
050919 - planning during the meeting with the primary care primary care
050920 - physician on 060825. ref SDS 87 N96O
050921 -
050922 -    [On 060922 slow response to treatment for 3rd IBC relapse reported
050923 -    in a letter to the doctor, ref SDS 89 LE48; study of patient
050924 -    history may indicate recovery compares favorably to treatment in
050925 -    2005 for 2nd IBC relapse. ref SDS 89 9F35
050927 -  ..
050928 - Nadine said the blood counts are good today.  This was confirmed by
050929 - the report showing counts are well above requirements for treatment.
050930 - ref SDS 0 P560
050932 -  ..
050933 - Millie had a blood draw on Sunday, 060907, per planning on 060825.
050934 - ref SDS 84 CN7I
050935 -
050938 -
050939 -
050940 -
050941 -
0510 -

SUBJECTS
Side Effects Consultation Pharmacist Dry Hands Nausea Sundries Xelod

0903 -
090401 -  ..
090402 - Side Effects Consultation Ross Biondi Pharmacist
090403 -
090404 - Ross the pharmacist called Millie this morning and asked about side
090405 - effects?
090406 -
090407 - On 060724 diary showing history of side effects for 2nd phase taking
090408 - Taxotere and capecitabine (Xeloda). ref SDS 80 QX8K
090410 -  ..
090411 - Millie discussed the following...
090412 -
090413 -            dry hands,  use hand lotion
090414 -
090415 -               [On 060929 lotion somewhat effective; other lotion more
090416 -               effective. ref SDS 90 ZV6H
090418 -             ..
090419 -            loose bowels -- no diarrhea
090420 -
090421 -               [On 060929 problem cleared without treatment.
090422 -               ref SDS 90 KW9K
090424 -             ..
090425 -            nausea - uneasy feeling in stomache  taking compasize.
090427 -                ..
090428 -               Ross further prescribed Anzemet today, described below.
090429 -               ref SDS 0 KZ3W, which Millie received at the pharmacy
090430 -               after treatment today, along with getting the new
090431 -               prescription for capecitabine (Xeloda) for the 11th
090432 -               cycle, per below. ref SDS 0 ME4G
090433 -
090434 -                  [On 060929 Anzemet was not effective, treatment
090435 -                  discontinued; nausea relieved eating small amounts of
090436 -                  food throughtout the day. ref SDS 90 D19M
090438 -             ..
090439 -            sores in mouth - none   cleaning mouth carefully
090441 -  ..
090442 - Ross said that the manufacturer of Xeloda provides complementary
090443 - sundries that includes hand lotion to treat side effects of blisters
090444 - on the hands and feet.  He suggested asking the nurse to see if
090445 - Kaiser has any of these left.
090447 -  ..
090448 - Millie asked Nadine about this, while getting set up for treatment.
090450 -  ..
090451 - Nadine brought Millie a small blue bag with various items.  It is a
090452 - small blue bag about 8" square, with a zipper.  Included among
090453 - several items are...
090454 -
090455 -                Hand lotion to ease blisters on hands caused by
090456 -                Xeloda.
090458 -                 ..
090459 -                Diary to track side effects.
090461 -      ..
090462 -     [On 060929 lotion somewhat effective; other lotion more
090463 -     effective. ref SDS 90 ZV6H
090464 -
090465 -
090466 -
090467 -
090468 -
090469 -
0905 -

SUBJECTS
Schedule Treatment Regular 3-week Cycle on Friday 060929 Nadine Holi

1203 -
120401 -  ..
120402 - Schedule Next Treatment Change to Fridays Accomodate Side Effects
120403 -
120404 - Follow up ref SDS 85 QK6L, ref SDS 79 QK6L.
120405 -
120406 - The original plan was for treatments on Friday, to fit Millie's
120407 - schedule of having Friday and Monday off-work, which gives time to
120408 - recover from ill feelings caused by Taxotere, reported on 060721,
120409 - ref SDS 79 QK6L, and citing case study on side effects reported on
120410 - 050422. ref SDS 52 JY3N
120412 -  ..
120413 - On 060814 treatment was scheduled for Monday to experiment.
120414 - ref SDS 85 D58L
120416 -  ..
120417 - Today, Millie's next treatment is scheduled for 060929 1600.
120419 -  ..
120420 - Meeting with the doctor today was changed to 060929 1400.
120421 -
120422 -
120423 -
120424 -
1205 -

SUBJECTS
Blood Tests Chemotherapy White Cell Count Good 11th Cycle Taxotere C

1503 -
150401 -  ..
150402 - Blood Counts Good Dose Chemotherapy Taxol Normal
150403 -
150404 - Follow up ref SDS 85 Q659, ref SDS 84 Q659.
150406 -  ..
150407 - Nadine submitted the report showing...
150408 -
150409 -    Patient   Provider  Category   View      FR Date   To Date
150415 -     ..
150416 -    Procedure              Results             Reference Range
150417 -
150420 -
150421 -                  ** Marina Way South **
150423 -     ..
150424 -    Test Name            Value Unit     <-------- RANGE-------->
150425 -    @CBC
150426 -    WBC x 10-3               9.0 K/uL           3.5   -     12.5
150427 -    RBC x 10-6              4.05 M/uL           3.60  -      5.70
150428 -    Hemoglobin              12.8 g/dL          11.5   -     15.0
150429 -    Hematocrit              39.1 %             34.0   -     46.0
150430 -    MCV                       97 fL            80.0   -    100.0
150431 -    RDW             H       15.6 %             11.9   -     14.3
150432 -    Plt x10-3              266   K/uL         140     -    400
150433 -     ..
150434 -    Neutrophils     H         71 %             50     -     70
150435 -    Lymphocytes               22 %             20     -     50
150436 -    Monocyte                   5 %              0     -     11
150437 -    Eosinophils                2 %              1     -      5
150438 -    Basophil                   1 %              0     -      2
150439 -    Bands             No Report  %              0     -      5
150441 -     ..
150442 -    CA 15-3           No Report  U/mL          -<     -     39
150444 -     ..
150445 -    Alkaline Phos             49 U/L           38     -    126
150446 -    Bili, Tot Adult          0.6 mg/dL        0.2     -    1.3
150447 -    Creatinine               0.7 mg/dL        0.6     -    1.2
150448 -    ALT (SGPT)                17 U/L           14     -     36
150449 -    AST (SGOT)        No Report  U/L           11     -     66
150451 -     ..
150452 -    RBC Morphology    No Report
150453 -    Poikilocytosis  * No Report
150454 -    Anisocytosis    * No Report
150455 -    Schistocytes    * No Report
150456 -    PLT Estimate      No Report
150457 -    PLT Morphology    No Report
150458 -
150459 -
150460 -
150461 -
1505 -

SUBJECTS
Absolute Neutrophils Count ANC 6390 Well Above 1500 Required for Tre

1803 -
180401 -  ..
180402 - ACN 6390 Well Above 1500 Criteria for Blood Counts Approve Treatment
180403 -
180404 - Follow up ref SDS 85 P560.
180405 -
180406 - Formula for ANC, from record on 050128. ref SDS 44 TZ3N
180408 -  ..
180409 - Calculation from 060810 yielded 1376. ref SDS 84 9C5N
180411 -  ..
180412 - Note that bands are added to neutrophils, but bands are 0 in the
180413 - report today.
180414 -
180415 -                  WBC               =   9.0
180416 -                  Neutrophils       =    .71
180418 -             ..
180419 -            ANC = 9.0 x 1000 x .71  = 6390
180420 -
180421 -
180422 -
180423 -
180424 -
180425 -
1805 -

SUBJECTS
CA 15-3 73 No Change Not Tested with Current Blood Test for Chemothe

2003 -
200401 -  ..
200402 - CA 15-3 73 No Change Not Reported with Current Blood Test for Chemo
200403 -
200404 - Follow up ref SDS 85 2N5J, ref SDS 84 2N5J.
200406 -  ..
200407 - Last test showing CA 15-3 73 suddenly dropped dramatically was
200408 - reported on 060817. ref SDS 86 PQWQ
200410 -  ..
200411 - Report today was not completed on time for the meeting today, per
200412 - above. ref SDS 0 5K6K  Will get it next week.
200414 -  ..
200415 - The doctor talked to the nurse and she said that he cancelled the
200416 - meeting today after treatment, because the CA 15-3 report is not
200417 - available until next week, and so bumped the next meeting 3 weeks.
200418 -
200419 -
200420 -
200421 -
2005 -

SUBJECTS
Port Connection Prepare for Treatment 1 Try Required Nadine Excellent    2

2203 -
2204 - 1417
220501 -  ..
220502 - Preparation for Treatment Required One (1) Attempt to Connect Port
220503 -
220504 - Follow up ref SDS 85 EB7J, ref SDS 79 EB7J.
220506 -  ..
220507 - Julie did the administration again with Nadine to verify Millie gets
220508 - the correct treatment.
220509 -
220510 -
220512 -  ..
2206 -
2207 -
2208 - 1609
2209 -
220901 - Nadine connected the IV tubes to the port....
220903 -       ..
220904 -      Interlink System Vented Paclitaxel set
220906 -  ..
220907 - This was done without incident, very professional and competent.
220908 -
220909 -
220910 -
220911 -
220912 -
2210 -

SUBJECTS
Decadron Millie Confirmed Taking Pills Yesterday to be Prepared for

2503 -
250401 -  ..
250402 - Treatment Nausea Taxotere Preparation Decadron Compazine Anzemet
250403 - Decadron Compazine Anzemet Treatment Nausea Taxotere Preparation
250404 -
250405 - Millie explained having taken Decadron tablets according to the
250406 - prescription to take two tablets twice a day, per instructions on
250407 - 050415. ref SDS 51 8U4O
250409 -  ..
250410 - Decadron was not given by Nadine again before treatment today, because
250411 - Millie took the pills this morning with her meal, as prescribed; and
250412 - Millie will take another dose of Decadron tomorrow as part of
250413 - chemotherapy treatment today.
250414 -
250415 -        Generic name:  dexamethasone
250416 -
250417 -              http://www.tirgan.com/decadron.htm
250419 -         ..
250420 -        Description and purpose of Decadron is reported in the record
250421 -        on 060721. ref SDS 79 4I4Q
250423 -  ..
250424 - Compazine - Nadine gave Millie a pill prior to treatment that reduces
250425 - nausea rather than as a drip treatment to avoid allergic reaction.
250426 -
250427 -        Generic name:  Prochlorperazine
250428 -
250429 -        Purpose of Compazine is reported on 060721. ref SDS 79 WD4M
250431 -  ..
250432 - Anzemet
250433 -
250434 -        Generic name:  dolasetron mesylate
250435 -
250436 -               http://www.anzemet.com
250437 -
250438 -        Purpose of Anzemet
250439 -
250440 -            Prevents nasuea and vomiting caused by chemotherapy.  It
250441 -            also helps patients maintain daily routine and complete
250442 -            chemotherapy treatments on schedule.
250443 -
250444 -               [On 060929 Anzemet was not effective, treatment
250445 -               discontinued; nausea relieved eating small amounts of
250446 -               food throughtout the day. ref SDS 90 D19M
250448 -             ..
250449 -            Nausea and vomiting may occur immediately after
250450 -            chemotherapy or a few days later.  Usually your greatest
250451 -            discomfort will be during the first twenty-four hours after
250452 -            treatment; this is known as acute nausea and vomiting.
250453 -            Sometimes, though, nausea and vomiting set in after the
250454 -            first twenty-four hours and last for a few days; this is
250455 -            called delayed nausea and vomiting.
250457 -             ..
250458 -            In some severe instances, you may be unable to eat or
250459 -            drink, which could lead to dehydration and weight loss.
250460 -            If this occurs, your chemotherapy treatments may need to
250461 -            be postponed.
250463 -             ..
250464 -            Side effects...
250465 -
250466 -                headaches
250467 -                fatigue
250468 -                diarrhea
250469 -                fever
250470 -                ECG changes
250472 -         ..
250473 -        Aventis Pharmaceuticals
250474 -        Bridgewater, NJ  08807
250475 -
250476 -
250477 -
250478 -
250479 -
2505 -

SUBJECTS
Benadryl Drip Treatment Prepares Patient for Taxotere Chemotherapy A

2703 -
2704 - 1347
270501 -  ..
270502 - Benedryl Reduce Side Effects Taxotere Chemotherapy Treatment
270503 -
270504 - Follow up ref SDS 85 DC7J.
270505 -
270506 - Benadryl started.
270507 -
270508 -              http://www.oncolink.org/treatment/article.cfm?c=2&s=10&id=150
270510 -         ..
270511 -        Generic name:  diphenhydramine
270513 -         ..
270514 -        Purpose reported on 060721. ref SDS 79 DC7J
270515 -
270516 -
270518 -  ..
2706 -
2707 -
2708 - 1356
2709 -
270901 - Benedryl completed.
270902 -
270903 -
270904 -
270905 -
2710 -

SUBJECTS
Taxotere 102 MG Drip Treatment 11th Cycle Taxotere Capecitiabine (Xe

3003 -
3004 - 1359
300501 -  ..
300502 - Taxotere Full Dose Blood Counts on Targets
300503 -
300504 - Follow up ref SDS 85 4N5M, ref SDS 79 4N5M.
300506 -  ..
300507 - Taxotere started - 102 MG.
300509 -  ..
300510 - There was no patient evaulation process today, which fits the
300511 - procedure the first time Millie was treated with Taxotere on 020610,
300512 - ref SDS 2 MR5I; later, on 050415 Kaiser performed patient evaluation
300513 - of side effects for Taxotere treatment. ref SDS 51 4333
300514 -
300515 -
300516 -
300518 -  ..
3006 -
3007 -
3008 - 1502
3009 -
300901 - Equipment beeped indicating treatment is over.
300902 -
300903 - Taxotere treatment completed.
300905 -  ..
300906 - Nadine disconnected the IV tubes.
300908 -  ..
300909 - She inserted Herceptin to flush the port.
300911 -  ..
300912 - She then removed the needle from the port, and swabbed the needle
300913 - wound, and placed a temporary bandage.
300914 -
300915 -
300916 -
300917 -
300918 -
3010 -

SUBJECTS
Vitals Blood Pressure Pulse Temperature Taxotere 102 MG Drip Treatme

3303 -
3304 - 1440
330501 -  ..
330502 - Vitals Show Patient Stable
330503 -
330504 - Follow up ref SDS 85 AW4L, ref SDS 79 AW4L.
330505 -
330506 - Nadine took vitals before starting Benedryl drip treatment...
330507 -
330508 -                    Blood
330509 -    Date   Time     Pressure   Pulse  Temprtr  Weight
330511 -     ..
330512 -    060908 1335..... 139  79     73     98.1
330513 -    060814 1610..... 139  80     59     98.2
330514 -    060722 1440..... 142  74     67     98.1
330515 -    060711.......... 172  87     54     97.5    147
330516 -    060623.......... 141  87     71     98.0    147
330517 -    060428.......... 129  73     80     99.4    149
330518 -    060217.......... 153  81     61     98.6    150
330519 -    050916.......... 120  80     80     98.5
330520 -
330521 -
330522 -
330523 -
3306 -

SUBJECTS
Pharmacist Orders Capecitabine Decadron Instructions Dose Capecitabi

3803 -
3804 - 1049
380501 -  ..
380502 - Pharmacist Orders Capecitabine Decadron Instructions
380503 -
380504 - Follow up ref SDS 85 TZ4I, ref SDS 79 TZ4I.
380505 -
380506 - Zan called Millie at home to discuss side effects, per above,
380507 - ref SDS 0 QU8K  He advised that he has placed an order for Millie's
380508 - medication.
380509 -
380511 -  ..
3806 -
3807 -
3808 - 1321
3809 -
380901 - Arrived at hospial.  Millie went to the pharmacy on the 2nd floor and
380902 - purchased the drugs ordered by Zan earlier today.
380903 -
380904 -
380906 -  ..
3810 -
3811 -
3812 - 1447
3813 -
381301 - Ross came through the clinic while Millie was getting treatment.
381302 - Millie asked about protocol on when to begin taking Xeloda
381303 - (capecitabine) pills?  Should she start this evening after dinner, or
381304 - tomorrow after an early breakfast?
381306 -  ..
381307 - Ross said the best practice is to begin taking complementary treatment
381308 - with Xeloda the same day that primary drip treatment starts, so that
381309 - would be this evening after dinner.
381311 -  ..
381312 - Ross asked if Millie got the Xeloda complementary sundries discussed
381313 - this morning.   Millie advised that the nurse, Nadine, handed this
381314 - our earlier during treatment, per above.
381316 -  ..
381317 - Millie asked medication for a side effect of nausea, as another side
381318 - effect, per above. ref SDS 0 D19M  Ross said he will prescribe
381319 - Anzemet, which Millie can pick up at the pharmacy after treatment,
381320 - per above. ref SDS 0 KZ3W
381321 -
381322 -
381324 -  ..
3814 -
3815 -
3816 - 1724
3817 -
381701 - After treatment, Millie went back to the pharmacy and got the
381702 - prescription for Anzimet.
381703 -
381704 -
381705 -
381706 -
381707 -
3818 -

SUBJECTS
Energy Normal Stable Alert Drive Home After Treatment IBC 3rd Relaps

4203 -
4204 - 1733
420501 -  ..
420502 - Energy Normal Stable After Treatment Taxotere Support Drugs
420503 -
420504 - Follow up ref SDS 85 F54N, ref SDS 79 F54N.
420505 -
420506 - Millie was a little disoriented after treatment today.  She was not
420507 - treated with Ativan, as was done on 060721, ref SDS 79 F54N, and so
420508 - Mil was alert enough to drive home.
420510 -  ..
420511 - On 060724 diary showing history of side effects for 2nd phase taking
420512 - Taxotere and capecitabine (Xeloda). ref SDS 80 QX8K
420513 -
420514 -
420515 -
420516 -
420517 -
420518 -
4206 -