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 17, 2007 08:30 AM Thursday; Rod Welch

Millie at UCSF 4th treatment 4th cycle cetuximab for 3rd relapse IBC.

1...Summary/Objective
2...Infusion Clinic for Cetuximab Treatent
..........Taxotere Capecitabine
..........Cetuxiab Clinical Study
3...Nurses Notes...
4...Side Effects Minimal...
........1...Rash acne-like
........2...Dry skin face, chest arm
........3...Inflammation Port Catheter Tender Red
........4...Lymphedema Cellulitis Complications
............Inflammation Erratic Upper Left Arm Side Effects Cetuximab
........5...Tired, fatigued - pulmonary emoblism
........6...Heavy chest - shortness of breathing
........7...Cough - clearing throat
5...Schedule Weekly Treatments Continue on Thursdays
6...CA 15-3 29 Drops Below Target 1st Time in 6 Years with Systemic Treatment
7...Preparation for Treatment Required One (1) Attempt to Connect Port
8...Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
9...Cetuximab Full Dose Blood Counts Below Targets Treatment 1 Hour
10...Vitals Show Patient Stable
11...Energy Normal Stable After Treatment Cetuximab Support Drugs


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

SUBJECTS
Cetuximab 4th Cycle 4th Treatment 16th Total Treatment Chemotherapy

0903 -
0903 -    ..
0904 - Summary/Objective
0905 -
090501 - Follow up ref SDS 75 0000, ref SDS 73 0000.
090502 -
090503 - Millie received the 4th treatment starting the 4th cycle of cetuximab
090504 - chemotherapy on clinical study at UCSF. ref SDS 0 7T3H  Side effects
090505 - remain mild, ref SDS 0 QU8K; slight inflammation returned to port
090506 - catheter penetration, no treatment prescribed. ref SDS 0 UD4K
090507 - Nurses's notes report UCSF considered taking interim blood test to
090508 - check elevated CA 15-3 56 reported by Kaiser, ref SDS 0 2N5J; this was
090509 - deferred to next week when Millie regularly scheduled for a blood test
090510 - according to the clinical study protocol. ref SDS 0 FG6H
090511 -
090512 -
090513 -
090514 -
090516 -  ..
0906 -
0907 -
0908 - Progress
0909 -
090901 - Infusion Clinic for Cetuximab Treatent
090902 -
090903 - Follow up ref SDS 75 1M6H, ref SDS 73 1M6H.
090905 -  ..
090906 - Agenda...
090907 -
090908 -    1.  Side effects.............................. ref SDS 0 QU8K
090909 -    2.  Treatment cetuximab....................... ref SDS 0 4N5M
090910 -    3.  Vitals.................................... ref SDS 0 AW4L
090911 -    4.  Energy after treatment.................... ref SDS 0 F54N
090913 -  ..
090914 - Millie received 16th overall and 4th treatment of 4th cycle with
090915 - cetuximab, starting from 070201, ref SDS 37 G68I, and the 23rd
090916 - treatment for 3rd relapse of IBC, beginning on 060721. ref SDS 16 407N
090918 -  ..
090919 - Catherine was the nurse today.
090921 -           ..
090922 -          Taxotere Capecitabine
090923 -
090924 -          Follow up ref SDS 75 PR8Q, ref SDS 73 PR8Q.
090925 -
090926 -                   Relapse Treatments
090927 -
090928 -      1.  Cycle 09 and 01 ................... 060721, ref SDS 16 407N
090929 -      2.  Cycle 10 and 02 ................... 060814, ref SDS 20 LY6O
090930 -      3.  Cycle 11 and 03 ................... 060908, ref SDS 21 407N
090931 -      4.  Cycle 12 and 04 ................... 060929, ref SDS 22 407N
090932 -      5.  Cycle 13 and 05 ................... 061020, ref SDS 28 407N
090933 -      6.  Cycle 14 and 06 ................... 061110, ref SDS 30 407N
090934 -      7.  Cycle 15 and 07 ................... 061201, ref SDS 31 407N
090936 -           ..
090937 -          Cetuxiab Clinical Study
090938 -
090939 -          Follow up ref SDS 75 7T3H, ref SDS 73 7T3H.
090940 -
090941 -                   Total    Cetuximab
090942 -      8.  Cycle 01 and 08 and 01 01.......... 070201, ref SDS 37 SG8I
090943 -      9.  Cycle 01 and 08 and 02 02.......... 070208, ref SDS 39 SG8I
090944 -     10.  Cycle 01 and 08 and 03 03.......... 070215, ref SDS 40 SG8I
090945 -     11.  Cycle 01 and 08 and 04 04.......... 070222, ref SDS 43 SG8I
090946 -     12.  Cycle 02 and 09 and 01 05.......... 070301, ref SDS 48 SG8I
090947 -     13.  Cycle 02 and 09 and 02 06.......... 070308, ref SDS 51 7T3H
090948 -     14.  Cycle 02 and 09 and 03 07.......... 070315, ref SDS 56 7T3H
090949 -     15.  Cycle 02 and 09 and 04 08.......... 070322, ref SDS 57 7T3H
090950 -     16.  Cycle 03 and 10 and 01 09.......... 070329, ref SDS 61 7T3H
090951 -     17.  Cycle 03 and 10 and 02 10.......... 070405, ref SDS 64 7T3H
090952 -     18.  Cycle 03 and 10 and 03 11.......... 070412, ref SDS 66 7T3H
090953 -     19.  Cycle 03 and 10 and 04 12.......... 070419, ref SDS 68 7T3H
090954 -     20.  Cycle 04 and 11 and 01 13.......... 070426, ref SDS 71 7T3H
090955 -     21.  Cycle 04 and 11 and 02 14.......... 070503, ref SDS 73 7T3H
090956 -     22.  Cycle 04 and 11 and 03 15.......... 070510, ref SDS 75 7T3H
090957 -     23.  Cycle 04 and 11 and 04 16.......... 070517, ref SDS 0 7T3H
090959 -  ..
090960 - Nurses Notes...
090971 -  ..
090972 - Why is the visit number constant in Nurse's Notes, and yet seems to
090973 - vary in the schedule received from Nola last week? ref SDS 56 159O
090975 -     ..
090976 -    UCSF Log Time...
090977 -
090978 -                   Blood
090979 -                    Test   Infusion
090980 -
090981 -          In.......          0830
090982 -          Out......          1130
090983 -          Visit....      Min  3.0  Hours  Total 2.5 Hours reported
090985 -      ..
090986 -     Pain Assessment...
090987 -
090988 -          x
090989 -          0123456789 10
090990 -
090991 -     <923k
090992 -     Administration Site:  Right Port Catheter
090993 -     Needle Size:          20 G 1"
090994 -     Blood Return Good:    Yes
090996 -      ..
090997 -     Remind patient to call MD if temp > 101 F, Shaking Chills
090998 -
090999 -            This protocol differs from Kaiser requirements, reported on
091000 -            041202. ref SDS 10 IX9N
091001 -
091002 -
091003 -
091004 -
0911 -

SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A

2703 -
2704 - 0840
270501 -  ..
270502 - Side Effects Minimal...
270503 -
270504 - Follow up ref SDS 75 QU8K, ref SDS 73 QU8K.
270506 -  ..
270507 - Nurse's notes report side effects...
270509 -             ..
270510 -        1.  Rash acne-like
270511 -
270512 -            Follow up ref SDS 75 958F, ref SDS 73 958F.
270513 -
270514 -            Very mild facial rash continues from 070208 around the nose
270515 -            and chin. ref SDS 39 QU8K  Some days better than others.
270516 -            Scattered red spots visible on chin mostly.  Antibiotic
270517 -            treatment effective prescribed on 070222. ref SDS 43 FO66
270518 -
270520 -             ..
270521 -        2.  Dry skin face, chest arm
270522 -
270523 -            Follow up ref SDS 75 JS6M, ref SDS 73 JS6M.
270524 -
270525 -            Background reported on 070503. ref SDS 68 JS6M  Condition
270526 -            continues controlled with Curel treatment prescribe on
270527 -            070301, ref SDS 45 5V73, and later Aquaphor on 070322.
270528 -            ref SDS 57 JS6M
270529 -
270531 -             ..
270532 -        3.  Inflammation Port Catheter Tender Red
270533 -
270534 -            Follow up ref SDS 73 RQ4O, ref SDS 71 RQ4O.
270535 -
270536 -            Nurses Notes report port catheter site red and tender again
270537 -            today.  This is a change from 2 weeks ago on 070503.
270538 -            ref SDS 73 RQ4O
270539 -
270541 -             ..
270542 -        4.  Lymphedema Cellulitis Complications
270543 -            Inflammation Erratic Upper Left Arm Side Effects Cetuximab
270544 -
270545 -            Follow up ref SDS 75 SU6L, ref SDS 73 SU6L.
270546 -
270547 -            Lymphedema continues relatively controlled with major
270548 -            swelling in the left reduced this morning to 11.00, cited
270549 -            in the study on 060509. ref SDS 13 HO7F  There is no evident
270550 -            association with cetuximab treatments.
270552 -             ..
270553 -            Changing intensity of rash on the upper left arm seems
270554 -            reduced in recent weeks, reported on 070503, ref SDS 73
270555 -            8B8I, and previously by the medical team on 070426,
270556 -            ref SDS 70 115F, and following the report at Kaiser on
270557 -            070330. ref SDS 63 N19J  Causes of erratic inflammation are
270558 -            listed in the record for treatment last week on 070426.
270559 -            ref SDS 71 8B8Y
270560 -
270562 -             ..
270563 -        5.  Tired, fatigued - pulmonary emoblism
270564 -
270565 -            Follow up ref SDS 75 FG3N, ref SDS 73 FG3N.
270566 -
270567 -            Fatigue, shortness of breath and other symptoms of
270568 -            pulmonary embolism were presented during meeting on 070130,
270569 -            ref SDS 35 CV5L, citing case study listed on 060722.
270570 -            ref SDS 17 ZV41  These are also side effects of cetuximab
270571 -            treatments, reported on 070116. ref SDS 34 O64M  Planning
270572 -            was discussed this morning with the medical team for thin
270573 -            slice spiral CT test to assess pulmonary embolism and Cor
270574 -            Pulmonale (enlarged right ventricle), per above.
270575 -            ref SDS 75 VP4H
270577 -             ..
270578 -            Energy and exercise remain active, reported on 070503.
270579 -            ref SDS 75 CA4K
270581 -             ..
270582 -            Millie has been taking naps 2 - 3 hours after treatments
270583 -            the past month, beginning on 070405. ref SDS 64 BB7G  May
270584 -            indicate accumulating effects of cetuximab that make
270585 -            patients tired, listed as side effect in Consent documents
270586 -            reviewed on 070116. ref SDS 34 O64M
270587 -
270589 -             ..
270590 -        6.  Heavy chest - shortness of breathing
270591 -
270592 -            Follow up ref SDS 75 UL6L, ref SDS 73 UL6L.
270593 -
270594 -            Patient history was reported to UCSF on 070130. ref SDS 35
270595 -            RT6I
270597 -             ..
270598 -            Condition seems improved, tracking continuing higher
270599 -            energy, per above. ref SDS 75 CA4K
270600 -
270602 -             ..
270603 -        7.  Cough - clearing throat
270604 -
270605 -            Follow up ref SDS 75 8N4G, ref SDS 73 8N4G.
270606 -
270607 -            Condition seems less evident lately.
270608 -
270609 -
270610 -
270611 -
2707 -

SUBJECTS
Schedule Treatment Weekly Thursday 0830 4 Week Cycles Clinical Study

3503 -
350401 -  ..
350402 - Schedule Weekly Treatments Continue on Thursdays
350403 -
350404 - Follow up ref SDS 75 QK6L, ref SDS 73 QK6L.
350406 -  ..
350407 - Millie's next treatment is scheduled for 070524 0830, reported by Nola
350408 - on 070315. ref SDS 55 159O
350410 -  ..
350411 - This conflicts with examination also scheduled for 0830 on 070524.
350412 -
350413 -
350414 -
350415 -
350416 -
350417 -
3505 -

SUBJECTS
Default Null Subject Account for Blank Record

4403 -
440401 -  ..
440402 - CA 15-3 29 Drops Below Target 1st Time in 6 Years with Systemic Treatment
440403 -
440404 - Follow up ref SDS 71 2N5J, ref SDS 61 2N5J.
440405 -
440406 - Nurses Notes report CA 15-3 elevated.  Nurse practitioner ordered
440407 - blood draw to retest.
440409 -  ..
440410 - Patient does not recall this issue being discussed, nor that a blood
440411 - test was performed today.
440413 -  ..
440414 - On 070511 Kaiser ordered an interim blood test which they said was
440415 - needed either because coordination failed transmitting results of the
440416 - test at UCSF on 070426, or because Kaiser needed a more recent test in
440417 - connection with the CT test scheduled to evaluate Millie's response to
440418 - treatment at UCSF on the cetuximab and carboplatin clinical study.
440419 - ref SDS 76 T76M   When Millie went to Kaiser on 070511 for the blood
440420 - test, she ordered a CA 15-3 test to support the meeting scheduled at
440421 - Kaiser on 070525 with the primary care physician. ref SDS 76 T77M
440423 -  ..
440424 - Yesterday, on 070516 Kaiser reported CA 15-3 56, ref SDS 77 RH9H,
440425 - which is considerably higher than recent CA 15-3 29 reported by UCSF
440426 - on 070426. ref SDS 70 087J  Millie sent a letter to Kaiser asking the
440427 - doctor to verify accuracy of this dramatic change in the cancer
440428 - marker, and to coordinate with UCSF sending notice of CA 15-3
440429 - increasing substantially. ref SDS 77 UH3R
440431 -  ..
440432 - Millie also sent a letter to Brigid notifying UCSF of preliminary
440433 - understandings on the change in CA 15-3 diagnostics, and that Kaiser
440434 - may contact UCSF after verifying their data. ref SDS 77 J55T
440436 -  ..
440437 - Evidently, Brigid initially notified Catherine this morning that CA
440438 - 15-3 increased, based on notice from Kaiser, requested by Millie,
440439 - ref SDS 77 UH3R; or, based on Millie's letter to UCSF yesterday, also,
440440 - on 070516, ref SDS 77 J55T  After initial notice this morning from
440441 - Brigid, Catherine entered in Nurse's Notes the plan to check CA 15-3
440442 - with another blood test today; but, before work was performed, Brigid
440443 - discussed the matter with Doctor Rugo, and UCSF decided not to perform
440444 - interim verification, since another test is due next week on 070524
440445 - when a new cycle is scheduled to start.
440447 -         ..
440448 -        [...in another record today Brigid discloses that coordinating
440449 -        divided responsibilities on referral projects is difficult; and
440450 -        that UCSF recommends avoiding laboratory work to cross-check
440451 -        tests for accuracy. ref SDS 78 466H
440452 -
440453 -
440454 -
440455 -
4405 -

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

5203 -
5204 - 0845
520501 -  ..
520502 - Preparation for Treatment Required One (1) Attempt to Connect Port
520503 -
520504 - Follow up ref SDS 75 EB7J, ref SDS 73 EB7J.
520506 -  ..
520507 - The nurse connected the IV tubes to the port....
520509 -       ..
520510 -      Interlink System Vented Paclitaxel set
520512 -  ..
520513 - Like last week and earlier on 070301, there were no problems getting
520514 - blood to flow from the port, ref SDS 48 EB7J, as occurred on 070222,
520515 - ref SDS 42 DC5W, and earlier on 070201. ref SDS 37 DC5W
520517 -  ..
520518 - The nurse flushed the port with saline.
520520 -  ..
520521 - Prior inflammation above and at the port catheter penetration reported
520522 - on 070419, ref SDS 68 UJ4M, has improved, reported on 070503,
520523 - ref SDS 73 RQ4O, however, today this location appears red and is
520524 - tender, per side effects. ref SDS 0 UD4K
520525 -
520526 -
5206 -

SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A

5903 -
5904 - 0845
590501 -  ..
590502 - Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
590503 -
590504 - Follow up ref SDS 75 DC7J, ref SDS 73 DC7J.
590505 -
590506 - Benadryl (diphenhydramine) started.   25 MG....... ref SDS 71 IJ44
590507 -
590508 -        Purpose reported on 060721. ref SDS 15 DC7J
590510 -  ..
590511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
590512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 75
590513 - IJ41
590514 -
590515 -
590517 -  ..
5906 -
5907 -
5908 - 0910
5909 -
590901 - Benedryl completed equipment beeps.
590902 -
590903 -
590904 -
590906 -  ..
5910 -
5911 -
5912 -
5913 -
591301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 57 FM4M
591302 -
591303 - On 070208 Decadron was not given because Millie did not experience
591304 - side effects of nausea and vomitting after treatment with cetuximab on
591305 - 070201. ref SDS 39 G57I  Since this favorable condition continues, per
591306 - above, ref SDS 57 D19M, Decadron was not given again today.
591307 -
591309 -  ..
5914 -
5915 -
5916 -
591601 - Decadron completed -- not reported.
591602 -
591603 -
591604 -
591605 -
5917 -

SUBJECTS
Cetuximab 4th Cycle 3rd Treatment Blood Counts Below Safe Levels Cli

6903 -
6904 - 0920
690501 -  ..
690502 - Cetuximab Full Dose Blood Counts Below Targets Treatment 1 Hour
690503 -
690504 - Follow up ref SDS 75 4N5M, ref SDS 73 4N5M.
690506 -  ..
690507 - Cetuximab started.
690508 -
690509 -           Verify chemotherapy order for 070208.
690511 -  ..
690512 - Chemotherapy order calls for cetuximab to start 30 - 60 minutes after
690513 - Beyadryl pre-tretment. ref SDS 71 IJ41
690515 -  ..
690516 - Chemotherapy Orders...
690517 -
690523 -    Auth#                                     Stor BCC LOC
690524 -    Visit:  12575738             DOS 20070201
690526 -     ..
690527 -    Date:  20070201
690529 -     ..
690530 -    Study Order for CC#05752:  Phase II Trial of Cetuximab alone and
690531 -    in combination with Carboplatin in ER-negative, PR-negative,
690532 -    HER2-negative Nonoverexpressing Metastatic Breast Cancers
690534 -     ..
690535 -    Dates to be given:  070201
690536 -    Arm 1:Cetuximab alone
690538 -     ..
690539 -    Diagnosis:  breast cancer
690541 -     ..
690542 -    ICD-9 codes: 174.9
690543 -    Allergies  NKDA
690545 -     ..
690546 -    Pre-medications 30 - 60 minutes prior to cetuximab infusion
690548 -     ..
690549 -    4. Diphenhydramine 25 mg IV or  [illegible writing]
690550 -
690551 -       Benadryl........... ref SDS 57 DC7J
690552 -
690553 -       On 070329 Brigid changed the Chemotherapy Order reducing
690554 -       Diphenhydramine (Benadryl) from 50 mg to 25 mg in order to
690555 -       reduce side effects of "restless legs." ref SDS 61 IJ44
690557 -        ..
690558 -       This was effective, reported above. ref SDS 61 7R6H
690560 -     ..
690561 -    5. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
690562 -
690563 -       Further premed TBD [barely legible handwriting??]
690565 -     ..
690566 -    Medication:  (plan to give weekly ********STUDY SUPPLY**********
690568 -     ..
690569 -    6. Cetuximab (Erbitux) (loading dose)
690570 -
690571 -              400 mg/m [squared] = 684 mg IV over 120 minutes for
690572 -              first dose x 1
690573 -
690574 -       dose on dcte 20070201   Maximum infusion rate is 5 ml/minute
690575 -       (concentration 2 mg/ml)
690577 -     ..
690578 -    7. Cetuximab (Erbitux) (maintenance dose)
690579 -
690580 -              250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
690581 -              ____mg) IV over 60 or ____ minutes.
690582 -
690583 -       Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
690584 -       Infuse once weekly for 8 weeks.  First dose to be given on date
690585 -       20070201.
690587 -        ..
690588 -       Cetuximab is administered undiluted through a low protien
690589 -       binding 0.22 micro in-line filter.  Use NS solution to flush the
690590 -       line at the end of the infusion.
690592 -        ..
690593 -       ARM 2:  Administer carboplatin of vital signs are unremarkable
690594 -       one hour after cetuximab infusion.
690596 -        ..
690597 -       Vital signs at baseline, upon cetuximab completion and one hour
690598 -       after cetuximab.
690599 -
690600 -       ****please note start and stop times****
690602 -        ..
690603 -       Laboratory work:
690604 -
690605 -          See carboplatin orders
690607 -        ..
690608 -       x  Notify MD for dose modifications if patient has severe
690609 -          acne in form rash
690610 -
690611 -          CBC with differential and platletes every 4 weeks
690612 -          Creatinine and magnesium every 4 weeks
690613 -          BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
690614 -          weeks.  If levels are outside of normal laboratory values
690615 -          notify Brigid NP  (MD/RN) at 415 443 4730
690617 -        ..
690618 -       x  Physician has discussed risks/benefits of therapy with the
690619 -          patient.  Signed consent obtained.
690620 -
690621 -
690622 -          Yes   5.  O2 by nasal cannula at 2 liters/min prn for chest
690623 -          pain or SOB
690625 -           ..
690626 -          Yes   6.  Diphenhydramine 50 mg IV prn x1 for urticaria
690627 -          [barely legible], pruritis SOB
690629 -           ..
690630 -          Yes   7.  Hydrocortizone 100 mg IV prn x1 for urticaria
690631 -          [barely legible], pruritis SOB
690633 -           ..
690634 -          Yes   8.  Albuterol inhaler 2-4 puffs prn SOB or chest
690635 -          tightness
690637 -           ..
690638 -          Yes   9.  Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
690639 -          anaphylaxis
690641 -           ..
690642 -          Breast CC05752 Cetuximab doc 20061024
690643 -          Approved 20060615
690645 -           ..
690646 -          Physician signature [Hope Rugo]
690648 -           ..
690649 -          Provider#  35313
690651 -           ..
690652 -          Date:  20010131
690653 -
690655 -  ..
6907 -
6908 -
6909 - 1020
6910 -
691001 - Cetuximab treatment completed.
691002 -
691003 - Millie had a 1 hour rest and observation period, required by the
691004 - protocol. ref SDS 75 G679
691005 -
691006 -
691007 -
691009 -  ..
6911 -
6912 -
6913 - 1120
6914 -
691401 - Nurse disconnected the IV tubes.
691403 -  ..
691404 - She inserted Herceptin to flush the port.
691406 -  ..
691407 - She then removed the needle from the port, and swabbed the needle
691408 - wound, and placed a temporary bandage.
691409 -
691410 -
691411 -
691412 -
691413 -
6915 -

SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme

7603 -
7604 - 0940
760501 -  ..
760502 - Vitals Show Patient Stable
760503 -
760504 - Follow up ref SDS 75 AW4L, ref SDS 73 AW4L.
760505 -
760506 -     Conversion Celsius to Farhenheit...
760507 -
760508 -              http://www.wbuf.noaa.gov/tempfc.htm
760509 -
760510 -                    Blood
760511 -    Date   Time     Pressure   Pulse  Temprtr  Weight   So2
760512 -    .
760513 -    070517 1120..... 126  72     56     36.7c           100
760514 -    070517 1020..... 140  75     54     36.6c            98
760515 -    070517 0940..... 140  75     54     36.1c            99
760516 -    070510 1145..... 145  86     54     35.9c           100
760517 -    070510 1045..... 149  82     69     37.0c            97
760518 -    070510 0900..... 132  75     62     36.8c            99
760519 -    070503 1150..... 113  67     59     36.8c            98
760520 -    070503 1055..... 125  72     54     36.1c           100
760521 -    070503 0915..... 127  70     60     36.9c            99
760522 -    070426 1130..... 119  70     57     36.3c            96
760523 -    070426 1030..... 141  73     67     36.4c            99
760524 -    070426 0900..... 130  78     52     36.5c            97
760525 -    070419 1230..... 133  79     57     36.3c            98
760526 -    070419 1130..... 141  78     56     37.6c **1        99
760527 -    070419 0930..... 153  80     53     36.1c           100
760528 -    070412 1120..... 114  65     53     36.6c            96
760529 -    070412 1020..... 130  66     57     36.8c            99
760530 -    070412 0900..... 116  69     65     36.8c            97
760531 -    070405 1130..... 133  75     55     36.2c            97
760532 -
760533 -            Consistently low pulse, does it reflect low blood pressure
760534 -            side effect of cetuximab, or improved fitness from working
760535 -            out that benefits emotional stress and immune system?
760537 -     ..
760538 -    070405 1030..... 114  69     57     36.4c            99
760539 -    070405 0900..... 128  78     54     36.5c           100
760540 -    070329 1140..... 125  74     53     36.8c            98
760541 -    070329 1045..... 125  72     53         c           100
760542 -    070329 0900..... 141  76     60     36.6c            99
760543 -    070322 1055..... 118  71     55     37.0c            97
760544 -    070322 1015..... 120  69     57     37.1c            98
760545 -    070322 0900..... 130  70     56     36.0c            98
760546 -    070315 1300..... 119  75     58     36.2c            98
760547 -    070315 1150..... 137  73     52     36.5c            99
760548 -    070315 0945..... 143  85     60     36.4c            97
760549 -    070308 1100..... 144  87     70     36.0c            98
760550 -    070301 1645..... 125  62     90 *   36.4c
760551 -    070301 1505..... 112  69     86 *   36.6c            98
760552 -    070222 1145..... 115  73     58     36.3c   147      98
760553 -    070222 1045..... 100  60     56     36.6c   147      98
760554 -    070222 0930..... 117  63     68     36.2c   147      97
760555 -    070215 1200..... 106  66     61     37.0c   147      97
760556 -    070215 1055.....  96  61     64     37.0c   147      94
760557 -    070215 0930..... 100  64     66     36.7c   147      98
760558 -    070208 0920..... 143  70     59     36.5c   147      98
760559 -    070201 1330..... 136  74     66             148      94
760560 -    070201 1220..... 110  65     62     36.3c   148      96
760561 -    070201 1000..... 132  80     65     36.9c   148      99
760562 -    061201 1534..... 123  76     76     97.5    150
760563 -    061110 1534..... 136  83     73     97.0    150      98
760564 -    061020 1534..... 140  79     67     99.8    151      97
760565 -    060929 1452..... 141  78     66     98.3    149
760566 -    060908 1335..... 139  79     73     98.1    149
760567 -    060814 1610..... 139  80     59     98.2    151
760568 -    060722 1440..... 142  74     67     98.1    149
760569 -    060711.......... 172  87     54     97.5    147
760570 -    060623.......... 141  87     71     98.0    147
760571 -    060428.......... 129  73     80     99.4    149
760572 -    060217.......... 153  81     61     98.6    150
760573 -    050916.......... 120  80     80     98.5
760574 -
760575 -  *    Need vitals taken twice to verify atypical diagnostics.
760576 -  **1  Nurses Notes seem to show 97.6 which is cellcius scale.
760577 -
760578 -
760579 -
7606 -

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

9003 -
9004 - 1120
900501 -  ..
900502 - Energy Normal Stable After Treatment Cetuximab Support Drugs
900503 -
900504 - Follow up ref SDS 75 F54N, ref SDS 73 F54N.
900506 -  ..
900507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
900508 - clinical study drug trial. ref SDS 17 YP4I
900510 -  ..
900511 - Millie was alert after treatment again today, and not wobbly nor
900512 - disoriented.  She was able to drive home without side effects of
900513 - treatment.
900515 -  ..
900516 - After arriving home about 1210, Millie took a nap from about 1320
900517 - until about 1445.  Could relate to side effects from cetuximab
900518 - treatments that cause fatigue, reported on 070116. ref SDS 34 O64M
900519 -
900520 -
900521 -
900522 -
900523 -
900524 -
900525 -
9006 -