CONTACTS 

SUBJECTS
Red Rash Left Arm Very Slight Notice New Issue Question on Slow Reco

1003 -
1003 -    ..
1004 - Summary/Objective
1005 -
100501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
100502 -
100503 - Millie notified Kaiser about a new problem of inflammation on the left
100504 - arm being treated for lymphedema.  By the later afernoon this problem
100505 - worsened, and she was hospitalized and treated for 5 days with severe
100506 - cellulitus. ref SDS 0 MS3Q  Millie thanked and commended Arlette's
100507 - good work supporting effective communications with the primary care
100508 - physician. ref SDS 0 QC5K  Slow response to treatment of IBC asks
100509 - about correlations with mastectomy surgery last year that removed
100510 - blood vessels that deliver chemotherapy treatment to infected tissue.
100511 - ref SDS 0 MS3Y  Millie reports slow recovery from pulmonary embolism
100512 - shown by rising symptoms. ref SDS 0 MS5P  Cites doctor's previous
100513 - diagnosis that symptoms reflect lack of fitness, and asks about
100514 - prospects of working out in the gym. ref SDS 0 KJ6H
100515 -
100516 -        [...in another record Millie hospitalized when rash symptoms
100517 -        increased severely into cellulitus. ref SDS 24 EX9L
100518 -
100519 -
100520 -
100521 -
100523 -  ..
1006 -
1007 -
1008 - Progress
1009 -
100901 - Millie had physical therapy for lymphedema at Kaiser again this
100902 - morning about 0900.  Mary, the therapyst, noticed several red dots on
100903 - the inner part of the Millie's left arm below the elbow.  She
100904 - recommended that Millie notify the doctor about this new problem, even
100905 - though it seems very slight, possibly caused by an alergy, as reported
100906 - in another record later today. ref SDS 24 HP52
100908 -  ..
100909 - Mil was very reluctant to send another letter to the doctor.  As
100910 - reported in another record, she began to feel badly.  By 1230 she was
100911 - chilled, and so put on a heavy coat, and was wrapped in a blanket.
100912 - Millie decided to go ahead and notify Kaiser about the new rash.
100913 -
100915 -  ..
100916 - Commend Kaiser Good Communication Support
100917 -
100918 - Millie submitted ref DIT 1 0001 to Arlette notifying Kaiser about the
100919 - new rash, and presenting additional issues...
100920 -
100921 -    1.  Thanks for facilitating communication with [the doctor] in your
100922 -        letter on October 14. ref DIT 1 0001
100924 -  ..
100925 - Millie received Arlette's letter in the record on 061015, ref SDS 22
100926 - 0001, confirming distribution of Millie's letter to Kaiser a few days
100927 - ago on 061013, ref SDS 21 UR7K, with questions on the pathology report
100928 - for the CT test on 060929, which was received and reviewed on 061012.
100929 - ref SDS 20 284J
100930 -
100931 -            [On 061103 Millie commended Arlette again for good
100932 -            communications. ref SDS 25 UQ6M
100933 -
100935 -  ..
100936 - Rash Left Arm Suffering Lymphedema May be Alergy
100937 -
100938 -
100939 - Letter to Kaiser continues...
100940 -
100941 -    2.  I was at Kaiser today for PT on my left arm to treat
100942 -        lymphedema.  The therapist noticed I have developed a rash.
100943 -        These are red fairly prominent dots lightly sprinkled mostly
100944 -        along the inner area below the elbow.  I haven't done anything
100945 -        that accounts for this new issue.  Hoping it isn't a side
100946 -        effect of medications, nor anything the doctor needs to
100947 -        address, but the therapist said I should let you know about it.
100948 -        ref DIT 1 AL5M
100949 -
100950 -             [...below Arlette reports that the doctor received
100951 -             Millie's letter on this matter. ref SDS 0 YH4J
100953 -  ..
100954 - After submission of this letter, Millie's condition worsened over the
100955 - next few hours with elevated temperature, reported in another record.
100956 - ref SDS 24 3N8K  At 1600 she went for treatment at Emergency Room.
100957 - When Millie removed her coat for a blood pressure test, the doctor
100958 - discovered that the rash which had been very slight at 0900 this
100959 - morning, per above, ref SDS 0 QC9F, had increased to engulf the entire
100960 - left arm with solid inflammation and swelling. ref SDS 24 WO6N  This
100961 - was eventually diagnosed as cellulitus, ref SDS 24 V759, caused by
100962 - trauma from a broken finger suffered on 060914, ref SDS 12 ZQ5I, and
100963 - complicated by loss of lymphatics from left breast mastectomy surgery
100964 - on 061021. ref SDS 24 714I
100965 -
100966 -
100967 -
100968 -
100969 -
1010 -

SUBJECTS
Blood Vessels Mastectomy Surgery Removed Expectations IBC Slow Recov

1503 -
150401 -  ..
150402 - Blood Vessels Mastectomy Removed Expectations IBC Slow Recovery
150403 - Expectations Slow Recovery IBC Surgery Removed Blood Vessels
150404 - IBC Slow Recovery Expectations Low Mastectomy Removes Blood Vessels
150405 - Mastectomy Removes Blood Vessels Slows Rate Recovery IBC Relapse
150406 -
150407 - Follow up ref SDS 13 MG6F, ref SDS 11 G57I.
150408 -
150409 - Millie's letter to Kaiser continues...
150411 -         ..
150412 -    3.  I have been wondering about slow improvement in the rash on my
150413 -        chest.  We talked about this getting worse back in August.  You
150414 -        helped arrange an examination, and on August 8th the rash
150415 -        seemed to get better.  Since then there has been no noticeable
150416 -        improvement with 3 more treatments.  I think Doctor Johnson or
150417 -        maybe one of the consultants said that mastectomy surgery
150418 -        removes blood vessels that normally aid recovery by delivering
150419 -        chemotherapy to infected tissue.  Does breast removal account
150420 -        for slow recovery.  I haven't seen any research on this.  Does
150421 -        Kaiser have a research department that patients can contact
150422 -        about factors that delay recovery? ref DIT 1 ZL6L
150423 -
150424 -             [...below Arlette reports that the doctor received
150425 -             Millie's letter on this matter. ref SDS 0 YH4J
150427 -  ..
150428 - Millie first asked Kaiser about slow recovery from IBC relapse on
150429 - 060806, ref SDS 5 OJ7S, and after 1 cycle of treatment with Taxotere
150430 - and capecitabine. ref SDS 5 7Q95  An emergency meeting at Kaiser on
150431 - 060808 seemed to show some improvemet, ref SDS 6 VO6G, so treatment
150432 - was not changed. ref SDS 6 4W9K
150433 -
150434 -             [On 061110 doctor examination shows stable to worsening
150435 -             IBC left breast. ref SDS 26 P69G
150437 -  ..
150438 - Slow recovery from IBC on left breast areas was noted in a letter to
150439 - the doctor on 060922. ref SDS 13 MG6F  Background on slow recovery
150440 - from IBC and correlation with mastectomy surgery on 051021 was also
150441 - reviewed on 060922. ref SDS 13 ML3I
150442 -
150443 -
150444 -
150445 -
1505 -

SUBJECTS
Pulmonary Embolism Symptoms Fatigue Shortness Breath Rising Slow Rec

2203 -
220401 -  ..
220402 - Slow Recovery Pulmonary Emboli Patient Work Out Increase Fitness
220403 - Fitness Fatigue Shortness Breath Slow Recover Pulmonary Embolism
220404 - Exercise Back in Gym Working Out Prognosis Recover Pulmonary Emboli
220405 - Pulmonary Embolism Recovery Slow Symptoms Continue Prognosis??
220406 -
220407 - Follow up ref SDS 23 CV5L, ref SDS 16 MI5I.
220408 -
220409 - Millie's letter to Kaiser continues...
220411 -         ..
220412 -    4.  Similarly, my feeling is that pulmonary emboli recovery was
220413 -        much faster after starting treatment on November 4, 2004, than
220414 -        has occurred this time around, ref DIT 1 ZM7O, starting on
220415 -        October 2nd after Doctor Johnson's call. [on 061002,
220416 -        ref SDS 16 MI5I]
220418 -         ..
220419 -    5.  I continue to feel shortness of breath with mild effort.  Maybe
220420 -        I am just suffering from chronic "age."  On July 29, 2005 the
220421 -        doctor attributed shortness of breath to lack of fitness,
220422 -        ref SDS 1 XX7G, from prolonged chemotherapy treatment.
220423 -        ref DIT 1 KJ6H
220424 -
220425 -             [...below Arlette reports that the doctor received
220426 -             Millie's letter on this matter. ref SDS 0 YH4J
220428 -         ..
220429 -    6.  I want to get back in the gym and start working out to address
220430 -        the fitness issue, but would like comment from the doctor about
220431 -        safety pushing myself to regain fitness.  Would that help solve
220432 -        or compound the shortness of breath issue?  Do we need a test
220433 -        of some kind in advance of increasing exercise?  I was planning
220434 -        to work out today, but will hold off until the doctor comments.
220435 -        ref DIT 1 5F8N
220437 -  ..
220438 - During the meeting with the doctor on 061020 Millie reported symptoms
220439 - that are improved, yet, still continue following start of treatment
220440 - beginning on 061002. ref SDS 23 VD4G
220442 -  ..
220443 - Continuing symptoms may reflect enlarged right ventricle diagnosed in
220444 - CT test on 060929 reviewed on 061012. ref SDS 20 7E5L
220445 -
220446 -            [On 061110 Millie confirmed notice in the letter today of
220447 -            continuing shortness of breath, fatigue; with a hectic
220448 -            schedule doctor did not have time to discuss treatment plan
220449 -            to restore cardio pulmonary health so that Millie can get
220450 -            back in the gym, there was no discussion of team care
220451 -            collaboration with heart specialist to assess enlarged
220452 -            right ventricle. ref SDS 26 P15N
220454 -             ..
220455 -            [On 061218 Millie letter to Kaisr requests examination by
220456 -            heart specialist for clearance to resume exercise in the
220457 -            gym and restore fitness. ref SDS 27 HX6V
220459 -  ..
220460 - Millie's letter to Kaiser continues...
220461 -
220462 -    7.  I see the doctor in two weeks, so unless he wants to check out
220463 -        the rash, I am good for addressing these issues in the next
220464 -        meeting. ref DIT 1 ZN9O
220466 -         ..
220467 -    8.  Thanks for helping on this. ref DIT 1 MS6W
220468 -
220469 -
220470 -
220471 -
220472 -
2205 -

SUBJECTS
Default Null Subject Account for Blank Record

2303 -
2304 - 2211
230501 -  ..
230502 - Millie received a letter, ref DRT 1 0001 from Arlette advising that
230503 - she received Millie's letter earlier today, and saying...
230504 -
230505 -    1.  I gave your e-mail to Doctor Johnson.
230507 -  ..
230508 - Arlette refers to Millie's letter commending Arlette for expediting
230509 - work on Millie's case, ref SDS 0 QC5K, and also notifying Kaiser of a
230510 - new red rash on the left, which later increased and required treatment
230511 - in the hospital, per above. ref SDS 0 MS3Q
230512 -
230513 -            [On 061103 Millie commended Arlette again for good
230514 -            communications. ref SDS 25 UQ6M
230516 -  ..
230517 - This further confirms that the doctor received Millie's inquiry about
230518 - slow recovery from IBC red rash on the left breast area, and asking
230519 - about effect of mastectomy surgery removing blood vessels, which
230520 - prevents delivery of treatment. ref SDS 0 MS3Y
230522 -  ..
230523 - The doctor also received Millie's letter saying that recovery from
230524 - pulmonary embolism seems very slow, with symptoms of fatigue, and
230525 - shortness of breath continuing to impede normal activity. ref SDS 0
230526 - MS5P
230528 -  ..
230529 - Arlette's letter continues...
230530 -
230531 -    2.  Your hubby called today and I transferred him to an RN.
230533 -         ..
230534 -    3.  I have been so busy, that I haven't had a chance to find out
230535 -        what happened.  I will ask Dr.J.  Sounds like you have a lot of
230536 -        issues!
230538 -         ..
230539 -    4.  Whew!  I hope you are feeling better soon.
230541 -  ..
230542 - Arlette refers to the call reported in another record asking for
230543 - advice on treating Millie's rising temperature. ref SDS 24 3N8K
230544 - Arlette was very helpful. ref SDS 24 LM9O
230545 -
230546 -            [On 061103 Millie reports in a follow up letter on results
230547 -            of treatment for cellulitus in the hospital for 5 days.
230548 -            ref SDS 25 UT7G
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2306 -