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: May 9, 2007 03:24 PM Wednesday; Rod Welch

Millie notifies UCSF CT scan scheduled, asks about blood test UTES/ANC

1...Summary/Objective
2...Thank Brigid for Notification Cancer Marker CA 15-3 29 Declines
3...Commend UCSF Brigid Timely Communication Collaboration Via Email
4...Requirements CT Scan Test Frequency Scheduled 070514
5...Schedule CT Scan Test 070514 Request Requirements Frequency
6...CT Scan Test Scheduled 070514 Request Requirements Frequency
7...Fall Through the Cracks Correct Mistake Failure to Perform CT Test
8...Pulmonary Emoblism Test Thin Slice Spiral CT Scan Enlared Right Ventrical
9...Scope CT Test Thin Slice Spiral Pulmonary Emoblism Enlared Right Ventrical
10...CT Test Scope Thin Slice Spiral Pulmonary Emoblism Enlared Right Ventrical
11...Safe Treatment Test Blood Counts ANC NEUTS for Patient
12...ANC NEUTS Blood Counts Test for Patient Safety Getting Treatment
13...Test Blood Counts ANC NEUTS for Patient Safety Getting Treatment


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

SUBJECTS
CA 15-3 29 Blood Test 070426 Appreciation  Cmmend UCSF Timely Effici

1703 -
1703 -    ..
1704 - Summary/Objective
1705 -
170501 - Follow up ref SDS 9 0000.
170502 -
170503 -
170504 -
170505 -
170506 -
170507 -
170508 -
170510 -  ..
1706 -
1707 -
1708 - Progress
1709 -
170901 - Thank Brigid for Notification Cancer Marker CA 15-3 29 Declines
170902 - Commend UCSF Brigid Timely Communication Collaboration Via Email
170903 -
170904 - Millie submitted ref DIT 1 0001 responding to Brigid's letter
170905 - submitting results of CA 15-3, ref DRP 1 0001, and received on 070501.
170906 - ref SDS 9 EQ6I
170907 -
170908 -    1.  Thanks very much for good news submitting CA 15-3 29 in your
170909 -        letter a week or so ago on May 1st. ref SDS 9 EQ6I  Patient
170910 -        history listed on 070426 shows we seem to be holding low
170911 -        numbers this time around for considerably longer with cetuximab
170912 -        than with prior solutions. ref SDS 8 087J, ref DIT 1 0001
170914 -  ..
170915 - Commending UCSF with attribution to Brigid for progress using email
170916 - for timely, accurate communication via email for collaboration and
170917 - coordination on patient history that enables effective doctor patient
170918 - partnership, which was previously resisted on 070329. ref SDS 6 W25L
170920 -  ..
170921 - Millie's letter to UCSF continues...
170922 -
170923 -    2.  Decline of my cancer marker reflects subsiding inflammation of
170924 -        IBC observed by the doctor on April 19th, ref SDS 7 M68J, and
170925 -        noted during your follow up examination a week later the 26th.
170926 -        ref SDS 8 M68J  Hopefully, favorable test diagnostics will hold
170927 -        rather than bounce back, as occurred previously. ref DIT 1 T76I
170928 -
170929 -
170930 -
1710 -

SUBJECTS
CT Scan Test Scheduled 070514 Request Requirements Frequency Avoid O

2803 -
280401 -  ..
280402 - Requirements CT Scan Test Frequency Scheduled 070514
280403 - Schedule CT Scan Test 070514 Request Requirements Frequency
280404 - CT Scan Test Scheduled 070514 Request Requirements Frequency
280405 -
280406 - Follow up ref SDS 6 DA8O.
280407 -
280408 - Millie's letter to UCSF continues...
280409 -
280410 -    3.  I received a call last night from Arlette advising that Kaiser
280411 -        has scheduled a CT test on 070514.  The last test was on
280412 -        070326, ref SDS 5 G74F, about 6 weeks ago.  Patient history
280413 -        listed on 070329 seems to show image testing was quarterly (3
280414 -        months) on the Avastin trial, ref SDS 6 DA8O, and less
280415 -        frequently (ad hoc) for other regimens, except Doctor Benz
280416 -        evidently engineered an immediate test on 041103 for pulmonary
280417 -        embolism after his review of the file at UCSF on 041018.
280418 -        ref SDS 1 LX96  He emphasized that Kaiser should investigate,
280419 -        noted in the doctor's 2nd opinion letter received on 041117.
280420 -        ref SDS 2 OT5Q  Thankfully people listened. ref DIT 1 T76N
280421 -
280422 -            [On 070510 Jackie coordinated with Kaiser to schedule the
280423 -            next CT test, which Kaiser set for 070514. ref SDS 11 DT8I
280425 -             ..
280426 -            [On 070510 Jackie notes Kaiser scheduled the CT test too
280427 -            soon for requirments of 8 week intervals on cetuximab
280428 -            clinical study. ref SDS 11 V36R  UCSF feels coordinating
280429 -            with Kaiser to correct the schedule mistake takes too much
280430 -            time and stress. ref SDS 11 V36O
280432 -             ..
280433 -            [On 070511 Kaiser called Millie to additional blood tests
280434 -            needed for the CT test; Millie explained requirements of
280435 -            the cetuximab clinical study for CT testing on 8 week
280436 -            cycles; Kaiser changed the test date from 070514 to 070520
280437 -            to better align with UCSF requirements. ref SDS 12 T77M
280439 -         ..
280440 -    4.  As you can see, I have had 20 or so of these tests.  They get
280441 -        difficult to endure, though I am prepared to go the extra mile
280442 -        to accomodate requirements of the study.  Can you please let me
280443 -        know tomorrow criteria on setting the frequency of CT tests.
280444 -        ref DIT 1 T77P
280446 -  ..
280447 - Requirements for the cetuximab clinical study were received from UCSF
280448 - on 070116.  CT testing is mentioned, but frequency is not specified,
280449 - indicating flexibility based on patient conditions. ref SDS 4 SE8M
280450 -
280451 -            [On 070510 UCSF seemed to confirm CT testing on the
280452 -            cetuximab clinical study occurs on an 8 week interval;
280453 -            there wasn't enough time for UCSF to submit documentation.
280454 -            ref SDS 11 V36R
280455 -
280456 -
280457 -
280458 -
2805 -

SUBJECTS
CT Test Scope Schedule 4th Cycle UCSF Clinical Study Cetuximab Asses

4203 -
420401 -  ..
420402 - Fall Through the Cracks Correct Mistake Failure to Perform CT Test
420403 - Pulmonary Emoblism Test Thin Slice Spiral CT Scan Enlared Right Ventrical
420404 - Scope CT Test Thin Slice Spiral Pulmonary Emoblism Enlared Right Ventrical
420405 - CT Test Scope Thin Slice Spiral Pulmonary Emoblism Enlared Right Ventrical
420406 -
420407 -
420408 - Millie's letter to UCSF continues...
420410 -         ..
420411 -    5.  I thought possibly this could be a make up thin slice spiral CT
420412 -        test for pulmonary embolism and Cor Pulmonale that was ordered
420413 -        for the test on 070326 to assess lung and heart damage that can
420414 -        occur with cetuximab.  Apparently, there was a mixup in
420415 -        paperwork and the scope was changed on 070326, so the matter is
420416 -        still pending.  Since I seem to be getting stronger and
420417 -        physically fit, this kind of issue can slip through the cracks.
420418 -        ref DIT 1 EP9J
420419 -
420420 -            [On 070510 UCSF relies on CT testing in Millie's case
420421 -            without thin slice spiral CT technology because that has
420422 -            been effective for other patients at UCSF. ref SDS 11 VP4H
420424 -             ..
420425 -            [On 070510 UCSF explains that coordinating with Kaiser to
420426 -            align the scope of CT testing with Millie's preconditions
420427 -            of pulmonary embolism and Cor Pulmonale takes too much time
420428 -            and effort and is too stressful. ref SDS 11 TK8H
420430 -             ..
420431 -            [On 070514 Millie coordinated with Kaiser to align CT
420432 -            testing with requirements for evaluating preconditions
420433 -            pulmonary embolism and Cor Pulmonale that can become
420434 -            complications from treatments on the cetuximab clinical
420435 -            study. ref SDS 13 EG3I
420436 -
420437 -
420438 -
420439 -
420440 -
4205 -

SUBJECTS
Blood Tests Schedule Evaluate Blood Counts ANC NEUTS High Enough Saf

5403 -
540401 -  ..
540402 - Safe Treatment Test Blood Counts ANC NEUTS for Patient
540403 - ANC NEUTS Blood Counts Test for Patient Safety Getting Treatment
540404 - Test Blood Counts ANC NEUTS for Patient Safety Getting Treatment
540405 -
540406 - Follow up ref SDS 10 P560.
540407 -
540408 - Millie's letter to UCSF continues...
540410 -         ..
540411 -    6.  Another issue is whether to have a test for blood counts
540412 -        tomorrow? ref DIT 1 TV4H
540414 -         ..
540415 -    7.  Last week we inched up to 1.54.  Catherine noted this is the
540416 -        right direction, but still below UCSF target of 1.8.
540417 -        ref SDS 10 P560  I'm not terribly concerned, since patient
540418 -        history shows many if not most of my treatments were given with
540419 -        ANC below 1500 (1.5 at UCSF). ref SDS 3 HV45, ref DIT 1 T78I
540420 -
540421 -            [On 070510 UCSF does not order follow up test. ref SDS 11
540422 -            MZ3N
540424 -         ..
540425 -    8.  So, looking forward to meeting tomorrow.
540426 -
540427 -
540428 -
540429 -
540430 -
540431 -
540432 -
540433 -
5405 -