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: June 12, 2007 08:13 AM Tuesday; Rod Welch

Millie Cellulitis IV treatment, Kaiser confirms treatment plan.

1...Summary/Objective
2...Cellulitis 4th Treatment Ceftriaxone IV 2gms Kaiser Martinez
3...Cat Bite May Compound Extend Recovery from Cellulitis
4...Keflex Oral Antibiotics Start after IV Treatments Completed
5...Kaiser Confirms Start Oral Antibiotics after IV Treatments Completed


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CONTACTS 

SUBJECTS
Examination Treatment Cetuximab 3rd Treatment 4th Cycle Chemotherapy

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 87 0000. ref SDS 86 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040509 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Cellulitis 4th Treatment Ceftriaxone IV 2gms Kaiser Martinez
040902 -
040903 - Millie went to Kaiser in Martinez at 0830 this morning to get the 4th
040904 - IV treatment of 5 total treatments for Cellulitis prescribed on
040905 - 070607, ref SDS 83 8L46, and scheduled the next day on 070608.
040906 - ref SDS 84 AL39
040908 -  ..
040909 - This follows up discussion with UCSF yesterday on communications
040910 - between UCSF and Kaiser on prescribing treatment, ref SDS 87 JQ6F, and
040911 - subsequent letter notifying UCSF that Millie would complete IV
040912 - treatments prescribed by Kaiser. ref SDS 87 VW4L
040914 -  ..
040915 - Millie asked the nurse this morning about when she can begin taking
040916 - Keflex oral antibiotics, which the doctor has discussed several times
040917 - in correspondence, but so far has not said when to start, per Millie's
040918 - letter to Kaiser yesterday on 070611. ref SDS 87 QE4M  Millie recalled
040919 - the nurse suggesting that Keflex should not be started until at least
040920 - the evening after the final IV antibiotic is given tomorrow morning on
040921 - 070513.  She said that Keflex oral antibiotic is similar to the IV
040922 - antibiotic, and so the concentration should not be increased by
040923 - starting too soon.
040925 -  ..
040926 - This aligns with guidance from UCSF on 070607.  When Millie was
040927 - released to go home after getting the same IV antibiotic in Kaiser's
040928 - current treatment plan, Catherine indicated Millie should wait until
040929 - the next day to start Keflex. ref SDS 83 8J67
040930 -
040931 -        [...below, primary care physician clarified Keflex oral
040932 -        antibiotics should start after completing IV antibiotic
040933 -        treatments. ref SDS 0 QE4M
040934 -
040935 -
040936 -
040937 -
040939 -  ..
0410 -
0411 -
0412 - 0900
0413 -
041301 - After treatment at Kaiser, Millie went shopping.
041302 -
041303 -
041305 -  ..
0414 -
0415 -
0416 - 1120
0417 -
041701 - Millie home from Kaiser and shopping.
041702 -
041704 -  ..
0418 -
0419 -
0420 - 1200
0421 -
042101 - Lunch.
042102 -
042103 - Temperature 98.4.
042104 -
042106 -  ..
0422 -
0423 -
0424 - 1313
0425 -
042501 - Millie goes to the library.
042502 -
042503 -
042505 -  ..
0426 -
0427 -
0428 - 1408
0429 -
042901 - Sleeping, nap.
042902 -
042903 -
042904 -
042905 -
0430 -
0431 -
043101 -
0432 -

SUBJECTS
Cat Bite Left Arm Above Wrist Bone May Compound Cellulitis Extend Re

0503 -
0504 - 2051
050501 -  ..
050502 - Cat Bite May Compound Extend Recovery from Cellulitis
050503 -
050504 - Follow up ref SDS 73 UJ44.
050505 -
050506 - Millie had another incident with the cat.  There is either a bite or
050507 - a scratch on the left arm on the top, above the wrist bone.
050509 -  ..
050510 - This bled enough to require a bandage, due in part to Coumadin
050511 - treatments.
050513 -  ..
050514 - The role of pets and cats in quality of life that present risk factor
050515 - is shown in a case study on 070315. ref SDS 61 SU6L  Cat bites were
050516 - cited on 070419 as possible cause of increased inflammation and fever.
050517 - ref SDS 73 UJ44  On 061115 Millie had a cat bite with no evident
050518 - complications. ref SDS 34 6T5L  Previously, on 050212 a cat bite
050519 - required treatment in Emergency. ref SDS 11 0001
050521 -  ..
050522 - Discussed procedures to avoid future cat problems.
050523 -
050524 -
050525 -
050527 -  ..
0506 -
0507 -
0508 - 2118
0509 -
050901 - Keflex Oral Antibiotics Start after IV Treatments Completed
050902 - Kaiser Confirms Start Oral Antibiotics after IV Treatments Completed
050903 -
050904 - Follow up ref SDS 87 QE4M.
050905 -
050906 - The primary care physician responded to Millie's letter yesterday
050907 - requesting clarification, ref SDS 87 QE4M, of Kaiser's discussion in a
050908 - letter, also, received yesterday on treating Cellulitis, and asking
050909 - for Kaiser's prescription on when to start taking Keflex "oral"
050910 - antibiotics. ref SDS 87 QE5H
050911 -
050912 -        Subject:  Clarify Cellulitis Treatments
050914 -         ..
050915 -        Date:  June 12, 2007 1529
050917 -         ..
050918 -        Start with completion of IV antibiotics.
050920 -  ..
050921 - Kaiser clarifies treatment plan to "start" oral antibiotics after
050922 - completing IV medications, answering Millie's letters yesterday.
050923 - ref SDS 87 OG7F and ref SDS 87 QE4M, and clarifying Kaiser's letter on
050924 - 070610. ref SDS 86 OG7F
050926 -  ..
050927 - The doctor does not specify whether starting Keflex should be the
050928 - same day, as indicated by the nurse at Kaiser in Martinez suggested
050929 - this morning, per above,
050930 - or to wait to the next day to start Keflex.
050932 -  ..
050933 - After completed IV treatment at UCSF on 070607, Catherine indicated
050934 - Millie should wait until the next day to start Keflex. ref SDS 83 8J67
050936 -  ..
050937 - The doctor does not comment on Millie's question about the
050938 - prescription for medicaiton to start with completion of IV
050939 - antibiotics. ref SDS 87 VV6Y
050940 -
050941 -
050942 -
050943 -
050944 -
050945 -
0510 -