CONTACTS 

SUBJECTS
Treatment Cetuximab 1st Treatment 4th Cycle Chemotherapy 11th Cycle

1103 -
1103 -    ..
1104 - Summary/Objective
1105 -
110501 - Follow up ref SDS 45 0000. ref SDS 43 0000.
110502 -
110503 - Millie received the 1st treatment starting the 4th cycle of cetuximab
110504 - treatment on clinical study at UCSF. ref SDS 0 7T3H  Concerns last
110505 - week about inflammation at the port catheter were resolved.  Rash
110506 - subsided without treatment, suggesting possible cetuximab side effect.
110507 - ref SDS 0 RQ4O  Testing today showed blood counts have suddenly fallen
110508 - below safe levels for treatment, reversing rising trends the past 8
110509 - weeks. ref SDS 0 P560  Scheduling snafu delayed getting test results
110510 - today until after treatment, too late for case management, and
110511 - conflicting with standard of care protocol. ref SDS 0 IP5M  Catherine
110512 - notified the medical team for authorization. ref SDS 0 ME4H
110513 -
110514 -
110515 -
110517 -  ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Clinic Examination Orientation Starting Treatment Cetuximab
110902 -
110903 - Follow up ref SDS 45 407N, ref SDS 43 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 Performed in Breast Care Clinic Prior to Treatmen

1903 -
190401 -  ..
190402 - Breast Examination IBC Intensity Declines
190403 -
190404 - Follow up ref SDS 45 FO6H, ref SDS 43 FO6H.
190405 -
190406 - Breast examination performed in Breast Care clinic, ref SDS 47 025H,
190407 - reported previously last week on 070419, ref SDS 45 FO6H, and citing
190408 - planning on 070412. ref SDS 43 FO6H
190409 -
190410 -
190411 -
1905 -

SUBJECTS
Emotional Health Examination in Breast Care Clinic Prior to Treatmen

2603 -
260401 -  ..
260402 - Emotional Roller Coaster Endemic Cancer Treatment and Coordination
260403 -
260404 - Follow up ref SDS 45 6A7J, ref SDS 43 6A7J.
260405 -
260406 - Emotional health reviewed during examination performed in Breast Care
260407 - clinic. ref SDS 47 Y642
260408 -
260409 -
260410 -
2605 -

SUBJECTS
Prognosis Reviewed Examination Breast Care Clinic Prior to Treatment

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 45 6A9H, ref SDS 43 6A9H.
320407 -
320408 - Favorable prognosis presented by medical team during examination in
320409 - the Breast Care Clinic earlier this morning. ref SDS 47 M645
320410 -
320411 -
320412 -
3205 -

SUBJECTS
Measurable Disease Reviewed Starting Treatment Cycle Examination Bre

3803 -
380401 -  ..
380402 - Measureable Disease Photographs IBC Rash Improving
380403 - IBC Rash Improved Measurable Disease Photographs Tape Measure
380404 -
380405 - Follow up ref SDS 45 6T6M, ref SDS 43 6T6M.
380406 -
380407 - Measurable disease was discussed with medical team during examination
380408 - in the Breast Care Clinic earlier this morning. ref SDS 47 M652
380409 -
380410 -
380411 -
380412 -
380413 -
3805 -

SUBJECTS
Side Effects Reviewed Examination in Breast Care Clinic Prior to Tre

4403 -
440401 -  ..
440402 - Side Effects Medicated After Weekly Examinations
440403 -
440404 - Follow up ref SDS 45 FO66, ref SDS 43 FO66.
440405 -
440406 - Side Effects reviewed with medical team during examination in the
440407 - Breast Care Clinic. ref SDS 44 TQ6L  Catherine also discussed side
440408 - effects in the Infusion Clinic, reported below. ref SDS 0 QU8K
440409 -
440410 -
440411 -
440412 -
4405 -

SUBJECTS
Cetuximab 4th Cycle 1st Treatment 13th Total Treatment Chemotherapy

5003 -
5004 - 0845
500501 -  ..
500502 - Infusion Clinic for Cetuximab Treatent
500503 -
500504 - Follow up ref SDS 45 1M6H, ref SDS 43 1M6H.
500506 -  ..
500507 - Millie received 13th overall and 1st treatment of 4th cycle with
500508 - Cetuximab, starting from 070201, ref SDS 18 G68I, and the 20th
500509 - treatment for 3rd relapse of IBC, beginning on 060721. ref SDS 6 407N
500511 -  ..
500512 - Catherine was the nurse today.
500514 -           ..
500515 -          Taxotere Capecitabine
500516 -
500517 -          Follow up ref SDS 45 PR8Q, ref SDS 43 PR8Q.
500518 -
500519 -                   Relapse Treatments
500520 -
500521 -      1.  Cycle 09 and 01 ................... 060721, ref SDS 6 407N
500522 -      2.  Cycle 10 and 02 ................... 060814, ref SDS 10 LY6O
500523 -      3.  Cycle 11 and 03 ................... 060908, ref SDS 11 407N
500524 -      4.  Cycle 12 and 04 ................... 060929, ref SDS 12 407N
500525 -      5.  Cycle 13 and 05 ................... 061020, ref SDS 13 407N
500526 -      6.  Cycle 14 and 06 ................... 061110, ref SDS 14 407N
500527 -      7.  Cycle 15 and 07 ................... 061201, ref SDS 15 407N
500529 -           ..
500530 -          Cetuxiab Clinical Study
500531 -
500532 -          Follow up ref SDS 45 7T3H, ref SDS 43 7T3H.
500533 -
500534 -                   Total    Cetuximab
500535 -      8.  Cycle 01 and 08 and 01 01.......... 070201, ref SDS 18 SG8I
500536 -      9.  Cycle 01 and 08 and 02 02.......... 070208, ref SDS 20 SG8I
500537 -     10.  Cycle 01 and 08 and 03 03.......... 070215, ref SDS 21 SG8I
500538 -     11.  Cycle 01 and 08 and 04 04.......... 070222, ref SDS 24 SG8I
500539 -     12.  Cycle 02 and 09 and 01 05.......... 070301, ref SDS 27 SG8I
500540 -     13.  Cycle 02 and 09 and 02 06.......... 070308, ref SDS 30 7T3H
500541 -     14.  Cycle 02 and 09 and 03 07.......... 070315, ref SDS 32 7T3H
500542 -     15.  Cycle 02 and 09 and 04 08.......... 070322, ref SDS 33 7T3H
500543 -     16.  Cycle 03 and 10 and 01 09.......... 070329, ref SDS 38 7T3H
500544 -     17.  Cycle 03 and 10 and 02 10.......... 070405, ref SDS 41 7T3H
500545 -     18.  Cycle 03 and 10 and 03 11.......... 070412, ref SDS 43 7T3H
500546 -     19.  Cycle 03 and 10 and 04 12.......... 070419, ref SDS 45 7T3H
500547 -     20.  Cycle 04 and 11 and 01 13.......... 070426, ref SDS 0 7T3H
500549 -  ..
500550 - Nurses Notes...
500561 -  ..
500562 - Why is the visit number constant in Nurse's Notes, and yet seems to
500563 - vary in the schedule received from Nola last week? ref SDS 32 159O
500565 -     ..
500566 -    UCSF Log Time...
500567 -
500568 -                   Blood
500569 -                    Test   Infusion
500570 -
500571 -          In.......          0830
500572 -          Out......          1130
500573 -          Visit....      Min  3.0  Hours  Total 3 Hours
500575 -      ..
500576 -     Pain Assessment...
500577 -
500578 -          x
500579 -          0123456789 10
500580 -
500581 -     <923k
500582 -     Administration Site:  Right Port Catheter
500583 -     Needle Size:          20 G 1"
500584 -     Blood Return Good:    Yes
500586 -      ..
500587 -     Remind patient to call MD if temp > 101 F, Shaking Chills
500588 -
500589 -            This protocol differs from Kaiser requirements, reported on
500590 -            041202. ref SDS 3 IX9N
500591 -
500592 -
500593 -
500594 -
5006 -

SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A

6803 -
6804 - 0840
680501 -  ..
680502 - Side Effects Minimal...
680503 -
680504 - Follow up ref SDS 45 QU8K, ref SDS 43 QU8K.
680506 -  ..
680507 - Nurse's notes report side effects...
680509 -             ..
680510 -        1.  Rash acne-like
680511 -
680512 -            Follow up ref SDS 45 SK9O
680513 -
680514 -            Minimal facial rash continues from 070208 around the nose
680515 -            and chin. ref SDS 20 QU8K  Treatment very effective with
680516 -            medication prescribed on 070222. ref SDS 24 FO66
680517 -
680519 -             ..
680520 -        2.  Dry skin face, chest arm
680521 -
680522 -            Follow up ref SDS 45 JS6M
680523 -
680524 -            Background on notice and treatments prescribed reported on
680525 -            070322. ref SDS 33 JS6M  Medical team commented during
680526 -            examination on 070329, how well Millie looks. ref SDS 36
680527 -            N49K  The next day on 070330, the primary care physician at
680528 -            Kaiser commented similarly, during follow up examination.
680529 -            ref SDS 40 N49K  This indicates UCSF examinations by
680530 -            Catherine in the Infusion Clinic, and by Brigid in the
680531 -            Breast Care Center has been timely, thorough, and effective
680532 -            prescribing Curel on 070301, ref SDS 26 5V73, and later
680533 -            Aquaphor on 070322. ref SDS 33 JS6M
680534 -
680536 -             ..
680537 -        3.  Inflammation Port Catheter Resolved
680538 -
680539 -            Follow up ref SDS 45 RQ4O.
680540 -
680541 -            Nurses Notes report redness at the port site, which was
680542 -            noticed last week by Doctor Rugo, ref SDS 44 S640, and then
680543 -            was tested for infection with a culture. ref SDS 45 R54J
680544 -            Continuing inflammation at the port catheter site today
680545 -            seems less severe than last week, noted during examination
680546 -            by the medical team earlier this morning in the Breast Care
680547 -            Clinic, reporting results of the culture were negative.
680548 -            ref SDS 47 IL3L
680549 -
680551 -             ..
680552 -        4.  Inflammation rash right chest
680553 -
680554 -            Follow up ref SDS 45 KU3L
680555 -
680556 -            Examination of right chest observes various blemishes.
680557 -            Nurses's Notes report no rash above the port, continuing
680558 -            observations the last several weeks reported on 070329.
680559 -            ref SDS 38 KU3L  Patient reports no interim recurrent rash
680560 -            at this location.
680561 -
680563 -             ..
680564 -        5.  Rash right arm
680565 -
680566 -            Follow up ref SDS 45 LI4M
680567 -
680568 -            Catherine does not comment on this issue in Nurse's Notes
680569 -            today.  Examination by the medical team on 070329 found no
680570 -            evidence of disease in the right arm. ref SDS 36 H15M
680571 -
680573 -             ..
680574 -        6.  Restless legs side effect Benedryl Resolved
680575 -
680576 -            Follow up ref SDS 45 F77K
680577 -
680578 -            This was resolved on 070329 by Brigid changing the
680579 -            chemotherapy order to reduce the dose of Benadryl
680580 -            pre-treatment. ref SDS 36 MF4N
680581 -
680583 -             ..
680584 -        7.  Sleeping difficulty subsided
680585 -
680586 -            Follow up ref SDS 45 NG3I
680587 -
680588 -            This problem has subsided as worry and doubt have been
680589 -            reduced by continuing favorable reports showing response to
680590 -            treatment, discussed with the medical team during
680591 -            examination earlir today. ref SDS 47 Y642
680592 -
680594 -             ..
680595 -        8.  Lymphedema Cellulitis Complications
680596 -            Inflammation Erratic Upper Left Arm Side Effects Cetuximab
680597 -
680598 -            Follow up ref SDS 45 SU6L, ref SDS 43 SU6L
680599 -
680600 -            Lymphedema continues relatively controlled with major
680601 -            swelling in the left reduced this morning to 11.0, shown in
680602 -            the report on meeting with the medical team, earlier this
680603 -            morning, ref SDS 47 T87G, and cited in the study on 060509.
680604 -            ref SDS 4 HO7F  There is no evident association with
680605 -            cetuximab treatments.
680607 -             ..
680608 -            Intensity of rash on the upper left arm continues to rise
680609 -            and fall since the report at Kaiser on 070330. ref SDS 40
680610 -            N19J
680612 -             ..
680613 -            Today, there is no evidence of increased inflammation rash
680614 -            intensity of the upper left arm, as seen during examination
680615 -            this morning by the medical team in the Breast Care Center
680616 -            on the 2nd floor prior to treatment. ref SDS 47 115F
680618 -             ..
680619 -            Causes of erratic inflammation were considered during
680620 -            examination in the Breast Care Center last week on 070419,
680621 -            ref SDS 44 S57H, to assess possibilities...
680622 -
680623 -              1.  IBC progression...................... ref SDS 44 527G
680624 -              2.  Cellulitis complications lymphedema.. ref SDS 44 4Y93
680625 -              3.  Cetuximab side effects inflammation.. ref SDS 44 F57K
680626 -              4.  Cat bite............................. ref SDS 44 P67J
680627 -
680629 -             ..
680630 -        9.  Tired, fatigued - pulmonary emoblism
680631 -
680632 -            Follow up ref SDS 45 FG3N
680633 -
680634 -            Fatigue, shortness of breath and other symptoms of
680635 -            pulmonary embolism were presented during meeting on 070130,
680636 -            ref SDS 17 CV5L, citing case study listed on 060722.
680637 -            ref SDS 7 ZV41
680639 -             ..
680640 -            Energy that seemed to be declining leading up to treatment
680641 -            on 070301, ref SDS 27 CA4K, has continued to rise back to
680642 -            normal, as reported last week on 070322. ref SDS 33 CA4K
680643 -            Millie continues working out in the gym, and has started
680644 -            hiking the trail at Lafayette Reservoir again, as reported
680645 -            to the medical team during examination on 070329.
680646 -            ref SDS 36 E44L  An active life that brings strength and
680647 -            stamina is reflected in Millie's improved vitals, shown
680648 -            today, per below. ref SDS 0 AW4L  Increased exercise in
680649 -            the morning on 070330 may have triggered symptoms of
680650 -            Cellulitis diagnosed during examination later in the
680651 -            afternoon on 070330. ref SDS 40 7C7F
680653 -             ..
680654 -            Millie has been taking naps 2 - 3 hours after treatments
680655 -            the past month, beginning on 070405. ref SDS 41 BB7G  May
680656 -            indicate accumulating effects of cetuximab that make
680657 -            patients tired, listed as side effect in Consent documents
680658 -            reviewed on 070116. ref SDS 16 O64M
680659 -
680661 -             ..
680662 -       10.  Heavy chest - shortness of breathing
680663 -
680664 -            Follow up ref SDS 45 UL6L
680665 -
680666 -            Patient history was reported to UCSF on 070130. ref SDS 17
680667 -            RT6I
680669 -             ..
680670 -            Condition seems improved, tracking continuing higher
680671 -            energy, per above. ref SDS 41 CA4K
680672 -
680674 -             ..
680675 -       11.  Cough - clearing throat
680676 -
680677 -            Follow up ref SDS 45 8N4G
680678 -
680679 -            This condition occassionally increases noticably with
680680 -            episodes of mild, contined cough and clearing throat, as
680681 -            reported to the doctor on 070130. ref SDS 17 RT6I
680682 -
680684 -             ..
680685 -       12.  Dry hands and feet
680686 -
680687 -            Follow up ref SDS 45 UM32
680689 -             ..
680690 -            Dry hands and feet seem much improved since ending
680691 -            treatment with Taxotere and capecitiabine on 061201.
680692 -
680694 -             ..
680695 -       13.  Eyes tearing
680696 -
680697 -            Follow up ref SDS 45 HM9G
680698 -
680699 -            This seems improved since ending treatment with Taxoter
680700 -            and capecitabine on 061201.
680701 -
680703 -             ..
680704 -       14.  Nausea and vomitting
680705 -
680706 -            Follow up ref SDS 45 D19M
680708 -             ..
680709 -            Problems with Taxotere and capecitabine reported on 061110,
680710 -            ref SDS 14 D19M, did not occur this past week after
680711 -            treatment with cetuximab.  As a result, there was no
680712 -            pre-treatment with Decadron today, per below. ref SDS 33
680713 -            G57I
680715 -             ..
680716 -       15.  Sores in mouth
680717 -
680718 -            Follow up ref SDS 45 KW4R
680719 -
680720 -            None yet, cleaning mouth carefully to avoid problem.
680721 -
680722 -
680723 -
680724 -
6808 -

SUBJECTS
Schedule Treatment Weekly Thursday 0800 4 Week Cycles Clinical Study

8203 -
820401 -  ..
820402 - Schedule Weekly Treatments Continue on Thursdays
820403 -
820404 - Follow up ref SDS 45 QK6L, ref SDS 43 QK6L.
820406 -  ..
820407 - Millie's next treatment is scheduled for 070503 0830, reported by Nola
820408 - on 070315. ref SDS 32 159O
820410 -  ..
820411 - The schedule was modifed by the medical team last week on 070412,
820412 - switching Millie's meeting with the doctor from next week to today.
820413 - ref SDS 43 FO6H  This change does not affect the schedule for
820414 - treatment next week.
820416 -  ..
820417 - Millie sent a letter to UCSF on 070424 with copies to Jackie, who
820418 - coordinates the work, and to Brigid who supports examinations, and to
820419 - Catherine who performs treatment, including blood draws. ref SDS 46
820420 - 407N   This issue was discussed with the medical team earlier this
820421 - morning. ref SDS 47 VF5M
820423 -  ..
820424 - The letter on 070424 scheduled a blood draw in the Infusion Clinic
820425 - this morning at 0800, ref SDS 46 MF5Y, which is the earliest they are
820426 - willing to perform work using Millie's port catheter.  Blood can be
820427 - drawn earlier at the Laboratory on the 1st floor.  The Laboratory
820428 - staff will not use the port catheter, which Millie requires to prevent
820429 - trauma from needle penetrations.  Therefore, Millie has to get the
820430 - blood draw in the Infusion Clinic.  Getting blood draws in the
820431 - Infusion Clinic at 0800 meets requirements for tests to verify blood
820432 - counts (ANC NEUTS above 1800 or at least 1500) are strong enough for
820433 - the the patient to safely receive chemotherapy treatments. ref SDS 46
820434 - 4J4O
820436 -  ..
820437 - For some reason the schedule was changed today.  Blood was drawn and
820438 - sent to the Lab for testing during treatment today, rather than prior
820439 - to treatment, per below, ref SDS 0 R54J, and so results were not
820440 - available in time today to guide decision during the meeting prior to
820441 - treatment, and by the staff in the Infusion Clinic on evaluating
820442 - safety of Millie getting treatment today, required by standard of care
820443 - protocol, reviewed on 070116. ref SDS 16 5U7Z  Test results later
820444 - showed blood counts are not high enough for safe treatment today.
820445 - ref SDS 0 P560
820447 -  ..
820448 - Patient history on medical mistakes is listed on 040416. ref SDS 2
820449 - GN7J
820451 -  ..
820452 - Planning was discussed with Catherine on 070424 to avoid this problem.
820453 - ref SDS 46 KK4N
820455 -  ..
820456 - Catherine asked why the schedule was changed, resulting in getting
820457 - notice of low blood counts after treatment was completed, rather than
820458 - the standard practice, and the practice in this case for the past 4
820459 - months, of getting blood tests as early as possible to avoid giving
820460 - unsafe treatment.  This was considered on 070424. ref SDS 46 1V3F
820461 -
820462 -     [On 070503 treatment was given after blood test results were
820463 -     received and reviewed with medical team, ref SDS 49 EY7H,
820464 -     correcting problem today. ref SDS 0 MN6M
820465 -
820466 -
820467 -
820468 -
8205 -

SUBJECTS
Blood Tests Counts Low Received After Treatment Could Not Evaluate S

9003 -
9004 - 0830
900501 -  ..
900502 - Blood Test Counts Low Full Dose Cetuximab Ordered Prior to Test
900503 -
900504 - Follow up ref SDS 45 R54J, ref SDS 38 Q659.
900505 -
900506 - Millie had a blood draw this morning during treatment in the Infusion
900507 - Clinic after meeting with the medical team for examination.
900508 - ref SDS 47 1R4H  A few days ago, Millie submitted a letter to UCSF on
900509 - 070424 coordinating the schedule, per above, ref SDS 0 IP5F, for blood
900510 - draws today at 0800 prior to meeting with the medical team, as
900511 - required by the protocol for evaluating patient fitness to safely get
900512 - treatment. ref SDS 46 MF5Y  This applied prior practice that was
900513 - effective on 070329. ref SDS 38 Q659
900515 -  ..
900516 - Millie subsequently asked UCSF about delaying the blood draw until
900517 - after examination to evaluate patient fitness for safe treatment, and
900518 - based recent trend of rising blood counts, reported last week with
900519 - NEUTS increasing to 1.87 (ANC 1870).  UCSF approved this change to the
900520 - protocol based on recent patient history.
900522 -  ..
900523 - Catherine received results of the test after Millie's treatment was
900524 - completed, which showed blood counts were too low for safe treatment,
900525 - reported below, ref SDS 0 P560, citing notification to the medical
900526 - team on standard of care performing blood tests for safe treatment
900527 - prior to treatment. ref SDS 0 ME4H
900528 -
900529 -     [On 070503 treatment was given after blood test results were
900530 -     received and reviewed with medical team, ref SDS 49 EY7H,
900531 -     correcting problem today. ref SDS 0 MN6M
900533 -  ..
900534 - Nurses Notes report redness at the port site, which was noticed last
900535 - week by Doctor Rugo, ref SDS 44 S640, and then was tested for
900536 - infection with a culture. ref SDS 45 R54J  Continuing inflammation at
900537 - the port catheter site seems less severe than last week, per above.
900538 - ref SDS 0 RQ4O
900539 -
900540 -
900542 -  ..
9006 -
9007 -
9008 - 1117
9009 -
900901 - During treatment, Catherine submitted results of the test.
900903 -     ..
900917 -     ..
900918 -    Log#:                   070426 08:30
900919 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
900920 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
900922 -     ..
900923 -    CBC with DIFF & PLT CT                                     CBCD
900924 -     ..
900925 -    WBC COUNT               4.2    x10E9/L     3.4  -   10     WBC   WBC x10-3        K/uL     3.4  -  10.0
900926 -    RBC COUNT               4.38   x10E12/L      4  -   5.2    RBC   RBC x10-6        M/uL    3.60  -  5.70
900927 -    HEMOGLOBIN             13.8    g/dL         12  -   15.5   HGB   Hemoglobin       g/dL    11.5  -  15.0
900928 -    HEMATOCRIT             40.3    PERCENT      36  -   46     HCT   Hematocrit       %       34.0  -  46.0
900929 -    MCV                    92      fL           80  -   100    MCV   MCV              fL      80.0  -  100.0
900930 -    MCH                    31.5    pg           26  -   34     MCH
900931 -    MCHC                   34.2    g/dL         31  -   36     MCHC
900932 -    PLATELETS             205      x10E9/L     140  -  450     PLT   Plt x10-3        K/uL     140  -  400
900933 -    ..
900934 -       (posted 070501, ref SDS 48 EQ6I)
900935 -    CA 15-3                 29     U/mL             <  31    CA15-3  CA 15-3                        <  39
900936 -    ..
900937 -     (NEUTS x 1000 = ANC for Kaiser)
900938 -    NEUTS                   1.47   x10E9/L     1.8  -  6.8     N-A   ANC                      1500
900939 -    Neutrophils    Not Reported                                      Neutrophils       %        50  -  70
900941 -     ..
900942 -    LYMPHS                  2.01   x10E9/L     0.9  -  2.9     L-A   Lymphocytes       %        20  -  50
900943 -    MONOS                   0.41   x10E9/L     0.1  -  0.6     M-A   Monocyte          %         0  -  11
900944 -    EOS                     0.22   x10E9/L       0  -  0.4     E-A   Esoinophils       %         1  -  5
900945 -    BASOS                   0.08   x10E9/L       0  -  0.1     B-A   Basophil          %         0  -  2
900946 -                                                                                                 0  -  5
900947 -     ..
900948 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
900949 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
900950 -     ..
900951 -    PT              H      29.4    S          12.5  - 16.0     PT    PT, patient       sec     8.9  -  11.1
900952 -    INL Nrm Ratio   H       2.7                0.9  -  1.2     INR   PT INR            sec     2.0  -  3.0
900953 -    PARTIAL
900954 -     THROMBOPLASTIN  Not Reported  S          22.4  - 33.3     PTT
900956 -     ..
900957 -    ELECTROLYTE PANEL                                          LYTE
900958 -    SODIUM                141      mmol/L      134  -  143     NA    Sodium            mEq/L   137  -  145
900959 -    POTASSIUM               4.2    mmol/L      3.4  -  4.9     K     Potassium         mEq/L   3.5  -  5.3
900960 -    CHLORIDE              106      mmol/L       98  -  107     CL
900961 -    CARBON DIOX TOTAL      26      mmol/L       23  -  32      CO2
900962 -    ANION GAP               9                    3  -  14      ANGA
900964 -     ..
900965 -    UREA NITROGEN          10      mg/dL         8  -  23      BUN   BUN               mg/dL     7  -  17
900966 -    CALCIUM                 9.3    mg/dL       8.7  -  10.1    CA    Calcium           mg/dL   8.4  -  10.2
900967 -    MAGNESIUM               1.8    mg/dL       1.8  -  2.3     MG    Magnesium         mg/dL   1.6  -  2.3
900969 -     ..
900970 -    CREATININE              0.7    mg/dL       0.6  -  1.2     CR    Creatinine        mg/dL   0.6  -  1.2
900971 -    GLUCOSE                74      mg/dL        70  -  199     GLU   Glucose           mg/dL     ?  -   ?
900972 -    AST                    34      U/L          16  -  41      AST   AST (SGOT)        U/L      14  -  36
900973 -    ALT                    21      U/L          11  -  54      ALT   ALT (SGPT)        U/L      11  -  66
900974 -    BILIRUBIN TOTAL         0.9    mg/dL       0.3  -  1.3     BILT  Bili Total        mg/dL   0.2  -  1.3
900975 -    ALKALINE PHOSPHATASE   55      U/L          29  -  111     ALKP  Alkaline Ph       U/L      38  -  126
900976 -    PROTEIN TOTAL        in lab    g/dL        5.8  -  8.0     TP    Protein, Total    g/dL    6.3  -  8.2
900977 -    ALBUMIN              in lab    g/dL        3.4  -  4.7     ALB   Albumin           g/dL    3.4  -  4.8
900978 -
900979 -
900980 -
900981 -
9010 -

SUBJECTS
INR 2.7 Coagulation Control Coumadin Treatment Pulmonary Embolism PT

9903 -
990401 -  ..
990402 - Coagulation Control INR 2.7 Normal Stable PT 29.4 High
990403 -
990404 - Follow up ref SDS 38 SE6N, ref SDS 33 SE6N.
990405 -
990406 - On 070330 Millie's letter to Kaiser notified Gloria of INR stable
990407 - blood tests for past 2 months, shown on 070329, ref SDS 38 SE6N,
990408 - continuing current Coumadin regimen. ref SDS 39 ZH4H
990410 -  ..
990411 - The test today shows PT 29.4 and INR 2.7, per above, ref SDS 0 PU7Y,
990412 - and was discussed with the medical team during the meeting in the
990413 - Breast Care Center on the 2nd floor, prior to treatment in the
990414 - Infusion Clinic on the 5th floor. ref SDS 47 CV5L
990416 -  ..
990417 - This has been stable for several months indicating the current regimen
990418 - is effective, and so supports continuing blood test regimen once a
990419 - month, per review on 070329, ref SDS 38 IL6G, citing planning on
990420 - 070308, ref SDS 30 CS6J, and communication with Gloria the day before
990421 - on 070307. ref SDS 29 IY6I
990422 -
990423 -
990424 -
990425 -
990426 -
9905 -

SUBJECTS
Absolute Neutrophils Count ANC 1470 Below 1800 Safe Level UCSF Requi

A703 -
A70401 -  ..
A70402 - ANC 1470 Below 1800 Criteria for Blood Counts to Approve Treatment
A70403 -
A70404 - Follow up ref SDS 45 P560, ref SDS 38 P560.
A70405 -
A70406 - Background on differences representing ANC in Kaiser and UCSF blood
A70407 - testing is reported on 070301. ref SDS 27 U37I
A70409 -  ..
A70410 - ANC reported as "NUETS" in the UCSF blood test reported as 1.47, per
A70411 - above. ref SDS 0 QY6H  This is equivalent to 1470 in Kaiser's scheme.
A70412 - Catherine noted NEUTS 1.47 is well below UCSF criteria of 1800 for
A70413 - safe treatment based on strength of the immune system.  Other
A70414 - authorities list 1.50 (ANC 1500) as a common level for safe
A70415 - treatments, including cetuximab.
A70417 -  ..
A70418 - Blood test scheduling to get results in time for authorizing safe
A70419 - treatment is reviewed above. ref SDS 0 IP5F  Patient history on
A70420 - medical mistakes is listed on 040416. ref SDS 2 GN7J
A70422 -  ..
A70423 - Catherine contacted Brigid in the Breast Care Center to review
A70424 - treatment authorization procedures, as reported in Nurse's Notes.
A70425 -
A70426 -     [On 070503 treatment was given after blood test results were
A70427 -     received and reviewed with medical team, ref SDS 49 EY7H,
A70428 -     correcting problem today. ref SDS 0 MN6M
A70430 -  ..
A70431 - Normally blood tests are done prior to treatment, so there is time to
A70432 - avoid or adjust treatment when counts are below safe levels, causing
A70433 - increased risk of infection due to weakened immune system, explained
A70434 - by the primary care physician during the meeting at Kaiser on 030606.
A70435 - ref SDS 1 JP7G  On 070424 Millie contacted UCSF and decided to rely on
A70436 - the test last week when NEUTS was 1.87, rather than rely on results of
A70437 - testing today to guide treatment decisions, ref SDS 46 1V3F, as
A70438 - further reported for the meeting with the medical team this morning in
A70439 - the Breast Care Center. ref SDS 47 PN9I  Millie's patient history
A70440 - lends support to taking a chance on prior testing.  The study on
A70441 - 060810 shows she has often been treated when blood counts are too low,
A70442 - ref SDS 9 HV45, and so far there have been no adverse consequences,
A70443 - which testing is designed to prevent.
A70444 -
A70445 -     [On 070524 treatment was approved based on favorable blood counts
A70446 -     prior to givint treatment. ref SDS 54 PN9I
A70448 -  ..
A70449 - ANC suddenly falls...
A70450 -
A70451 -        6972................................ 060814, ref SDS 10 P560
A70452 -        6390................................ 060908, ref SDS 11 P560
A70453 -        5200................................ 060929, ref SDS 12 P560
A70454 -        3869................................ 061020, ref SDS 13 P560
A70455 -        2880................................ 061110, ref SDS 14 P560
A70456 -        2888................................ 061201, ref SDS 15 P560
A70457 -        1760................................ 070201, ref SDS 18 P560
A70458 -        1230................................ 070301, ref SDS 27 P560
A70459 -        1510................................ 070308, ref SDS 26 P560
A70460 -        1810................................ 070329, ref SDS 38 P560
A70461 -        1870................................ 070419, ref SDS 45 P560
A70462 -        1470................................ 070426, ref SDS 0 P560
A70464 -  ..
A70465 - Blood counts falling below safe levels for treatment shows weakening
A70466 - immune system that reverses prior trend over the past 2 months, which
A70467 - can delay or impede schedule of weekly treatments, especially if the
A70468 - doctor adds carboplatin to increase effectiveness of treatments, as
A70469 - reported last month on 070301. ref SDS 27 AZ4G  ANC rising over the
A70470 - past 2 months validates UCSF treatment plan.  Unexpected reversal
A70471 - today and falling blood counts may reflect recent cat bites reported
A70472 - on 070419. ref SDS 44 P67J  Millie's patient history shows low blood
A70473 - counnts occurred with a cat bite and Millie was in the hospital for a
A70474 - week. ref SDS 44 FA9K
A70475 -
A70476 -    [On 070503 additional test shows blood counts rise to 1.54, well
A70477 -    below UCSF standards for safe treatment; treatment approved based
A70478 -    on patient history. ref SDS 49 P560
A70480 -     ..
A70481 -    [On 070509 Millie's letter asks UCSF about follow up testing blood
A70482 -    counts for safe treatment. ref SDS 50 3N5P
A70484 -     ..
A70485 -    [On 070510 UCSF does not order follow up test. ref SDS 51
A70486 -    MZ3N
A70488 -     ..
A70489 -    [On 070524 blood test shows ANC (NEUTS) increased to 1.84.
A70490 -    ref SDS 55 P560
A70491 -
A70492 -
A70493 -
A70494 -
A705 -

SUBJECTS
CA 15-3 29 Blood Tests 070426 Results Submitted by UCSF Cancer Marke

AG03 -
AG0401 -  ..
AG0402 - CA 15-3 29 Drops Below Target 1st Time in 6 Years with Systemic Treatment
AG0403 -
AG0404 - Follow up ref SDS 38 2N5J, ref SDS 33 2N5J.
AG0405 -
AG0406 - CA 15-3 was not available from the blood test today.  On 070501
AG0407 - results show the cancer marker declined again dropping from 33 down to
AG0408 - 29, per above. ref SDS 0 A16M  Continued decline in the cancer marker
AG0409 - shows response to treatment on the cetuximab clinical study.
AG0411 -  ..
AG0412 - Patient history of CA 15-3 is reported in the record on examination
AG0413 - today, 070426. ref SDS 47 087J
AG0414 -
AG0415 -    [On 070501 received letter from UCSF confirming CA 15-3 29.
AG0416 -    ref SDS 48 EQ6I
AG0418 -  ..
AG0419 - Cancer marker CA 15-3 dropping below the target level of 31 for the
AG0420 - 1st time in six (6) years of systemic treatments, aligns with
AG0421 - observations during examination today by the medical team that IBC
AG0422 - rash is subsiding at all locations, and no new IBC sites have occurred
AG0423 - during the past 4-week treatment cycle, reported in another record
AG0424 - today. ref SDS 47 M68J
AG0425 -
AG0426 -     [On 070514 Millie requests CA 15-3 results from Kaiser for test on
AG0427 -     070511 cross-check. ref SDS 52 YQ6O
AG0429 -      ..
AG0430 -     [On 070516 Kaiser reported CA 15-3 increased to 56.
AG0431 -     ref SDS 53 RH9H
AG0432 -
AG0433 -
AG05 -

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

AO03 -
AO04 - 0845
AO0501 -  ..
AO0502 - Preparation for Treatment Required One (1. Attempt to Connect Port
AO0503 -
AO0504 - Follow up ref SDS 45 EB7J, ref SDS 43 EB7J.
AO0506 -  ..
AO0507 - The nurse connected the IV tubes to the port....
AO0509 -       ..
AO0510 -      Interlink System Vented Paclitaxel set
AO0512 -  ..
AO0513 - Like last week and earlier on 070301, there were no problems getting
AO0514 - blood to flow from the port, ref SDS 27 EB7J, as occurred on 070222,
AO0515 - ref SDS 23 DC5W, and earlier on 070201. ref SDS 18 DC5W
AO0517 -  ..
AO0518 - The nurse flushed the port with saline.
AO0520 -  ..
AO0521 - Prior inflammation above and at the port catheter penetration reported
AO0522 - a week ago on 070419, ref SDS 45 UJ4M, has resolved itself.  Today,
AO0523 - there is no inflammation observed today.  Results of the blood culture
AO0524 - taken last week, ref SDS 45 R54J, were negative.
AO0525 -
AO0526 -
AO0527 -
AO0528 -
AO06 -

SUBJECTS
Blood Draws 7 Vials Clinical Study Research Cetuximab Drug Trial Blo

AW03 -
AW04 - 0830
AW0501 -  ..
AW0502 - Blood Draws 7 Vials for Clinical Study Research
AW0503 -
AW0504 - Follow up ref SDS 45 O56V, ref SDS 43 O56V.
AW0505 -
AW0506 - The nurse drew seven (7) vials of blood today for research on the
AW0507 - cetuximab clincial trial, and required to start each cycle.  Today is
AW0508 - the 1st treatment for the 4th cycle. ref SDS 0 7T3H
AW0509 -
AW0510 -
AW0511 -
AW0512 -
AW06 -

SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A

B303 -
B304 - 0850
B30501 -  ..
B30502 - Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
B30503 -
B30504 - Follow up ref SDS 45 DC7J, ref SDS 43 DC7J.
B30505 -
B30506 - Benadryl (diphenhydramine) started.   25 MG....... ref SDS 0 IJ44
B30507 -
B30508 -        Purpose reported on 060721. ref SDS 5 DC7J
B30510 -  ..
B30511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
B30512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 0
B30513 - IJ41
B30514 -
B30515 -
B30517 -  ..
B306 -
B307 -
B308 - 0910
B309 -
B30901 - Benedryl completed equipment beeps.
B30902 -
B30903 -
B30904 -
B30906 -  ..
B310 -
B311 -
B312 -
B313 -
B31301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 33 FM4M
B31302 -
B31303 - On 070208 Decadron was not given because Millie did not experience
B31304 - side effects of nausea and vomitting after treatment with cetuximab on
B31305 - 070201. ref SDS 20 G57I  Since this favorable condition continues, per
B31306 - above, ref SDS 33 D19M, Decadron was not given again today.
B31307 -
B31309 -  ..
B314 -
B315 -
B316 -
B31601 - Decadron completed -- not reported.
B31602 -
B31603 -
B31604 -
B31605 -
B317 -

SUBJECTS
Cetuximab 4th Cycle 1st Treatment Blood Counts Below Safe Levels Cli

BD03 -
BD04 - 0920
BD0501 -  ..
BD0502 - Cetuximab Full Dose Blood Counts Below Targets Treatment 1 Hour
BD0503 -
BD0504 - Follow up ref SDS 45 4N5M, ref SDS 43 4N5M.
BD0506 -  ..
BD0507 - Cetuximab started.
BD0508 -
BD0509 -           Verify chemotherapy order for 070208.
BD0511 -  ..
BD0512 - Chemotherapy order calls for cetuximab to start 30 - 60 minutes after
BD0513 - Beyadryl pre-tretment. ref SDS 0 IJ41
BD0515 -  ..
BD0516 - Millie received a full dose of cetuximab treatment, even though blood
BD0517 - counts from the test today were below the level for safe treatment,
BD0518 - discussed above. ref SDS 0 P560  Treatment was given with blood counts
BD0519 - too low because this was not known due a scheduling issue that delayed
BD0520 - the blood tests until after treatment, rather than following
BD0521 - requirements for blood tests to assess safety of giving treatment,
BD0522 - also reported above. ref SDS 0 IP5F
BD0523 -
BD0524 -     [On 070503 treatment was given after blood test results were
BD0525 -     received and reviewed with medical team, ref SDS 49 EY7H,
BD0526 -     correcting problem today. ref SDS 0 LR9G
BD0528 -  ..
BD0529 - Chemotherapy Orders...
BD0530 -
BD0536 -    Auth#                                     Stor BCC LOC
BD0537 -    Visit:  12575738             DOS 20070201
BD0539 -     ..
BD0540 -    Date:  20070201
BD0542 -     ..
BD0543 -    Study Order for CC#05752:  Phase II Trial of Cetuximab alone and
BD0544 -    in combination with Carboplatin in ER-negative, PR-negative,
BD0545 -    HER2-negative Nonoverexpressing Metastatic Breast Cancers
BD0547 -     ..
BD0548 -    Dates to be given:  070201
BD0549 -    Arm 1:Cetuximab alone
BD0551 -     ..
BD0552 -    Diagnosis:  breast cancer
BD0554 -     ..
BD0555 -    ICD-9 codes: 174.9
BD0556 -    Allergies  NKDA
BD0558 -     ..
BD0559 -    Pre-medications 30 - 60 minutes prior to cetuximab infusion
BD0561 -     ..
BD0562 -    4. Diphenhydramine 25 mg IV or  [illegible writing]
BD0563 -
BD0564 -       Benadryl........... ref SDS 33 DC7J
BD0565 -
BD0566 -       On 070329 Brigid changed the Chemotherapy Order reducing
BD0567 -       Diphenhydramine (Benadryl) from 50 mg to 25 mg in order to
BD0568 -       reduce side effects of "restless legs." ref SDS 38 IJ44
BD0570 -        ..
BD0571 -       This was effective, reported above. ref SDS 38 7R6H
BD0573 -     ..
BD0574 -    5. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
BD0575 -
BD0576 -       Further premed TBD [barely legible handwriting??]
BD0578 -     ..
BD0579 -    Medication:  (plan to give weekly ********STUDY SUPPLY**********
BD0581 -     ..
BD0582 -    6. Cetuximab (Erbitux) (loading dose)
BD0583 -
BD0584 -              400 mg/m [squared] = 684 mg IV over 120 minutes for
BD0585 -              first dose x 1
BD0586 -
BD0587 -       dose on dcte 20070201   Maximum infusion rate is 5 ml/minute
BD0588 -       (concentration 2 mg/ml)
BD0590 -     ..
BD0591 -    7. Cetuximab (Erbitux) (maintenance dose)
BD0592 -
BD0593 -              250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
BD0594 -              ____mg) IV over 60 or ____ minutes.
BD0595 -
BD0596 -       Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
BD0597 -       Infuse once weekly for 8 weeks.  First dose to be given on date
BD0598 -       20070201.
BD0600 -        ..
BD0601 -       Cetuximab is administered undiluted through a low protien
BD0602 -       binding 0.22 micro in-line filter.  Use NS solution to flush the
BD0603 -       line at the end of the infusion.
BD0605 -        ..
BD0606 -       ARM 2:  Administer carboplatin of vital signs are unremarkable
BD0607 -       one hour after cetuximab infusion.
BD0609 -        ..
BD0610 -       Vital signs at baseline, upon cetuximab completion and one hour
BD0611 -       after cetuximab.
BD0612 -
BD0613 -       ****please note start and stop times****
BD0615 -        ..
BD0616 -       Laboratory work:
BD0617 -
BD0618 -          See carboplatin orders
BD0620 -        ..
BD0621 -       x  Notify MD for dose modifications if patient has severe
BD0622 -          acne in form rash
BD0623 -
BD0624 -          CBC with differential and platletes every 4 weeks
BD0625 -          Creatinine and magnesium every 4 weeks
BD0626 -          BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
BD0627 -          weeks.  If levels are outside of normal laboratory values
BD0628 -          notify Brigid NP  (MD/RN) at 415 443 4730
BD0630 -        ..
BD0631 -       x  Physician has discussed risks/benefits of therapy with the
BD0632 -          patient.  Signed consent obtained.
BD0633 -
BD0634 -
BD0635 -          Yes   5.  O2 by nasal cannula at 2 liters/min prn for chest
BD0636 -          pain or SOB
BD0638 -           ..
BD0639 -          Yes   6.  Diphenhydramine 50 mg IV prn x1 for urticaria
BD0640 -          [barely legible], pruritis SOB
BD0642 -           ..
BD0643 -          Yes   7.  Hydrocortizone 100 mg IV prn x1 for urticaria
BD0644 -          [barely legible], pruritis SOB
BD0646 -           ..
BD0647 -          Yes   8.  Albuterol inhaler 2-4 puffs prn SOB or chest
BD0648 -          tightness
BD0650 -           ..
BD0651 -          Yes   9.  Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
BD0652 -          anaphylaxis
BD0654 -           ..
BD0655 -          Breast CC05752 Cetuximab doc 20061024
BD0656 -          Approved 20060615
BD0658 -           ..
BD0659 -          Physician signature [Hope Rugo]
BD0661 -           ..
BD0662 -          Provider#  35313
BD0664 -           ..
BD0665 -          Date:  20010131
BD0666 -
BD0668 -  ..
BD07 -
BD08 -
BD09 - 1025
BD10 -
BD1001 - Cetuximab treatment completed.
BD1002 -
BD1003 - Millie had a 1 hour rest and observation period, required by the
BD1004 - protocol. ref SDS 33 G679
BD1005 -
BD1006 -
BD1007 -
BD1009 -  ..
BD11 -
BD12 -
BD13 - 1130
BD14 -
BD1401 - Nurse disconnected the IV tubes.
BD1403 -  ..
BD1404 - She inserted Herceptin to flush the port.
BD1406 -  ..
BD1407 - She then removed the needle from the port, and swabbed the needle
BD1408 - wound, and placed a temporary bandage.
BD1409 -
BD1410 -
BD1411 -
BD1412 -
BD1413 -
BD15 -

SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme

BK03 -
BK04 - 0900
BK0501 -  ..
BK0502 - Vitals Show Patient Stable
BK0503 -
BK0504 - Follow up ref SDS 45 AW4L, ref SDS 43 AW4L.
BK0505 -
BK0506 -                    Blood
BK0507 -    Date   Time     Pressure   Pulse  Temprtr  Weight   So2
BK0509 -     ..
BK0510 -    070426 1130..... 119  70     57     36.3c            96
BK0511 -    070426 1030..... 141  73     67     36.4c            99
BK0512 -    070426 0900..... 130  78     52     36.5c            97
BK0513 -    070419 1230..... 133  79     57     36.3c            98
BK0514 -    070419 1130..... 141  78     56     37.6c **1        99
BK0515 -    070419 0930..... 153  80     53     36.1c           100
BK0516 -    070412 1120..... 114  65     53     36.6c            96
BK0517 -    070412 1020..... 130  66     57     36.8c            99
BK0518 -    070412 0900..... 116  69     65     36.8c            97
BK0519 -    070405 1130..... 133  75     55     36.2c            97
BK0520 -
BK0521 -            Consistently low pulse, does it reflect low blood pressure
BK0522 -            side effect of cetuximab, or improved fitness from working
BK0523 -            out that benefits emotional stress and immune system?
BK0525 -     ..
BK0526 -    070405 1030..... 114  69     57     36.4c            99
BK0527 -    070405 0900..... 128  78     54     36.5c           100
BK0528 -    070329 1140..... 125  74     53     36.8c            98
BK0529 -    070329 1045..... 125  72     53         c           100
BK0530 -    070329 0900..... 141  76     60     36.6c            99
BK0531 -    070322 1055..... 118  71     55     37.0c            97
BK0532 -    070322 1015..... 120  69     57     37.1c            98
BK0533 -    070322 0900..... 130  70     56     36.0c            98
BK0534 -    070315 1300..... 119  75     58     36.2c            98
BK0535 -    070315 1150..... 137  73     52     36.5c            99
BK0536 -    070315 0945..... 143  85     60     36.4c            97
BK0537 -    070308 1100..... 144  87     70     36.0c            98
BK0538 -    070301 1645..... 125  62     90 *   36.4c
BK0539 -    070301 1505..... 112  69     86 *   36.6c            98
BK0540 -    070222 1145..... 115  73     58     36.3c   147      98
BK0541 -    070222 1045..... 100  60     56     36.6c   147      98
BK0542 -    070222 0930..... 117  63     68     36.2c   147      97
BK0543 -    070215 1200..... 106  66     61     37.0c   147      97
BK0544 -    070215 1055.....  96  61     64     37.0c   147      94
BK0545 -    070215 0930..... 100  64     66     36.7c   147      98
BK0546 -    070208 0920..... 143  70     59     36.5c   147      98
BK0547 -    070201 1330..... 136  74     66             148      94
BK0548 -    070201 1220..... 110  65     62     36.3c   148      96
BK0549 -    070201 1000..... 132  80     65     36.9c   148      99
BK0550 -    061201 1534..... 123  76     76     97.5    150
BK0551 -    061110 1534..... 136  83     73     97.0    150      98
BK0552 -    061020 1534..... 140  79     67     99.8    151      97
BK0553 -    060929 1452..... 141  78     66     98.3    149
BK0554 -    060908 1335..... 139  79     73     98.1    149
BK0555 -    060814 1610..... 139  80     59     98.2    151
BK0556 -    060722 1440..... 142  74     67     98.1    149
BK0557 -    060711.......... 172  87     54     97.5    147
BK0558 -    060623.......... 141  87     71     98.0    147
BK0559 -    060428.......... 129  73     80     99.4    149
BK0560 -    060217.......... 153  81     61     98.6    150
BK0561 -    050916.......... 120  80     80     98.5
BK0562 -
BK0563 -  *    Need vitals taken twice to verify atypical diagnostics.
BK0564 -  **1  Nurses Notes seem to show 97.6 which is impossible, so.....
BK0565 -
BK0566 -
BK0567 -
BK06 -

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

BY03 -
BY04 - 1130
BY0501 -  ..
BY0502 - Energy Normal Stable After Treatment Cetuximab Support Drugs
BY0503 -
BY0504 - Follow up ref SDS 45 F54N, ref SDS 43 F54N.
BY0506 -  ..
BY0507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
BY0508 - clinical study drug trial. ref SDS 8 YP4I
BY0510 -  ..
BY0511 - Millie was alert after treatment again today, and not wobbly nor
BY0512 - disoriented.  She was able to drive home without side effects of
BY0513 - treatment.
BY0515 -  ..
BY0516 - We had to drive a long way around, going North to Penole and Hercules
BY0517 - on highway 80, to get home, because the bridge from the San Francisco
BY0518 - - Oakland Bay bridge to get to Highway 24 on the way to Walnut Creek
BY0519 - was exploded by a truck accident a few days ago.  This made the trip
BY0520 - home about 60 minutes instead of 40 minutes.
BY0522 -  ..
BY0523 - After arriving home about 1320, Millie took a nap from about 1320
BY0524 - until about 1600.  Could relate to side effects from cetuximab
BY0525 - treatments that cause fatigue, reported on 070116. ref SDS 16 O64M
BY0526 -
BY0527 -
BY0528 -
BY0529 -
BY0530 -
BY0531 -
BY0532 -
BY06 -