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: February 15, 2007 09:00 AM Thursday; Rod Welch

Millie at UCSF 1st cycle 3nd treatment Cetuximab for IBC relapse.

1...Summary/Objective
2...Clinic Examination Orientation Starting Treatment Cetuximab
3...Breast Examination Assess Effectiveness Cetuximab Clinical Study
4...Measureable Disease Photographs IBC Rash Improving
5...IBC Rash Improved Measurable Disease Photographs Tape Measure
6...Side Effects Medicated After Weekly Examinations
7...Blood Tests 1 Per Month on Cetuximab Performed at UCSF Saves Time Cost
8...INR 2.5 Low Pulmonary Embolism Needs Increase Coumadin Treatment
9...Pulmonary Embolism Treatment Coumadin Needs Increase Low INR 2.5
10...Infusion Clinic for Cetuximab Treatent
..........Taxotere Capecitabine
..........Cetuxiab Clinical Study
11...Nurses Notes...
12...Side Effects Consultation Pharmacist Heavy Chest Difficult Breathing
13...Schedule Weekly Treatments Continue on Thursdays
14...Blood Counts Good Dose Cetuximab Normal
....Anticoagulattion Therapy INR Low 2.5 PT Patient
15...ANC 1760 Well Above 1500 Criteria for Blood Counts Approve Treatment
16...CA 15-3 56 Fall from 68 Cancer Marker Test Pending
17...Preparation for Treatment Required One (1) Attempt to Connect Port
18...Blood Draws 10 Vials for Clinical Study Research
19...Benedryl Reduce Side Effects Cetuximab Chemotherapy Treatment
20...Cetuximab Full Dose Blood Counts on Targets Treatment 1 Hour
21...Vitals Show Patient Stable
22...Energy Normal Stable After Treatment Taxotere Support Drugs


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

SUBJECTS
Examination Treatment Cetuximab 3rd Treatment 1st Cycle Chemotherapy

0603 -
0603 -    ..
0604 - Summary/Objective
0605 -
060501 - Follow up ref SDS C5 0000. ref SDS C2 0000.
060502 -
060503 - Millie had treatment today without examination, as previously planned
060504 - for the clinical study protocol. ref SDS 0 FO6H  Treatment was delayed
060505 - until 0900 by a clinic staff meeting. ref SDS 0 1M6H  The work went
060506 - smoothly.  Catherine reported that the pharmacy doctor ordered
060507 - medication to treat facial rash that is a side effect of cetuximab
060508 - chemotherapy treatment for IBC. ref SDS 0 QU8K
060509 -
060510 -
060511 -
060513 -  ..
0606 -
0607 -
0608 - Progress
0609 -
060901 - Clinic Examination Orientation Starting Treatment Cetuximab
060902 -
060903 - Follow up ref SDS C5 407N, ref SDS C2 407N.
060904 -
060905 - Agenda...
060906 -
060907 -    1.  Side effects.............................. ref SDS 0 QU8K
060908 -    2.  Infusion Clinic........................... ref SDS 0 1M6H
060909 -
060910 -
060911 -
0610 -

SUBJECTS
Breast Examination Shows Improvement IBC Rash Left Right Breast Stom

0903 -
090401 -  ..
090402 - Breast Examination Assess Effectiveness Cetuximab Clinical Study
090403 -
090404 - Follow up ref SDS C5 FO6H, ref SDS C2 FO6H.
090405 -
090406 - No examination was scheduled today under the clinical study protocol.
090407 - ref SDS C5 IU5M
090408 -
090409 -
090410 -
0905 -

SUBJECTS
Measureable Disease IBC Rash Photographs Tape Measure Evaluate Progr

1203 -
120401 -  ..
120402 - Measureable Disease Photographs IBC Rash Improving
120403 - IBC Rash Improved Measurable Disease Photographs Tape Measure
120404 -
120405 - Follow up ref SDS C5 6T6M, ref SDS C2 6T6M.
120406 -
120407 - No examination was scheduled today.
120408 -
120409 -
120410 -
1205 -

SUBJECTS
Cetuximab Side Effects Mild Face Rash Acne-like Medication Prescript
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A

1504 -
150501 -  ..
150502 - Side Effects Medicated After Weekly Examinations
150503 -
150504 - Follow up ref SDS C5 FO66, ref SDS C2 FO66.
150505 -
150506 - No examination was scheduled today.
150507 -
150508 -
1506 -

SUBJECTS
Blood Tests Cetuximab Monthly Clinical Study Drug Trial Performed at

1803 -
180401 -  ..
180402 - Blood Tests 1 Per Month on Cetuximab Performed at UCSF Saves Time Cost
180403 -
180404 - Follow up ref SDS C5 XR40, ref SDS C2 XR40.
180405 -
180406 - No blood test today for cetuximab treatment; Jackie has scheduled the
180407 - next blood test for the clinical study on 070301, per planning on
180408 - 070208. ref SDS C5 XR40
180409 -
180411 -  ..
180412 - INR 2.5 Low Pulmonary Embolism Needs Increase Coumadin Treatment
180413 - Pulmonary Embolism Treatment Coumadin Needs Increase Low INR 2.5
180414 -
180415 - Follow up ref SDS C5 6U5J, ref SDS C2 6U5J.
180416 -
180417 - On 070208 Millie sent a letter to Kaiser asking about skipping a blood
180418 - test today for INR. ref SDS C6 X26T  At that time, on 070208, Gloria
180419 - in Kaiser's Coagulation Control Clinic agreed with this plan.
180420 - ref SDS C6 4R5M
180422 -  ..
180423 - Today, Millie decided to test for INR, since INR was only 1.8 on the
180424 - test last week, ref SDS C6 5L9M, and so was still below the target
180425 - range of 2 - 3 for stabalizing Coumadin (warfarin) treatments.  This
180426 - morning, we arrived at UCSF on Divisadero street in San Francisco,
180427 - about 0630.  Millie walked over to Kaiser which is only a block away
180428 - on Geary street, and had blood drawn for another test.
180430 -  ..
180431 - When Millie arrived home this afternoon after treatment, there was a
180432 - message from Gloria saying INR was 2.5, which is perfect within the
180433 - target range of 2.0 to 3.0.  This means the test next week can be
180434 - skipped, and INR can now be tested on the schedule for treatments with
180435 - cetuximab on the clinical study, as planned on 070208. ref SDS C5 WW5K
180436 -
180437 -    [On 070301 significant differences between blood test
180438 -    diagnostic reporting shows requirements for coordination
180439 -    plan. ref SDS D1 OX6L  INR 2.5 is a perfect test result
180440 -    under Kaiser's methods and practices, indicating Coumadin
180441 -    treatment for pulmonary embolism is adequate; INR 2.5 is
180442 -    too high by UCSF standards, requiring changing Coumadin
180443 -    treatment protocol. ref SDS D1 SE6N
180444 -
180445 -
180446 -
180447 -
180448 -
1805 -

SUBJECTS
Cetuximab 1st Cycle 3rd Treatment Chemotherapy 8th Cycle IBC 3rd Rel

2103 -
2104 - 0850
210501 -  ..
210502 - Infusion Clinic for Cetuximab Treatent
210503 -
210504 - Follow up ref SDS C5 1M6H, ref SDS C2 1M6H.
210505 -
210506 - Treatment was delayed an hour today due to a clinic staff meeting.
210507 - As a result, treatment processing began at 0900.
210509 -  ..
210510 - Millie received 3rd treatment of 1st cycle with Cetuximab, and the
210511 - 10th treatment for 3rd relapse of IBC.
210513 -           ..
210514 -          Taxotere Capecitabine
210515 -
210516 -          Follow up ref SDS C5 PR8Q.
210517 -
210518 -                   Relapse Treatments
210519 -
210520 -      1.  Cycle 09 and 01 ................... 060721, ref SDS 89 407N
210521 -      2.  Cycle 10 and 02 ................... 060814, ref SDS 98 LY6O
210522 -      3.  Cycle 11 and 03 ................... 060908, ref SDS A1 407N
210523 -      4.  Cycle 12 and 04 ................... 060929, ref SDS A3 407N
210524 -      5.  Cycle 13 and 05 ................... 061020, ref SDS A7 407N
210525 -      6.  Cycle 14 and 06 ................... 061110, ref SDS B0 407N
210526 -      7.  Cycle 15 and 07 ................... 061201, ref SDS B2 407N
210528 -           ..
210529 -          Cetuxiab Clinical Study
210530 -
210531 -          Follow up ref SDS C5 7T3H.
210532 -
210533 -                   Total    Cetuximab
210534 -      8.  Cycle 01 and 08 and 01............. 070201, ref SDS C2 407N
210535 -      9.  Cycle 01 and 08 and 02............. 070208, ref SDS C5 407N
210536 -     10.  Cycle 01 and 08 and 03............. 070215, ref SDS 0 407N
210538 -  ..
210539 - Nurses Notes...
210550 -     ..
210551 -    UCSF Log Time...
210552 -
210553 -          In....... 0930
210554 -          Out...... 1200
210555 -          Visit.... 2.5  Hours
210557 -      ..
210558 -     Pain Assessment...
210559 -
210560 -          x
210561 -          0123456789 10
210562 -
210563 -     <923k
210564 -     Administration Site:  Right Port Catheter
210565 -     Needle Size:          20 G 1"
210566 -     Blood Return Good:    Yes
210568 -      ..
210569 -     Remind patient to call MD if temp > 101 F, Shaking Chills
210570 -
210571 -            This protocol differs from Kaiser requirements, reported on
210572 -            041202. ref SDS 49 IX9N
210573 -
210576 -
210577 -
210578 -
210579 -
2106 -

SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A

3003 -
3004 - 0911
300501 -  ..
300502 - Side Effects Consultation Pharmacist Heavy Chest Difficult Breathing
300503 -
300504 - Follow up ref SDS C5 QU8K, ref SDS C2 QU8K.
300506 -  ..
300507 - Catherine asked Millie about side effects...
300508 -
300509 -            Rash like acne
300510 -
300511 -               Mild condition continues from 070208 around the nose,
300512 -               ref SDS C5 QU8K, observed by Catherine today; Nurse's
300513 -               Notes report pharmacy doctor prescribed treatment for
300514 -               rash, following up examination on 070208. ref SDS C5
300515 -               FO66
300516 -
300517 -                  [On 070222 Brigid wrote prescription for Benza Clin
300518 -                  Clindamycin benzoyl peroxide gel medication to treat
300519 -                  facial rash side effects from cetuximab chemotherapy
300520 -                  treatments. ref SDS C9 FO66
300522 -             ..
300523 -            Lymphedema Cellulitis Complications
300524 -
300525 -               Yesterday on 070214 Millie asked Kaiser for Keflex
300526 -               antibiotic medication to treat recurrence of possible
300527 -               cellulitis on the upper left arm, ref SDS C7 R66P, first
300528 -               observed by the primary care physician at Kaiser during
300529 -               examination on 070202, ref SDS C3 6Q5N, and which may
300530 -               turn out to be advancing IBC. ref SDS C3 6H6L
300531 -
300532 -                   [...in another record today, after treatment at
300533 -                   UCSF, Millie submitted another letter to Kaiser with
300534 -                   a copy to UCSF notifying of new rash, and asking
300535 -                   about renewal of prescription for treaing
300536 -                   cellulitis, and noting prospect of IBC progression.
300537 -                   ref SDS C8 VW4R
300538 -
300540 -             ..
300541 -            Tired, fatigued - pulmonary emoblism...
300542 -
300543 -               Fatigue, shortness of breath and other symptoms of
300544 -               pulmonary embolism were presented during meeting on
300545 -               070130, ref SDS C0 CV5L, citing case study listed on
300546 -               060722. ref SDS 90 ZV41
300548 -                ..
300549 -               On 070204 UCSF notified no initial side effects of
300550 -               treatment, and energy has increased; planning for CT
300551 -               test to evaluate pulmonary embolism. ref SDS C4 JJ7O
300553 -                ..
300554 -               Energy at this time remains elevated compared past 6
300555 -               months during treatment with Taxotere and capecitabine,
300556 -               and after suffering pulmonary embolism, ref SDS A6 M36G,
300557 -               and enlarged right ventricle, reported on 061012.
300558 -               ref SDS A6 7E5L
300559 -
300561 -             ..
300562 -            Heavy chest - shortness of breathing
300563 -
300564 -               Patient history was reported to UCSF on 070130.
300565 -               ref SDS C0 RT6I
300566 -
300567 -               Condition seems improved, as reported on 070204.
300568 -               ref SDS C4 JJ7O
300570 -             ..
300571 -            Cough - clearing throat
300572 -
300573 -               This condition seems improved, as reported to the doctor
300574 -               on 070130. ref SDS C0 RT6I
300575 -
300577 -             ..
300578 -            Dry face, hands and feet...
300579 -
300580 -               Dry hands and feet seem much improved since ending
300581 -               treatment with Taxotere and capecitiabine on 061201.
300582 -
300583 -               Millie's face is beginning to seem dryer than normal.
300584 -
300586 -             ..
300587 -            Eyes tearing
300588 -
300589 -               This seems improved since ending treatment with Taxoter
300590 -               and capecitabine on 061201.
300591 -
300593 -             ..
300594 -            Nausea, vomitting
300595 -
300596 -               Problems with Taxotere and capecitabine reported on
300597 -               061110, ref SDS B0 D19M, did not occur this past week
300598 -               after treatment with cetuximab.  As a result, there was
300599 -               no pre-treatment with Decadron today, per below.
300600 -               ref SDS 0 G57I
300601 -
300603 -             ..
300604 -            Sores in mouth
300605 -
300606 -               None yet, cleaning mouth carefully to avoid problem.
300607 -
300608 -
300609 -
300610 -
3007 -

SUBJECTS
Schedule Treatment Weekly Thursday 0800 4 Week Cycles Clinical Study

3303 -
330401 -  ..
330402 - Schedule Weekly Treatments Continue on Thursdays
330403 -
330404 - Follow up ref SDS C5 QK6L, ref SDS C2 QK6L.
330406 -  ..
330407 - Today, Millie's next treatment is scheduled for 070222 0830.
330409 -  ..
330410 - Blood draw will not be needed for 2 weeks on 070301, per discusison
330411 - with Brigid, reported on 070201. ref SDS C2 XR40
330412 -
330413 -
330414 -
330415 -
3305 -

SUBJECTS
Blood Counts Good Test 070131 Enables Full Dose Treatment Cetuximab

3603 -
360401 -  ..
360402 - Blood Counts Good Dose Cetuximab Normal
360403 -
360404 - Follow up ref SDS C5 Q659, ref SDS C2 Q659.
360406 -  ..
360407 - There was no blood test today.  The next test is scheduled for 070301
360408 - 1130 to start the next cycle.
360410 -  ..
360411 - Catherine confirmed today that she can specify INR test with blood
360412 - test for evaluating patient ready for chemotherapy treatment with
360413 - cetuximab.  Testing for CA 15-3 cancer marker to test for measurable
360414 - disease on the clinical study requires an order by the physician.
360415 -
360416 -
360417 -
360418 -
360419 -
360420 -
3605 -

SUBJECTS
Anticoagulation Therapy Pulmonary Emboli INR Perfect 2.5 PT Patient

3903 -
390401 -     ..
390402 -    Anticoagulattion Therapy INR Low 2.5 PT Patient
390403 -
390404 -    Follow up ref SDS C5 SE6N, ref SDS C2 SE6N.
390405 -
390406 -    PT, patient    H        ??.? sec           8.9    -     11.1
390407 -    PT INR         L         2.5 sec           2      -      3
390409 -  ..
390410 - Millie went to Kaiser before treatment today to get a blood test for
390411 - evaluating Coumadin to control pulmonary embolism.  Gloria called and
390412 - left a message that INR from the test today was 2.5.  As a result,
390413 - Millie can continue the current treatment regimen, per above.
390414 - ref SDS 0 6U5J
390415 -
390416 -
390417 -
390418 -
3905 -

SUBJECTS
Absolute Neutrophils Count ANC 1760 Well Above 1500 Required for Tre

4203 -
420401 -  ..
420402 - ANC 1760 Well Above 1500 Criteria for Blood Counts Approve Treatment
420403 -
420404 - Follow up ref SDS C5 P560, ref SDS C2 P560.
420405 -
420406 - No blood test for treatment today.
420407 -
420408 -
420409 -
4205 -

SUBJECTS
CA 15-3 67 Rise from 61 Cancer Marker Current Blood Test Reversing P

4503 -
450401 -  ..
450402 - CA 15-3 56 Fall from 68 Cancer Marker Test Pending
450403 -
450404 - Follow up ref SDS C5 2N5J, ref SDS C2 2N5J.
450405 -
450406 - On 070202 CA 15-3 dropped to 52 and rose to 56 in 2 tests. ref SDS C3
450407 - 087J
450409 -  ..
450410 - CA 15-3 presents a diagnostic of measurable disease in Millie's case,
450411 - noted in the record for the meeting at UCSF on 070130. ref SDS C0 M652
450413 -  ..
450414 - There are now two (2) CA 15-3 tests pending report from Kaiser.
450416 -  ..
450417 - CA 15-3 for the blood test on 070208 taken for INR diagnostics to
450418 - evaluate pulmonary embolism, ref SDS C5 2N5J, was reported this past
450419 - week in a telephone call by Arlette to be about 56.  Kaiser has not
450420 - formally submitted test results to the patient.  CA 15-3 for the test
450421 - this morning, per above, ref SDS 0 L59G, has not been submitted.
450422 -
450423 -    [On 070228 letter to UCSF requests coordination Kaiser on results
450424 -    of blood test today for CA 15-3 to evaluate IBC progression, and
450425 -    assess changing treatments. ref SDS C0 ED5H
450427 -     ..
450428 -    [On 070307 Kaiser submitted reports for blood tests on 070208 and
450429 -    070215 that show CA 15-3 declining. ref SDS D2 MK8J
450430 -
450431 -
450432 -
450433 -
4505 -

SUBJECTS
Port Catheter IV Connection Prepare for Drip Treatment 1 Try Require

4703 -
4704 - 0907
470501 -  ..
470502 - Preparation for Treatment Required One (1) Attempt to Connect Port
470503 -
470504 - Follow up ref SDS C5 EB7J, ref SDS C2 EB7J.
470506 -  ..
470507 - Catherine connected the IV tubes to the port....
470509 -       ..
470510 -      Interlink System Vented Paclitaxel set
470512 -  ..
470513 - There were no problems getting blood to flow from the port for the
470514 - blood sample research vials, as occurred previously on 070201.
470515 - ref SDS C2 DC5W
470517 -  ..
470518 - Catherine flushed the port with saline.
470519 -
470520 -
470522 -  ..
470523 - Blood Draws 10 Vials for Clinical Study Research
470524 -
470525 - Follow up ref SDS C5 O56V, ref SDS C2 O56V.
470526 -
470527 - Blood draw for cetuximab clinical study research not required today,
470528 - after 10 vials were taken on 070201, ref SDS C2 O56V, and another 10
470529 - vials were drawn again on 070208. ref SDS C5 O56V
470530 -
470531 -
470532 -
470533 -
470534 -
470535 -
4706 -

SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A

4903 -
4904 - 0850
490501 -  ..
490502 - Benedryl Reduce Side Effects Cetuximab Chemotherapy Treatment
490503 -
490504 - Follow up ref SDS C5 DC7J, ref SDS C2 DC7J.
490505 -
490506 - Benadryl (diphenhydramine) started.   50 MG....... ref SDS 0 IJ41
490507 -
490508 -        Purpose reported on 060721. ref SDS 89 DC7J
490510 -  ..
490511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
490512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 0
490513 - IJ41
490514 -
490515 -
490517 -  ..
4906 -
4907 -
4908 - 0901
4909 -
490901 - Benedryl completed equipment beeps.
490902 -
490903 -
490905 -  ..
4910 -
4911 -
4912 -
4913 -
491301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 0 FM4M
491302 -
491303 - On 070208 Decadron was not given because Millie did not experience
491304 - side effects of nausea and vomitting after treatment with cetuximab on
491305 - 070201. ref SDS C5 G57I  Since this favorable condition continues, per
491306 - above, ref SDS 0 D19M, Decadron was not given again today.
491307 -
491308 -
491310 -  ..
4914 -
4915 -
4916 -
4917 -
491701 - Decadron completed -- not reported.
491702 -
491703 -
491704 -
491705 -
4918 -

SUBJECTS
Cetuximab 1st Cycle 3rd Treatment Clinical Study Drug Trial Treatmen

5103 -
5104 - 0915
510501 -  ..
510502 - Cetuximab Full Dose Blood Counts on Targets Treatment 1 Hour
510503 -
510504 - Follow up ref SDS C5 4N5M, ref SDS C2 4N5M.
510505 -
510506 - Cetuximab started.
510507 -
510508 -           Verify chemotherapy order for 070208.
510510 -  ..
510511 - Chemotherapy Orders...
510512 -
510518 -    Auth#                                     Stor BCC LOC
510519 -    Visit:  12575738             DOS 20070201
510521 -     ..
510522 -    Date:  20070201
510524 -     ..
510525 -    Study Order for CC#05752:  Phase II Trial of Cetuximab alone and
510526 -    in combination with Carboplatin in ER-negative, PR-negative,
510527 -    HER2-negative Nonoverexpressing Metastatic Breast Cancers
510529 -     ..
510530 -    Dates to be given:  070201
510531 -    Arm 1:Cetuximab alone
510533 -     ..
510534 -    Diagnosis:  breast cancer
510536 -     ..
510537 -    ICD-9 codes: 174.9
510538 -    Allergies  NKDA
510540 -     ..
510541 -    Pre-medications 30 - 60 minutes prior to cetuximab infusion
510543 -     ..
510544 -    3. Diphenhydramine 50 mg IV or  [illegible writing]
510546 -     ..
510547 -    4. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
510548 -
510549 -       Further premed TBD [barely legible handwriting??]
510551 -     ..
510552 -    Medication:  (plan to give weekly ********STUDY SUPPLY**********
510554 -     ..
510555 -    5. Cetuximab (Erbitux) (loading dose)
510556 -
510557 -              400 mg/m [squared] = 684 mg IV over 120 minutes for
510558 -              first dose x 1
510559 -
510560 -       dose on dcte 20070201   Maximum infusion rate is 5 ml/minute
510561 -       (concentration 2 mg/ml)
510563 -     ..
510564 -    6. Cetuximab (Erbitux) (maintenance dose)
510565 -
510566 -              250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
510567 -              ____mg) IV over 60 or ____ minutes.
510568 -
510569 -       Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
510570 -       Infuse once weekly for 8 weeks.  First dose to be given on date
510571 -       20070201.
510573 -        ..
510574 -       Cetuximab is administered undiluted through a low protien
510575 -       binding 0.22 micro in-line filter.  Use NS solution to flush the
510576 -       line at the end of the infusion.
510578 -        ..
510579 -       ARM 2:  Administer carboplatin of vital sighs are unremarkable
510580 -       one hour after cetuximab infusion.
510582 -        ..
510583 -       Vital signs at baseline, upon cetuximab completion and one hour
510584 -       after cetuximab.
510585 -
510586 -       ****please note start and stop times****
510588 -        ..
510589 -       Laboratory work:
510590 -
510591 -          See carboplatin orders
510593 -        ..
510594 -       x  Notify MD for dose modifications if patient has severe
510595 -          acneinform rash
510596 -
510597 -          CBC with differential and platletes every 4 weeks
510598 -          Creatinine and magnesium every 4 weeks
510599 -          BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
510600 -          weeks.  If levels are outside of normal laboratory values
510601 -          notify Brigid NP  (MD/RN) at 415 443 4730
510603 -        ..
510604 -       x  Physician has discussed risks/benefits of therapy with the
510605 -          patient.  Signed consent obtained.
510606 -
510607 -
510608 -          Yes  No   O2 by nasal cannula at 2 liters/min prn for chest
510609 -          pain or SOB
510611 -           ..
510612 -          Yes  No   Diphenhydramine 50 mg IV prn x1 for urticaria
510613 -          [barely legible], pruritis SOB
510615 -           ..
510616 -          Yes  No   Hydrocortizone 100 mg IV prn x1 for urticaria
510617 -          [barely legible], pruritis SOB
510619 -           ..
510620 -          Yes  No   Albuterol inhaler 2-4 puffs prn SOB or chest
510621 -          tightness
510623 -           ..
510624 -          Yes  No   Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
510625 -          anaphylaxis
510627 -           ..
510628 -          Breast CC05752 Cetuximab doc 20061024
510629 -          Approved 20060615
510631 -           ..
510632 -          Physician signature [Hope Rugo]
510634 -           ..
510635 -          Provider#  35313
510637 -           ..
510638 -          Date:  20010131
510639 -
510641 -  ..
5107 -
5108 -
5109 - 1015
5110 -
511001 - Cetuximab treatment completed.
511002 -
511003 - Millie had a 1 hour rest and observation period.
511004 -
511005 -
511007 -  ..
5111 -
5112 -
5113 - 1115
5114 -
511401 - Catherine disconnected the IV tubes.
511403 -  ..
511404 - She inserted Herceptin to flush the port.
511406 -  ..
511407 - She then removed the needle from the port, and swabbed the needle
511408 - wound, and placed a temporary bandage.
511409 -
511410 -
511411 -
511412 -
511413 -
5115 -

SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme

5403 -
5404 - 0930
540501 -  ..
540502 - Vitals Show Patient Stable
540503 -
540504 - Follow up ref SDS C5 AW4L, ref SDS C2 AW4L.
540505 -
540506 - Catherine took vitals after starting Taxotere drip treatment...
540507 -
540508 -                    Blood
540509 -    Date   Time     Pressure   Pulse  Temprtr  Weight   So2
540511 -     ..
540512 -    070215 1200..... 106  66     61     37.0c   147      97
540513 -    070215 1055.....  96  61     64     37.0c   147      94
540514 -    070215 0930..... 100  64     66     36.7c   147      98
540515 -    070208 0920..... 143  70     59     36.5c   147      98
540516 -    070201 1330..... 136  74     66             148      94
540517 -    070201 1220..... 110  65     62     36.3c   148      96
540518 -    070201 1000..... 132  80     65     36.9c   148      99
540519 -    061201 1534..... 123  76     76     97.5    150
540520 -    061110 1534..... 136  83     73     97.0    150      98
540521 -    061020 1534..... 140  79     67     99.8    151      97
540522 -    060929 1452..... 141  78     66     98.3    149
540523 -    060908 1335..... 139  79     73     98.1    149
540524 -    060814 1610..... 139  80     59     98.2    151
540525 -    060722 1440..... 142  74     67     98.1    149
540526 -    060711.......... 172  87     54     97.5    147
540527 -    060623.......... 141  87     71     98.0    147
540528 -    060428.......... 129  73     80     99.4    149
540529 -    060217.......... 153  81     61     98.6    150
540530 -    050916.......... 120  80     80     98.5
540531 -
540532 -  *  Need vitals taken today, maybe twice.
540533 -
540534 -
540535 -
540536 -
5406 -

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

5703 -
5704 - 1705
570501 -  ..
570502 - Energy Normal Stable After Treatment Taxotere Support Drugs
570503 -
570504 - Follow up ref SDS C5 F54N, ref SDS C2 F54N.
570506 -  ..
570507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
570508 - clinical study drug trial. ref SDS 92 YP4I
570510 -  ..
570511 - On 070204 Millie reported to Kaiser and to UCSF increased energy,
570512 - working out in the gym. ref SDS C4 HF5H
570514 -  ..
570515 - Millie was alert after treatment again today, and not wobbly nor
570516 - disoriented.  She was able to drive home without side effects of
570517 - treatment.
570518 -
570519 -
570520 -
570521 -
570522 -
570523 -
570524 -
5706 -