CONTACTS 

SUBJECTS
Cetuximab 12th Cycle 3rd Treatment 18th Total Treatment Chemotherapy

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 18 0000. ref SDS 16 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - There was a staff meeting at 0800, so treatment was delayed until
040902 - 0900.  We met Laura, and were saddened to hear that her mother, who
040903 - has been traveling from Minnesota coming to the Infusion Clinic in San
040904 - Francisco to assist Laura, has been diagnosed with ductal carcinoma in
040905 - situ, which is low grade form of breast cancer.  She has decided to
040906 - have a dual mastectomy, since she is over 70.
040908 -  ..
040909 - Catherine submitted the lab report showing Millie's CA 15-3 climbed to
040910 - 51 for the blood test last week on 080110. ref SDS 18 A16M
040912 -  ..
040913 - This presents a declining rate of increase, which in some cases has
040914 - preceeded actual decline.
040916 -  ..
040917 - The lab report also shows Magnesium was tested on 080110, contrary to
040918 - indications during the meeting at UCSF that testing Magnesium occurs
040919 - only "occassionally," ref SDS 17 JH6F  Late reporting for Magnesium
040920 - aligns with the Chemotherapy order on 070201 showing Magnesium should
040921 - be tested every 4 weeks to start a new cycle of treatment. ref SDS 2
040922 - 5594
040924 -  ..
040925 - This record indicates communication error.  Perhaps Magnesium was not
040926 - listed in the order for blood tests on 080110, or it was listed and
040927 - the Lab forgot to test it.  When Millie asked the medical team why
040928 - Magnesium was not tested, ref SDS 17 JH6F, to assess effectiveness of
040929 - treatment for low Magnesium on 071213, ref SDS 11 HH5I, explanation
040930 - that Magnesium is tested only "occasionally," seemed ambiguous.
040931 - ref SDS 17 S24K
040933 -  ..
040934 - Evidently, after discussing absence of Magnesium on the Lab report
040935 - during the meeting on 080110 the medical team investigated and
040936 - discovered the Chemotherapy Order requires testing Magnesium every 4
040937 - weeks, as shown on 070201. ref SDS 2 5594  The order was then amended
040938 - for the Lab to conform testing on 080110 with the Chemotherapy Order
040939 - by adding a test for Magnesium.
040940 -
040941 -        [On 080403 Magnesium was again not reported for the blood test
040942 -        to the start the next cycle. ref SDS 19 RW6F
040944 -         ..
040945 -        [On 080404 Brigid reported that Magnesium was again added to
040946 -        the specification for the blood test on 080403, and the report
040947 -        shows Magnesium 1.5, which is well below the target range of
040948 -        1.8, ref SDS 20 O059, and so required Millie to get treatment
040949 -        again. ref SDS 20 OP6U
040951 -  ..
040952 - The report today for the test on 080110 shows Magnesium increased to
040953 - 1.8, which is the low end of the target range.  This shows response to
040954 - treatment, supporting Brigid's decision not to continue treatment for
040955 - Magnesium, ref SDS 17 JH6F, which was given on 071213 to recover from
040956 - the lab test showing Magnesium fell below the target range.
040957 - ref SDS 10 S24K
040958 -
040959 -
040960 -
0410 -

SUBJECTS
Schedule Treatment Cetuximab 080131 Weekly Through 080417 Clinical S

0903 -
090401 -  ..
090402 - Schedule Weekly Treatments Continue on Thursdays
090403 -
090404 - Follow up ref SDS 4 QK6L, ref SDS 3 QK6L
090405 -
090406 - This morning, Millie asked Nola about scheduling treatments for the
090407 - next few months, per discussions with the medical team earlier this
090408 - morning. ref SDS 17 KE4G  Nola checked the computer and submitted an
090409 - updated schedule that also shows meetings with the doctor for
090410 - examinations...
090411 -
090412 -    Date  Time  Staff      Sta Type Dept  Loc  Dur Number Cycl/Trmnt
090413 -    -----------------------------------------------------------------
090414 -    080131 0830  Catherine    PEN  P3H  CCINF  INF 180  13861356  13  04
090415 -    080207 0900  Rugo         CAN  CHF  BCC    Z4F  30  13986253  14  01
090416 -                 Brigid
090417 -                 Jackie
090418 -    080207 0930  Catherine    PEN  P3H  CCINF  INF 180  13861357  14  01
090419 -    080214 0830  Catherine    PEN  P3H  CCINF  INF 180  13861358  14  02
090420 -    080221 0830  Catherine    PEN  P3H  CCINF  INF 180  14045382  14  03
090421 -    080228 0830  Catherine    PEN  P3H  CCINF  INF 180  14045392  14  04
090422 -    080306 0830  Rugo         PEN  CHF  BCC    Z4F  30  14018890  15  01
090423 -                 Brigid
090424 -                 Jackie
090425 -    080306 0900  Catherine    PEN  P3H  CCINF  INF 180  14045392  15  01
090426 -    080313 0830  Catherine    PEN  P3H  CCINF  INF 180  14045406  15  02
090427 -    080320 0830  Catherine    PEN  P3H  CCINF  INF 180  14045414  15  03
090428 -    080327 0830  Catherine    PEN  P3H  CCINF  INF 180  14045420  15  04
090429 -    080403 0900  Rugo         PEN  CHF  BCC    Z4F  30  13986278  16  01
090430 -                 Brigid
090431 -                 Jackie
090432 -    080403 0930  Catherine    PEN  P3H  CCINF  INF 180  14045430  16  01
090433 -    080410 0830  Catherine    PEN  P3H  CCINF  INF 180  14045441  16  02
090434 -    080417 0830  Catherine    PEN  P3H  CCINF  INF 180  14045445  16  03
090435 -
090436 -            [On 080529 schedule updated. ref SDS 21 IK7H
090437 -
090438 -
090439 -
090440 -
090441 -
090442 -
090443 -
090444 -
090445 -
090446 -
0905 -