THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: January 31, 2008 08:30 AM Thursday; Rod Welch

Millie at UCSF 4th treatment 13th cycle cetuximab for 3rd relapse IBC.

1...Summary/Objective
2...Fall Injury Right Eye Right Arm Examination Blood Test
3...Labs Blood Test


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CONTACTS 

SUBJECTS
Cetuximab 12th Cycle 3rd Treatment 18th Total Treatment Chemotherapy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 17 0000. ref SDS 16 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040508 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040510 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040903 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040904 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040905 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040906 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040907 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0410 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Examination UCSF Right Eye Left Eye Head During Treatment UCSF Cance                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
1303 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
130401 -  ..
130402 - Fall Injury Right Eye Right Arm Examination Blood Test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130403 - 
130404 - Follow up ref SDS 18 N65K.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
130405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130406 - Millie explained the fall suffered on 080125, ref SDS 18 N65K, that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
130407 - caused bruises on the right eye, and to a lessor extent on the right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
130408 - eye.  The bruise on the upper right arm was not visible, and Millie                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
130409 - did not mention this issue to Catherine.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
130411 -  ..
130412 - Catherine reported this to Brigid.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
130414 -  ..
130415 - Brigid ordered blood tests.  This was only a part of the normal range                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
130416 - of tests Millie gets to evaluate safety of betting chemotherapy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130417 - treatments.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
130418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130420 -  ..
130421 - Labs Blood Test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
130422 - 
130423 - Follow up ref SDS 15 BD6I, ref SDS 8 BD6I.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
130424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130425 - During treatment, Catherine submitted results of the test.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
130426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130441 -     ..
130442 -    Log#:                   080131 09:10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130443 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
130444 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130446 -     ..
130447 -    CBC with DIFF & PLT CT                                     CBCD
130448 -     ..
130449 -    WBC COUNT               3.7    x10E9/L     3.4  -   10     WBC   WBC x10-3        K/uL     3.4  -  10.0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
130450 -    RBC COUNT               4.44   x10E12/L      4  -   5.2    RBC   RBC x10-6        M/uL    3.60  -  5.70                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
130451 -    HEMOGLOBIN             13.9    g/dL         12  -   15.5   HGB   Hemoglobin       g/dL    11.5  -  15.0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
130452 -    HEMATOCRIT             40.2    PERCENT      36  -   46     HCT   Hematocrit       %       34.0  -  46.0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
130453 -    MCV                    91      fL           80  -   100    MCV   MCV              fL      80.0  -  100.0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
130454 -    MCH                    31.2    pg           26  -   34     MCH                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
130455 -    MCHC                   34.5    g/dL         31  -   36     MCHC                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
130456 -    PLATELETS             223      x10E9/L     140  -  450     PLT   Plt x10-3        K/uL     140  -  400                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
130458 -     ..
130459 -    CA 15-3            No Test     U/mL             <  31    CA15-3  CA 15-3                        <  39
130460 -    ..
130461 -     (NEUTS x 1000 = ANC for Kaiser)
130462 -    NEUTS       L*          1.67   x10E9/L     1.8  -  6.8     N-A   ANC                      1500                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
130463 -    Neutrophils    Not Reported                                      Neutrophils       %        50  -  70                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
130465 -     ..
130466 -    LYMPHS                  1.51   x10E9/L     0.9  -  2.9     L-A   Lymphocytes       %        20  -  50                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
130467 -    MONOS                   0.37   x10E9/L     0.1  -  0.6     M-A   Monocyte          %         0  -  11                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
130468 -    EOS                     0.13   x10E9/L       0  -  0.4     E-A   Esoinophils       %         1  -  5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130469 -    BASOS                   0.06   x10E9/L       0  -  0.1     B-A   Basophil          %         0  -  2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130470 -                                                                                                 0  -  5
130471 -  ..
130472 - Tests show no evidence of collateral damage from the fall last week.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
130474 -  ..
130475 - Good news is ANC (NEUTS) increased above the level safe for treatment,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
130476 - ref SDS 0 QZ67, compared to the test for NEUTS 1.25 on 080110 that was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
130477 - very low. ref SDS 15 QY6H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130479 -  ..
130480 - Catherine advised that injuries like Millie suffered present increased                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
130481 - risks for patients treated with Coumadin for pulmonary embolism.  She                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
130482 - explained to Millie that if there is a recurrence, she should go to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
130483 - the ER for immediate treatment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130484 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130485 -     [On 080202 right arm still significantly bruised with very dark                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
130486 -     skin; considering going to ER for examination. ref SDS 19 PPWU                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
130488 -      ..
130489 -     [On 080204 Millie examined at Minor Injury Clinic at Kaiser in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
130490 -     Walnut Creek; no finding of serious injury; no xrays were taken;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
130491 -     treatment was heat to speed recovery from bruises. ref SDS 20 546N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
130493 -      ..
130494 -     [On 080207 0900 severe bruising noted by Doctor Rugo during                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
130495 -     examination for cancer treatment; doctor asks if Millie wants                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
130496 -     to consult social worker to report cause and prevention of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
130497 -     further injuries. ref SDS 21 QY5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
130498 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130499 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130500 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130501 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
130506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
1306 -