CONTACTS 

SUBJECTS
Treatment Cetuximab 3rd Treatment 3rd Cycle Chemotherapy 10th Cycle

1103 -
1103 -    ..
1104 - Summary/Objective
1105 -
110501 - Follow up ref SDS 37 0000. ref SDS 34 0000.
110502 -
110503 - UCSF cancelled the regularly schedule examination for the 3rd
110504 - treatment in the cetuximab clinical study cycle, and scheduled an
110505 - examination by the doctor next week for the 4th treatment in the
110506 - cycle, which is a week early for the doctor's regularly scheduled
110507 - examination prior to the 1st treatment of the next cycle. ref SDS 0
110508 - FO6H  Catherine did excellent work reviewing side effects, which
110509 - remain moderate. ref SDS 0 QU8K  Emotional stress appears to remain
110510 - minimal, shown by calm vitals. ref SDS 0 AW4L  This reflects effective
110511 - treatment prescribed by Doctor Rugo, and Millie's ability to resume an
110512 - active life, including vigorous exercise. ref SDS 0 CA4K  Energy
110513 - continues to recover well after treatment.  Fatigue also may reflect
110514 - accumulating side effects of cetuximab shown by sleeping for several
110515 - hours following treatment. ref SDS 0 D48I
110516 -
110517 -
110518 -
110520 -  ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Clinic Examination Orientation Starting Treatment Cetuximab
110902 -
110903 - Follow up ref SDS 37 407N, ref SDS 34 407N.
110905 -  ..
110906 - Agenda...
110907 -
110908 -    1.  Breast examination........................ ref SDS 0 FO6H
110909 -    2.  Infusion Clinic........................... ref SDS 0 1M6H
110910 -    3.  Side effects.............................. ref SDS 0 QU8K
110911 -
110912 -
110913 -
110914 -
1110 -

SUBJECTS
Breast Examination Advanced Week 070419 Not Performed in Breast Care

1903 -
190401 -  ..
190402 - Breast Examination Likely IBC 2 Scenarios Spreading Intensity Declines
190403 -
190404 - Follow up ref SDS 37 FO6H, ref SDS 34 FO6H.
190405 -
190406 - Brigid and Jackie came into the examination room.  Brigid advised that
190407 - UCSF decided to move the meeting today for examination prior to the
190408 - 3rd treatment, to next week and make an examination prior to the 4th
190409 - treatment, which normally does not include examination, per planning
190410 - on 070201. ref SDS 15 DQ3F
190412 -  ..
190413 - This change accomodates Doctor Rugo's schedule.  She will be traveling
190414 - on 070426, and so unavailable to meet for examination starting the
190415 - next cycle of treatment.  Since she will be in the Breast Care Center
190416 - on 070419, Brigid wants to take advantage of availability for the
190417 - doctor to examin Millie and review progress at that time.
190419 -  ..
190420 - As a result the examination scheduled for today was not performed, and
190421 - will be done next week on 070419.  This will delay treatment in the
190422 - Infusion Clinic scheduled for 070419 0830, per below. ref SDS 0 QK6L
190423 -
190424 -
190425 -
190426 -
1905 -

SUBJECTS
Emotional Health Not Reviewed Examination Breast Care Clinic Prior t

2603 -
260401 -  ..
260402 - Emotional Roller Coaster Endemic Cancer Treatment and Coordination
260403 -
260404 - Follow up ref SDS 37 6A7J, ref SDS 34 6A7J.
260405 -
260406 - There was no examination today.
260407 -
260408 -
2605 -

SUBJECTS
Prognosis Not Reviewed No Examination Breast Care Clinic Prior to Tr

3203 -
320401 -  ..
320402 - Cetuximab Prognosis IBC May Subside for 10 Months Before Progressing
320403 - Prognosis Disease May Subside 10 Months or More Before Progression
320404 - Progresssion of Disease May be Delayed for 10 Months or More
320405 -
320406 - Follow up ref SDS 37 6A9H, ref SDS 34 6A9H.
320407 -
320408 - There was no examination today.
320409 -
320410 -
320411 -
320412 -
3205 -

SUBJECTS
Measurable Disease Not Reviewed No Examination Breast Care Clinic Pr

3803 -
380401 -  ..
380402 - Measureable Disease Photographs IBC Rash Improving
380403 - IBC Rash Improved Measurable Disease Photographs Tape Measure
380404 -
380405 - Follow up ref SDS 37 6T6M, ref SDS 34 6T6M.
380406 -
380407 - There was no examination today.
380408 -
380409 -
380410 -
380411 -
3805 -

SUBJECTS
Side Effects Not Reviewed No Examination Breast Care Clinic Prior to

4403 -
440401 -  ..
440402 - Side Effects Medicated After Weekly Examinations
440403 -
440404 - Follow up ref SDS 37 FO66, ref SDS 34 FO66.
440405 -
440406 - There was no examination today.
440407 -
440408 -
440409 -
4405 -

SUBJECTS
Cetuximab 3rd Cycle 3rd Treatment 11th Total Treatment Chemotherapy

5003 -
5004 - 0845
500501 -  ..
500502 - Infusion Clinic for Cetuximab Treatent
500503 -
500504 - Follow up ref SDS 37 1M6H, ref SDS 34 1M6H.
500505 -
500506 - This meeting on the 5th floor was scheduled for 0830, the same time
500507 - scheduled for meeting with the medical team in the Breast Care Center
500508 - on the 2nd floor, reported on 070315. ref SDS 29 UQ4J  Since
500509 - examinations typically take from 30 minutes to an hour, meeting with
500510 - the treatment people should have been delayed by that much to 0900 or
500511 - beyond to 0930.
500513 -  ..
500514 - Since the medical team cancelled the examination scheduled for the
500515 - Breast Care Center this morning, per above, ref SDS 0 FO6H, and moved
500516 - the meeting to next week, Millie arrived in the Infusion Clinic on the
500517 - 5th floor only 15 minutes late for the scheduled 0830 meeting.
500519 -  ..
500520 - Millie received 11th overall and 3rd treatment of 3rd cycle with
500521 - Cetuximab, starting from 070201, ref SDS 15 G68I, and the 18th
500522 - treatment for 3rd relapse of IBC, beginning on 060721. ref SDS 4 407N
500524 -  ..
500525 - Catherine was the nurse today.
500527 -           ..
500528 -          Taxotere Capecitabine
500529 -
500530 -          Follow up ref SDS 37 PR8Q, ref SDS 34 PR8Q.
500531 -
500532 -                   Relapse Treatments
500533 -
500534 -      1.  Cycle 09 and 01 ................... 060721, ref SDS 4 407N
500535 -      2.  Cycle 10 and 02 ................... 060814, ref SDS 7 LY6O
500536 -      3.  Cycle 11 and 03 ................... 060908, ref SDS 8 407N
500537 -      4.  Cycle 12 and 04 ................... 060929, ref SDS 9 407N
500538 -      5.  Cycle 13 and 05 ................... 061020, ref SDS 10 407N
500539 -      6.  Cycle 14 and 06 ................... 061110, ref SDS 11 407N
500540 -      7.  Cycle 15 and 07 ................... 061201, ref SDS 12 407N
500542 -           ..
500543 -          Cetuxiab Clinical Study
500544 -
500545 -          Follow up ref SDS 37 7T3H, ref SDS 34 7T3H.
500546 -
500547 -                   Total    Cetuximab
500548 -      8.  Cycle 01 and 08 and 01 01.......... 070201, ref SDS 15 SG8I
500549 -      9.  Cycle 01 and 08 and 02 02.......... 070208, ref SDS 17 SG8I
500550 -     10.  Cycle 01 and 08 and 03 03.......... 070215, ref SDS 18 SG8I
500551 -     11.  Cycle 01 and 08 and 04 04.......... 070222, ref SDS 21 SG8I
500552 -     12.  Cycle 02 and 09 and 01 05.......... 070301, ref SDS 24 7T3H
500553 -     13.  Cycle 02 and 09 and 02 06.......... 070308, ref SDS 27 7T3H
500554 -     14.  Cycle 02 and 09 and 03 07.......... 070315, ref SDS 29 7T3H
500555 -     15.  Cycle 02 and 09 and 04 08.......... 070322, ref SDS 30 7T3H
500556 -     16.  Cycle 03 and 10 and 01 09.......... 070329, ref SDS 34 7T3H
500557 -     17.  Cycle 03 and 10 and 02 10.......... 070405, ref SDS 37 7T3H
500558 -     18.  Cycle 03 and 10 and 03 11.......... 070412, ref SDS 0 7T3H
500560 -  ..
500561 - Nurses Notes...
500572 -  ..
500573 - Why is the visit number constant in Nurse's Notes, and yet seems to
500574 - vary in the schedule received from Nola last week? ref SDS 29 159O
500576 -     ..
500577 -    UCSF Log Time...
500578 -
500579 -                   Blood
500580 -                    Test   Infusion
500581 -
500582 -          In.......          0830
500583 -          Out......          1130
500584 -          Visit....      Min  2.5  Hours  Total 3 Hours
500586 -      ..
500587 -     Pain Assessment...
500588 -
500589 -          x
500590 -          0123456789 10
500591 -
500592 -     <923k
500593 -     Administration Site:  Right Port Catheter
500594 -     Needle Size:          20 G 1"
500595 -     Blood Return Good:    Yes
500597 -      ..
500598 -     Remind patient to call MD if temp > 101 F, Shaking Chills
500599 -
500600 -            This protocol differs from Kaiser requirements, reported on
500601 -            041202. ref SDS 1 IX9N
500602 -
500603 -
500604 -
500605 -
5007 -

SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A
Cetuximab 3rd Cycle 3rd Treatment 11th Total Treatment Chemotherapy

6304 -
6305 - 0840
630601 -  ..
630602 - Side Effects Minimal...
630603 -
630604 - Follow up ref SDS 37 QU8K, ref SDS 34 QU8K.
630606 -  ..
630607 - Nurse's notes report side effects...
630608 -
630609 -        1.  Rash acne-like...... ref SDS 37 SK9O
630610 -
630611 -               Minimal facial rash continues from 070208 around the
630612 -               nose and chin. ref SDS 17 QU8K  Millie reported slight
630613 -               increased rash on the chin, which is not noticable
630614 -               today, except by careful examination.  Treatment very
630615 -               effective with medication prescribed on 070222.
630616 -               ref SDS 21 FO66
630618 -             ..
630619 -        2.  Dry skin face, chest arm...... ref SDS 37 JS6M
630620 -
630621 -               Background on notice and treatments prescribed reported
630622 -               on 070322. ref SDS 30 JS6M  Medical team commented
630623 -               during examination on 070329, how well Millie looks.
630624 -               ref SDS 33 N49K  The next day on 070330, the primary
630625 -               care physician at Kaiser commented similarly, during
630626 -               follow up examination. ref SDS 36 N49K  This indicates
630627 -               UCSF examinations by Catherine in the Infusion Clinic,
630628 -               and by Brigid in the Breast Care Center has been timely,
630629 -               thorough, and effective prescribing Curel on 070301,
630630 -               ref SDS 23 5V73, and later Aquaphor on 070322.
630631 -               ref SDS 30 JS6M
630633 -             ..
630634 -        3.  Rash on right chest....... ref SDS 37 KU3L
630635 -
630636 -               Examination of right chest observes various blemishes.
630637 -               Nurses's Notes report no rash above the port, continuing
630638 -               observations the last several weeks reported on 070329.
630639 -               ref SDS 34 KU3L  Patient reports no interim recurrent
630640 -               rash at this location.
630642 -             ..
630643 -        4.  Rash right arm............... ref SDS 37 LI4M
630644 -
630645 -               Catherine does not comment on this issue in Nurse's
630646 -               Notes today.  Examination by the medical team on 070329
630647 -               found no evidence of disease in the right arm.
630648 -               ref SDS 33 H15M
630650 -             ..
630651 -        5.  Restless legs side effect Benedryl...... ref SDS 37 F77K
630652 -
630653 -               This was resolved on 070329 by Brigid changing the
630654 -               chemotherapy order to reduce the dose of Benadryl
630655 -               pre-treatment. ref SDS 33 MF4N
630657 -             ..
630658 -        6.  Sleeping difficulty................. ref SDS 37 NG3I
630659 -
630660 -               This problem has subsided as worry and doubt have been
630661 -               reduced by continuing favorable reports showing response
630662 -               to treatment, discussed with the medical team during
630663 -               examination on 070329. ref SDS 33 Y642
630664 -
630666 -             ..
630667 -        7.  Lymphedema Cellulitis Complications...... ref SDS 37 SU6L
630668 -
630669 -               Lymphedema continues relatively controlled with major
630670 -               swelling in the left arm measured this morning at 11.5,
630671 -               and shown by the study on 060509. ref SDS 2 HO7F  There
630672 -               is no evident association with cetuximab treatments.
630673 -               Proximate cause was left breast mastectomy with removal
630674 -               of lymph nodes in the left axillary, complicated by
630675 -               exercise to strengthen the immune system for resisting
630676 -               cancer, and by cat bites that flow from engaging pets
630677 -               for qualify of life, reported in the case study on
630678 -               070130. ref SDS 14 VX6F
630680 -                ..
630681 -               Increased intensity of rash on the upper left arm was
630682 -               reported on 070330 during examination at Kaiser by
630683 -               primary care physician. ref SDS 36 N19J
630685 -                ..
630686 -               these dramatic changes in diagnosed
630687 -               without biopsy as complications of lymphedema causing
630688 -               Cellulitis with elevated temperature, and possibly
630689 -               triggered by patient's increased exercise that overtaxed
630690 -               the system. ref SDS 36 7C7F  Keflex antibiotics was
630691 -               prescribed, ref SDS 36 474O; about 3 hours later
630692 -               self-examination showed these erruptive rash conditions
630693 -               had subsided, and so Keflex treatment was not performed.
630694 -               ref SDS 36 KZ6L   Today, there is no evidence of
630695 -               increased rash intensity of the upper left arm.
630696 -
630698 -             ..
630699 -        8.  Tired, fatigued - pulmonary emoblism... ref SDS 37 FG3N
630700 -
630701 -               Fatigue, shortness of breath and other symptoms of
630702 -               pulmonary embolism were presented during meeting on
630703 -               070130, ref SDS 14 CV5L, citing case study listed on
630704 -               060722. ref SDS 5 ZV41
630706 -                ..
630707 -               Energy that seemed to be declining leading up to
630708 -               treatment on 070301, ref SDS 24 CA4K, has continued to
630709 -               rise back to normal, as reported last week on 070322.
630710 -               ref SDS 30 CA4K  Millie continues working out in the
630711 -               gym, and has started hiking the trail at Lafayette
630712 -               Reservoir again, as reported to the medical team during
630713 -               examination on 070329. ref SDS 33 E44L  An active life
630714 -               that brings strength and stamina is reflected in
630715 -               Millie's improved vitals, shown today, per below.
630716 -               ref SDS 0 AW4L  Increased exercise in the morning on
630717 -               070330 may have triggered symptoms of Cellulitis
630718 -               diagnosed during examination later in the afternoon on
630719 -               070330. ref SDS 36 7C7F
630721 -             ..
630722 -        9.  Heavy chest - shortness of breathing..... ref SDS 37 UL6L
630723 -
630724 -               Patient history was reported to UCSF on 070130.
630725 -               ref SDS 14 RT6I
630726 -
630727 -               Condition seems improved, tracking continuing higher
630728 -               energy, per above. ref SDS 37 CA4K
630729 -
630731 -             ..
630732 -       10.  Cough - clearing throat............... ref SDS 37 8N4G
630733 -
630734 -               This condition occassionally increases noticably with
630735 -               episodes of mild, contined cough and clearing throat, as
630736 -               reported to the doctor on 070130. ref SDS 14 RT6I
630737 -
630739 -             ..
630740 -       11.  Dry hands and feet................ ref SDS 37 UM32
630741 -
630742 -               Dry hands and feet seem much improved since ending
630743 -               treatment with Taxotere and capecitiabine on 061201.
630744 -
630746 -             ..
630747 -       12.  Eyes tearing...................... ref SDS 37 HM9G
630748 -
630749 -               This seems improved since ending treatment with Taxoter
630750 -               and capecitabine on 061201.
630751 -
630753 -             ..
630754 -       13.  Nausea and vomitting................. ref SDS 37 D19M
630755 -
630756 -               Problems with Taxotere and capecitabine reported on
630757 -               061110, ref SDS 11 D19M, did not occur this past week
630758 -               after treatment with cetuximab.  As a result, there was
630759 -               no pre-treatment with Decadron today, per below.
630760 -               ref SDS 30 G57I
630762 -             ..
630763 -       14.  Sores in mouth................... ref SDS 37 KW4R
630764 -
630765 -               None yet, cleaning mouth carefully to avoid problem.
630766 -
630767 -
630768 -
630769 -
6308 -

SUBJECTS
Schedule Treatment Weekly Thursday 0800 4 Week Cycles Clinical Study

6903 -
690401 -  ..
690402 - Schedule Weekly Treatments Continue on Thursdays
690403 -
690404 - Follow up ref SDS 37 QK6L, ref SDS 34 QK6L.
690406 -  ..
690407 - Millie's next treatment is scheduled for 070419 0830, reported by Nola
690408 - on 070315. ref SDS 29 159O
690410 -  ..
690411 - This schedule was modifed by the medical team this morning.  Millie
690412 - was schedule for examination by Doctor Rugo next week on 070419, per
690413 - above. ref SDS 0 FO6H
690414 -
690415 -
690416 -
690417 -
690418 -
6905 -

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

7603 -
7604 - 0850
760501 -  ..
760502 - Preparation for Treatment Required One (1) Attempt to Connect Port
760503 -
760504 - Follow up ref SDS 37 EB7J, ref SDS 34 EB7J.
760506 -  ..
760507 - The nurse connected the IV tubes to the port....
760509 -       ..
760510 -      Interlink System Vented Paclitaxel set
760512 -  ..
760513 - Like last week and earlier on 070301, there were no problems getting
760514 - blood to flow from the port, ref SDS 24 EB7J, as occurred on 070222,
760515 - ref SDS 20 DC5W, and earlier on 070201. ref SDS 15 DC5W
760517 -  ..
760518 - The nurse flushed the port with saline.
760519 -
760520 -
760521 -
760522 -
7606 -

SUBJECTS
Blood Draws None Today 7 Vials Clinical Study Research Cetuximab Dru

8303 -
830401 -  ..
830402 - Blood Draws 7 Vials for Clinical Study Research
830403 -
830404 - Follow up ref SDS 37 O56V, ref SDS 34 O56V.
830405 -
830406 - Blood draws for the clinical study occur only to start a new cycle; so
830407 - there were no blood draws today during the 2nd treatment of cycle 3.
830408 -
830409 -
830410 -
830411 -
830412 -
8305 -

SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A

8903 -
8904 - 0900
890501 -  ..
890502 - Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
890503 -
890504 - Follow up ref SDS 37 DC7J, ref SDS 34 DC7J.
890505 -
890506 - Benadryl (diphenhydramine) started.   50 MG....... ref SDS 0 IJ41
890507 -
890508 -        Purpose reported on 060721. ref SDS 4 DC7J
890510 -  ..
890511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
890512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 37
890513 - IJ41
890514 -
890516 -  ..
8906 -
8907 -
8908 - 0915
8909 -
890901 - Benedryl completed equipment beeps.
890903 -  ..
890904 - Millie reported that decreasing the dose of Benadryl pre-treatment to
890905 - 25 mg completely eliminated previous problems of "restless legs," per
890906 - above. ref SDS 34 F77K
890907 -
890908 -
890910 -  ..
8910 -
8911 -
8912 -
8913 -
891301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 30 FM4M
891302 -
891303 - On 070208 Decadron was not given because Millie did not experience
891304 - side effects of nausea and vomitting after treatment with cetuximab on
891305 - 070201. ref SDS 17 G57I  Since this favorable condition continues, per
891306 - above, ref SDS 30 D19M, Decadron was not given again today.
891307 -
891309 -  ..
8914 -
8915 -
8916 -
891601 - Decadron completed -- not reported.
891602 -
891603 -
891604 -
891605 -
8917 -

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

9803 -
9804 - 0925
980501 -  ..
980502 - Cetuximab Full Dose Blood Counts on Targets Treatment 1 Hour
980503 -
980504 - Follow up ref SDS 37 4N5M, ref SDS 34 4N5M.
980506 -  ..
980507 - Cetuximab started.
980508 -
980509 -           Verify chemotherapy order for 070208.
980511 -  ..
980512 - Chemotherapy order calls for cetuximab to start 30 - 60 minutes after
980513 - Beyadryl pre-tretment. ref SDS 30 IJ41
980515 -  ..
980516 - Chemotherapy Orders...
980517 -
980523 -    Auth#                                     Stor BCC LOC
980524 -    Visit:  12575738             DOS 20070201
980526 -     ..
980527 -    Date:  20070201
980529 -     ..
980530 -    Study Order for CC#05752:  Phase II Trial of Cetuximab alone and
980531 -    in combination with Carboplatin in ER-negative, PR-negative,
980532 -    HER2-negative Nonoverexpressing Metastatic Breast Cancers
980534 -     ..
980535 -    Dates to be given:  070201
980536 -    Arm 1:Cetuximab alone
980538 -     ..
980539 -    Diagnosis:  breast cancer
980541 -     ..
980542 -    ICD-9 codes: 174.9
980543 -    Allergies  NKDA
980545 -     ..
980546 -    Pre-medications 30 - 60 minutes prior to cetuximab infusion
980548 -     ..
980549 -    4. Diphenhydramine 25 mg IV or  [illegible writing]
980550 -
980551 -       Benadryl........... ref SDS 30 DC7J
980552 -
980553 -       Earlier this morning, Brigid changed the Chemotherapy Order
980554 -       reducing Diphenhydramine (Benadryl) from 50 mg to 25 mg in order
980555 -       to reduce side effects of "restless legs," per above.
980556 -       ref SDS 34 F77K
980558 -        ..
980559 -       This was effective, reported above. ref SDS 34 7R6H
980561 -     ..
980562 -    5. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
980563 -
980564 -       Further premed TBD [barely legible handwriting??]
980566 -     ..
980567 -    Medication:  (plan to give weekly ********STUDY SUPPLY**********
980569 -     ..
980570 -    6. Cetuximab (Erbitux) (loading dose)
980571 -
980572 -              400 mg/m [squared] = 684 mg IV over 120 minutes for
980573 -              first dose x 1
980574 -
980575 -       dose on dcte 20070201   Maximum infusion rate is 5 ml/minute
980576 -       (concentration 2 mg/ml)
980578 -     ..
980579 -    7. Cetuximab (Erbitux) (maintenance dose)
980580 -
980581 -              250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
980582 -              ____mg) IV over 60 or ____ minutes.
980583 -
980584 -       Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
980585 -       Infuse once weekly for 8 weeks.  First dose to be given on date
980586 -       20070201.
980588 -        ..
980589 -       Cetuximab is administered undiluted through a low protien
980590 -       binding 0.22 micro in-line filter.  Use NS solution to flush the
980591 -       line at the end of the infusion.
980593 -        ..
980594 -       ARM 2:  Administer carboplatin of vital signs are unremarkable
980595 -       one hour after cetuximab infusion.
980597 -        ..
980598 -       Vital signs at baseline, upon cetuximab completion and one hour
980599 -       after cetuximab.
980600 -
980601 -       ****please note start and stop times****
980603 -        ..
980604 -       Laboratory work:
980605 -
980606 -          See carboplatin orders
980608 -        ..
980609 -       x  Notify MD for dose modifications if patient has severe
980610 -          acne in form rash
980611 -
980612 -          CBC with differential and platletes every 4 weeks
980613 -          Creatinine and magnesium every 4 weeks
980614 -          BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
980615 -          weeks.  If levels are outside of normal laboratory values
980616 -          notify Brigid NP  (MD/RN) at 415 443 4730
980618 -        ..
980619 -       x  Physician has discussed risks/benefits of therapy with the
980620 -          patient.  Signed consent obtained.
980621 -
980622 -
980623 -          Yes  No   O2 by nasal cannula at 2 liters/min prn for chest
980624 -          pain or SOB
980626 -           ..
980627 -          Yes  No   Diphenhydramine 50 mg IV prn x1 for urticaria
980628 -          [barely legible], pruritis SOB
980630 -           ..
980631 -          Yes  No   Hydrocortizone 100 mg IV prn x1 for urticaria
980632 -          [barely legible], pruritis SOB
980634 -           ..
980635 -          Yes  No   Albuterol inhaler 2-4 puffs prn SOB or chest
980636 -          tightness
980638 -           ..
980639 -          Yes  No   Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
980640 -          anaphylaxis
980642 -           ..
980643 -          Breast CC05752 Cetuximab doc 20061024
980644 -          Approved 20060615
980646 -           ..
980647 -          Physician signature [Hope Rugo]
980649 -           ..
980650 -          Provider#  35313
980652 -           ..
980653 -          Date:  20010131
980654 -
980656 -  ..
9807 -
9808 -
9809 - 1025
9810 -
981001 - Cetuximab treatment completed.
981002 -
981003 - Millie had a 1 hour rest and observation period, required by the
981004 - protocol. ref SDS 30 G679
981005 -
981006 -
981007 -
981009 -  ..
9811 -
9812 -
9813 - 1125
9814 -
981401 - Nurse disconnected the IV tubes.
981403 -  ..
981404 - She inserted Herceptin to flush the port.
981406 -  ..
981407 - She then removed the needle from the port, and swabbed the needle
981408 - wound, and placed a temporary bandage.
981409 -
981410 -
981411 -
981412 -
981413 -
9815 -

SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme

A503 -
A504 - 0900
A50501 -  ..
A50502 - Vitals Show Patient Stable
A50503 -
A50504 - Follow up ref SDS 37 AW4L, ref SDS 34 AW4L.
A50505 -
A50506 -                    Blood
A50507 -    Date   Time     Pressure   Pulse  Temprtr  Weight   So2
A50508 -
A50509 -        [On 070329 followed up. ref SDS 33 XU6M
A50511 -     ..
A50512 -    070412 1120..... 114  65     53     36.6c            96
A50513 -    070412 1020..... 130  66     57     36.8c            99
A50514 -    070412 0900..... 116  69     65     36.8c            97
A50515 -    070405 1130..... 133  75     55     36.2c            97
A50516 -    070405 1030..... 114  69     57     36.4c            99
A50517 -    070405 0900..... 128  78     54     36.5c           100
A50518 -    070329 1140..... 125  74     53     36.8c            98
A50519 -    070329 1045..... 125  72     53         c           100
A50520 -    070329 0900..... 141  76     60     36.6c            99
A50521 -    070322 1055..... 118  71     55     37.0c            97
A50522 -    070322 1015..... 120  69     57     37.1c            98
A50523 -    070322 0900..... 130  70     56     36.0c            98
A50524 -    070315 1300..... 119  75     58     36.2c            98
A50525 -    070315 1150..... 137  73     52     36.5c            99
A50526 -    070315 0945..... 143  85     60     36.4c            97
A50527 -    070308 1100..... 144  87     70     36.0c            98
A50528 -    070301 1645..... 125  62     90 *   36.4c
A50529 -    070301 1505..... 112  69     86 *   36.6c            98
A50530 -    070222 1145..... 115  73     58     36.3c   147      98
A50531 -    070222 1045..... 100  60     56     36.6c   147      98
A50532 -    070222 0930..... 117  63     68     36.2c   147      97
A50533 -    070215 1200..... 106  66     61     37.0c   147      97
A50534 -    070215 1055.....  96  61     64     37.0c   147      94
A50535 -    070215 0930..... 100  64     66     36.7c   147      98
A50536 -    070208 0920..... 143  70     59     36.5c   147      98
A50537 -    070201 1330..... 136  74     66             148      94
A50538 -    070201 1220..... 110  65     62     36.3c   148      96
A50539 -    070201 1000..... 132  80     65     36.9c   148      99
A50540 -    061201 1534..... 123  76     76     97.5    150
A50541 -    061110 1534..... 136  83     73     97.0    150      98
A50542 -    061020 1534..... 140  79     67     99.8    151      97
A50543 -    060929 1452..... 141  78     66     98.3    149
A50544 -    060908 1335..... 139  79     73     98.1    149
A50545 -    060814 1610..... 139  80     59     98.2    151
A50546 -    060722 1440..... 142  74     67     98.1    149
A50547 -    060711.......... 172  87     54     97.5    147
A50548 -    060623.......... 141  87     71     98.0    147
A50549 -    060428.......... 129  73     80     99.4    149
A50550 -    060217.......... 153  81     61     98.6    150
A50551 -    050916.......... 120  80     80     98.5
A50552 -
A50553 -  *  Need vitals taken twice to verify atypical diagnostics.
A50554 -
A50555 -
A50556 -
A50557 -
A506 -

SUBJECTS
Energy Normal Stable Alert Drive Home After Treatment Tired Sleep 2

AI03 -
AI04 - 1120
AI0501 -  ..
AI0502 - Energy Normal Stable After Treatment Cetuximab Support Drugs
AI0503 -
AI0504 - Follow up ref SDS 37 F54N, ref SDS 34 F54N.
AI0506 -  ..
AI0507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
AI0508 - clinical study drug trial. ref SDS 6 YP4I
AI0510 -  ..
AI0511 - Millie was alert after treatment again today, and not wobbly nor
AI0512 - disoriented.  She was able to drive home without side effects of
AI0513 - treatment.
AI0515 -  ..
AI0516 - After arriving home about 1210, Millie had lunch.  She took a nap from
AI0517 - about 1300 until about 1500.  Could relate to side effects from
AI0518 - cetuximab treatments that cause fatigue, reported on 070116.
AI0519 - ref SDS 13 O64M
AI0520 -
AI0521 -
AI0522 -
AI0523 -
AI0524 -
AI0525 -
AI0526 -
AI06 -