CONTACTS 

SUBJECTS
Labs Blood Test 080306 Results INR 2.0 Submitted Kaiser Coalgulation

2003 -
2003 -    ..
2004 - Summary/Objective
2005 -
200501 - Follow up ref SDS 18 0000. ref SDS 10 0000.
200502 -
200503 - Coagulation Control Department at Kaiser in Martinez CA was notified
200504 - of results for blood tests on INR at UCSF yesterday, and for the
200505 - purpose of evaluating medication prescription of warfarin Coumadin to
200506 - treat pulmonary embolism. ref SDS 0 EX5H  Kaiser was notified that
200507 - blood tests will be performed weekly; request guidance continue to
200508 - test INR and reported to Kaiser every 4 weeks. ref SDS 0 RW7Q  Blood
200509 - test was also submitted to primary care physician at Kaiser for the
200510 - purpose of maintaining accurate patient history in the Medical Chart
200511 - on Kaiser's computer. ref SDS 0 JY5K  Similarly, changes to medication
200512 - ordered by UCSF were submitted to correct omissions in Kaiser's
200513 - Medical Chart listing current medications. ref SDS 0 RW3T  Request
200514 - Kaiser order new medications prescribed by UCSF. ref SDS 0 RW6X  She
200515 - was able to get the medications at the Kaiser Park Shadelands
200516 - pharmacy. ref SDS 0 GN7F  Kaiser submitted the xray taken on 080305.
200517 - It shows no evidence of injury to the right arm from the fall on
200518 - 080125. ref SDS 0 IT8N  Millie wrote a letter to Kaiser thanking the
200519 - primary care physician for timely action submitting the xray report,
200520 - performing examination on short notice, and ordering medications
200521 - today. ref SDS 0 GZ4H  Millie reports to Kaiser worry about
200522 - maintaining blood counts, which will prevent getting treatment at UCSF
200523 - for cancer. ref SDS 0 HS6R  Millie further reported improvement
200524 - recovering from Cellulitis. ref SDS 0 HS6W  Kaiser notified that UCSF
200525 - is relying on Kaiser examinations for backup 2nd opinons to strengthen
200526 - comprehensive care at UCSF. ref SDS 0 HT3U
200527 -
200528 -
200529 -
200530 -
200532 -  ..
2006 -
2007 -
2008 - Progress
2009 -
200901 - Labs Blood Tests INR Reported Kaiser Coagulation Control Department
200902 - Pulmonary Embolism Warfarin Coumadin Avoid Medication Conflicts
200903 - Coordination Kaiser Coagulation Control Department Coumadin for PE
200904 -
200905 - Follow up ref SDS 18 EX5H.
200906 -
200907 - Millie submitted ref DIT 1 0001 submitting blood test and current
200908 - medications to manage Coumadin treatments for pulmonary embolism.
200909 - This implements the letter to Kaiser on 080226 that planned submit
200910 - labs. ref SDS 18 S13U
200911 -
200912 -    1.  As planned in my letter to Kaiser on 080226, ref SDS 18 S13U,
200913 -        there was another blood test at UCSF yesterday on 080306,
200914 -        ref SDS 22 075H, to follow up the test on 080207, ref SDS 15
200915 -        075H, reported last week. ref DIT 1 0001
200917 -         ..
200918 -    2.  INR for yesterday was 2.0. ref SDS 22 PU7Y, ref DIT 1 WD5N
200920 -         ..
200921 -    3.  This is a bit anomalous compared to the past 6 months showing
200922 -        INR generally between 2.3 - 2.7. ref SDS 22 JN8N, ref DIT 1
200923 -        3K6H
200925 -  ..
200926 - May relate to Cellulitis and/or treatment with Keflex beginning on
200927 - 080304. ref SDS 19 106G
200928 -
200929 -            [On 080403 Millie submits INR results to Kaiser from the
200930 -            next blood test at UCSF. ref SDS 29 K26H
200932 -  ..
200933 - Millie's letter to Kaiser continues...
200934 -
200935 -    4.  Please note my understanding that going forward blood tests
200936 -        will be performed weekly for the clinical trial study.  Please
200937 -        advise if this needs to include INR each week, every other
200938 -        week, or to continue with monthly INR tests, as done the past
200939 -        [year]. ref DIT 1 3K49
200940 -
200941 -            [On 080312 letter to UCSF reports Kaiser has not proposed
200942 -            increasing INR testing, and discusses maintaining blood
200943 -            tests for INR and CA 15-3 to reduce costs and level of
200944 -            effort, since in the case of INR, testing has shown
200945 -            consistent compliance with criteria for the past year.
200946 -            ref SDS 23 RT7Q
200947 -
200948 -
200949 -
200950 -
200951 -
2010 -

SUBJECTS
Laboratory Blood Test 080306 UCSF Report Submitted to Kaiser for Med

4303 -
430401 -  ..
430402 - Laboratory UCSF Report Submitted to Kaiser for Medical Chart
430403 -
430404 - Follow up ref SDS 20 417N.
430405 -
430406 - Millie's letter to Kaiser continues...
430407 -
430408 -    5.  By copy providing the complete test [at UCSF on 080306] to the
430409 -        primary care physician for incorporation into the medical
430410 -        chart. ref SDS 22 439L, ref DIT 1 3K6M
430412 -         ..
430413 -    6.  Note that CA 15-3 is still in Lab.  Results are typically
430414 -        reported OA Tuesday. ref DIT 1 LS7M
430416 -  ..
430417 - At this time, Kaiser's medical chart for the meeting on 080305 simply
430418 - says "Labs."  There is no effective date and there is no statement
430419 - showing the source. ref SDS 20 417N
430421 -  ..
430422 - Submitting the UCSF blood test enables Kaiser to add this record to
430423 - the medical chart, which solves the problem of incomplete and outdated
430424 - test data reported in the record on 080305. ref SDS 20 K85L
430425 -
430426 -            [On 080409 Millie treated in Kaiser Emergency Care
430427 -            Department for recurrent Cellulitis; nurse reports blood
430428 -            tests stable compared to prior testing in October 2007,
430429 -            which was incorrect, because Kaiser's computer omits test
430430 -            results performed for 6 months at UCSF on referral from
430431 -            Kaiser. ref SDS 30 439L
430433 -  ..
430434 - Referral coordination plan discussed at UCSF on 070222, ref SDS 2
430435 - WY6J, requires distribution of current, accurate laboratory blood test
430436 - reports prepared by UCSF for entering into the medical chart at Kaiser
430437 - in order for Kaiser to provide backup medical opinion which UCSF
430438 - reported yesterday has been relied upon by UCSF to enable
430439 - comprehensive care for Millie. ref SDS 21 JT3L
430440 -
430441 -
430442 -
430443 -
4305 -

SUBJECTS
Medications Changes Coordination Notify Kaiser Coagulation Control D

7103 -
710401 -  ..
710402 - Medication Changes Evaluate Conflicts Adding New Treatments
710403 -
710404 - Follow up ref SDS 20 7Y6F.
710405 -
710406 -    7.  Please note changes to medication.  The medical chart listing
710407 -        Current Medications from the meeting at Kaiser Wednesday,
710408 -        080305, ref SDS 20 7Y6F shows... ref DIT 1 3K7L
710409 -
710410 -                TIMOLOL MALEATE 0.5% EYE DR
710411 -                WARFARIN 4MG TABLETS
710412 -                ACYCLOVIR 800MG TABLETS
710413 -                LORAZEPAM 1 MG TABLETS
710414 -                ERBITUX
710415 -
710416 -                    [...below, notified primary care physician of
710417 -                    notice to Coagulation Control Clinic that
710418 -                    prescribed medications have been significantly
710419 -                    changed. ref SDS 0 HT3P
710421 -         ..
710422 -    8.  To this list the primary care physician, ref DIT 1 PPUS, has
710423 -        added...
710424 -
710425 -                Keflex........ 10 day treatment beginning on 080304
710426 -                Prozac
710428 -         ..
710429 -    9.  This was reported during a meeting at Kaiser on 080305.
710430 -        ref SDS 20 5L5M, ref DIT 1 PPUX
710431 -
710432 -                    [On 080312 Millie notifies Kaiser that treatment
710433 -                    with Prozac was stopped after 2 treatments.
710434 -                    ref SDS 23 RT8Y
710436 -         ..
710437 -   10.  UCSF further added beginning on 080313...
710438 -
710439 -                Carboplatin
710440 -                Compazine
710441 -                Zofran
710442 -
710443 -        ...as reported during the meeting yesterday on 080306.
710444 -        ref SDS 21 459G, ref DIT 1 AU9O
710446 -  ..
710447 - This performs action item listed from the meeting at Kaiser on 080305.
710448 - ref SDS 20 IE6M
710450 -  ..
710451 - Another issue is who checks all medications for conflicts?
710453 -  ..
710454 - Letter to Kaiser continues...
710455 -
710456 -   11.  By copy to the doctor and to Arlette, alerting we need a
710457 -        prescription for Compazine and Zofran. ref DIT 1 3K44
710458 -
710459 -                    [...below letter to primary care physician commends
710460 -                    Kaiser's timely order for medications prescribed by
710461 -                    UCSF for Millie's treatment with Carboplatin
710462 -                    beginning next week. ref SDS 0 GZ4H
710464 -  ..
710465 - Copy of this letter to primary care physician updating list of current
710466 - medications in the medical chart at Kaiser, which was incomplete
710467 - during the meeting on 080305. ref SDS 20 7Y6F
710468 -
710469 -
710471 -  ..
7105 -
7106 -
7107 - 1542
7108 -
710801 - Millie picked up medications prescribed by Brigid yesterday, per
710802 - letter to Kaiser asking the doctor to place the order. ref SDS 0 RW6X
710803 -
710804 -
7109 -

SUBJECTS
Xray 080305 Right Arm Shoulder Evaluate Injury Fall 080125 Continuin

8303 -
8304 - 1937
830501 -  ..
830502 - Xray Shows No Evident Fracture or Injury Causing Pain to Right Arm
830503 -
830504 - Follow up ref SDS 20 5M39.
830505 -
830506 - Millie received ref DRT 1 0001 from the primary care physician at
830507 - Kaiser, and transmitting results of xray ordered on 080305 during
830508 - examination of the right arm by the doctor.   At that time, Millie
830509 - complained of continuing pain for 6 weeks, ref SDS 20 5M39, since
830510 - falling on 080125. ref SDS 11 N65K
830511 -
830512 -               [On 080312 submitted results of xray report showing now
830513 -               findings of fracture or trauma, to medical team at UCSF.
830514 -               ref SDS 23 RT6S
830516 -  ..
830517 - This record omits document identification for tests, shown by example
830518 - for CT test on 080215. ref SDS 16 DA6Q
830520 -  ..
830521 - Generally, the test was performed at Kaiser Walnut Creek CA on 080305
830522 - OA 1330...
830523 -
830524 -    1.  RIGHT HUMERUS
830525 -
830526 -    2.  HISTORY
830527 -
830528 -           Trauma.
830530 -         ..
830531 -    3.  FINDINGS
830532 -
830533 -           No fracture is seen. Alignment is maintained. ref DRT 1 JF5O
830538 -  ..
830539 - Finding no fracture and alignment maintained supports Doctor Malone's
830540 - examination in the Minor Injury Clinic on 080204. ref SDS 14 JQ8N
830542 -  ..
830543 - On 080305 the doctor considering an MRI test if xray is negative, as
830544 - reported in findings today, and pain continues. ref SDS 20 5M4K
830545 -
830546 -               [On 080312 Millie reports continuing pain in right arm,
830547 -               but now subsiding, and so MRI not needed at this time.
830548 -               ref SDS 23 RU3S
830549 -
830550 -
830551 -
8306 -

SUBJECTS
Coordination Referral Commend Collaboration Communication Timely Sub

A003 -
A00401 -  ..
A00402 - Referral Coordination Kaiser Commended
A00403 - Commend Kaiser Timely Submission Test Report Ordering Medications
A00404 - Kaiser Ordered Medications Prescribed by UCSF Timely Examination
A00405 -
A00407 -  ..
A00408 - Millie submitted ref DIT 2 0001 a letter to the primary care physician
A00409 - through Kaiser's Knowledge Management and medical management system,
A00410 - saying...
A00411 -
A00412 -    1.  Thanks for submitting the xray report on Wedensday [ordered by
A00413 -        the doctor on 080305, ref SDS 20 5M39, performed at Kaiser
A00414 -        later on 080305, ref SDS 20 P14M, received today from the
A00415 -        doctor, per above. ref SDS 0 IT8N], and for seeing me on short
A00416 -        notice [on 080304 UCSF recommended same day examination of
A00417 -        Cellulitis recurrence, ref SDS 19 5U8I; Kaiser scheduled
A00418 -        examination for the next day on 080305 1200. ref SDS 20 QY5I]
A00419 -        Thanks too for ordering the additional meds Doctor Rugo
A00420 -        prescribed yesterday getting me ready to start carbo next week
A00421 -        [implements request in Millie's letter to Kaiser earlier this
A00422 -        morning, per above. ref SDS 0 RW5V]  I picked them up earlier
A00423 -        today. ref DIT 2 0001
A00424 -
A00425 -            [On 080605 primary care physician terrific referral
A00426 -            commended by surgery department for presenting patient
A00427 -            history that enables productive meeting planning operation
A00428 -            for Power Port. ref SDS 36 635W
A00429 -
A00430 -
A00431 -
A005 -

SUBJECTS
Labs UCSF Blood Counts Worry Emotional Trauma NEUTS ANC Too Low Prev

AL03 -
AL0401 -  ..
AL0402 - Worry Blood Counts Problematic Starting Chemotherapy
AL0403 -
AL0404 - Follow up ref SDS 21 NW7K, ref SDS 17 1K4P.
AL0405 -
AL0406 -    2.  I'm worried if blood counts will hold up for weekly carbo [see
AL0407 -        discussion on 080305, ref SDS 20 PC6M, and the letter to UCSF
AL0408 -        on 080219, ref SDS 17 1K4P], but did you notice NEUTS was 2.75
AL0409 -        [test on 080306 at UCSF, ref SDS 22 QY6H, and reported during
AL0410 -        meeting with UCSF medical team. ref SDS 21 033B].  I think
AL0411 -        that's ANC 2750.  It has not been that high for 2 years, so I'm
AL0412 -        grateful to be starting out with some cushion. ref DIT 2 Q45O
AL0413 -
AL0414 -             [On 080313 blood counts NEUTS 2.05 still high enough for
AL0415 -             treatment. ref SDS 24 QY6H
AL0417 -              ..
AL0418 -             [On 080320 blood counts fall NEUTS 1.28. ref SDS 25 QY6H
AL0420 -              ..
AL0421 -             [On 080327 blood counts rise NEUTS 2.30, ref SDS 26 QY6H
AL0423 -              ..
AL0424 -             [On 080403 blood counts fall NEUTS 1.34, ref SDS 28 QY6H,
AL0425 -             Neupogen prescribed to increase blood counts.
AL0427 -              ..
AL0428 -             [On 080403 UCSF prescribes Neupogen to increase blood
AL0429 -             counts for safe weekly treatments with Carboplatin
AL0430 -             chemotherapy added to cetuximab. ref SDS 27 I33G
AL0432 -              ..
AL0433 -             [On 080410 NEUTS 6.85 rise to highest ever after treatment
AL0434 -             with Neupogen, and suffering Cellulitis and lymphedema
AL0435 -             recurrence, treated in Emergency Room clinic at Kaiser on
AL0436 -             080409. ref SDS 31 EH5K
AL0438 -              ..
AL0439 -             [On 080417 NEUTS 0.95 lowest ever blood counts reflects
AL0440 -             concern today about holding blood counts. ref SDS 32 PU6K
AL0442 -              ..
AL0443 -             [On 080417 Millie notifies medical team that concern today
AL0444 -             about maintaining blood counts for weekly chemotherapy
AL0445 -             treatments, ref SDS 33 P45J, correctly anticipated
AL0446 -             problems that have occurred consistently. ref SDS 33 4W8X
AL0448 -              ..
AL0449 -             [On 080418 Brigid says Neupogen treatment not needed this
AL0450 -             week, because not Carboplatin chemothearpy next week for
AL0451 -             4th treatment in the cycle; discusses new treatment plan
AL0452 -             lowering dose of Carboplatin to achieve consistent
AL0453 -             treatments. ref SDS 34 MR3L
AL0455 -              ..
AL0456 -             [On 080423 Millie notifies medical team to maintain full
AL0457 -             dose of Carboplatin chemotherapy to optimize prospects of
AL0458 -             recovery based on favorable response to initial
AL0459 -             treatments. ref SDS 35 TY6Y
AL0461 -              ..
AL0462 -             [On 080821 case study neutropenia low blood counts causes
AL0463 -             Millie to miss 4 chemotherapy treatments with Carboplatin
AL0464 -             from beginning 2nd arm of clinical study. ref SDS 37 EP7N
AL0465 -
AL0466 -
AL0467 -
AL0468 -
AL0469 -
AL0470 -
AL05 -

SUBJECTS
Cellulitis Subsides from Recurrence on 080304 Examination at Kaiser

B503 -
B50401 -         ..
B50402 -        Cellulitis Subsides
B50403 -
B50404 -
B50405 -    3.  Seems like Cellulitis has subsided. ref DIT 2 I46J
B50406 -
B50407 -            [On 080312 Millie confirmed that Cellulitis has fully
B50408 -            subsided responding to treatment beginning on 080304.
B50409 -            ref SDS 23 RU4Q
B50410 -
B50411 -
B50412 -
B505 -

SUBJECTS
Medications Current Notified Coagulation Control Department Coordina

BK03 -
BK0401 -         ..
BK0402 -        Medications Coagulation Control Department Notified
BK0403 -
BK0404 -
BK0405 -    4.  I sent a letter to Gloria listing all the medications so she
BK0406 -        can figure out Coumadin [see above, ref SDS 0 RW3T].  I just
BK0407 -        wonder if there is any downside to taking so many things.  I
BK0408 -        feel like opening my own pharmacy. ref DIT 2 U46M
BK0409 -
BK0410 -
BK0411 -
BK0412 -
BK05 -

SUBJECTS
Backup Teamwork Referral Coordination Plan UCSF Relies on Kaiser Ver

CG03 -
CG0401 -         ..
CG0402 -        Backup Medical Review Strengthens Health Care
CG0403 -        Referral Coordination Plan UCSF Relies Kaiser Backup Review
CG0404 -
CG0405 -        Follow up ref SDS 21 JT3L, ref SDS 6 FT5H.
CG0406 -
CG0407 -    5.  Brigid said yesterday they are glad you see me regularly so
CG0408 -        they have a backup because my case is really complex.
CG0409 -        ref SDS 21 JT3L  I'm very glad too. ref DIT 2 N57H
CG0410 -
CG0411 -            [On 080312 primary care physician at Kaiser concurrs Kaiser
CG0412 -            and UCSF functioning as a team for Millie's treatment on
CG0413 -            referral deserves support. ref SDS 23 HT3U
CG0415 -             ..
CG0416 -            [On 090213 1140 Doctor Johnson explains Millie's good
CG0417 -            results surviving stage IV cancer 3 times longer than other
CG0418 -            patients show benefits of synergy between Kaiser's
CG0419 -            knowledge of patient history, and UCSF research have been
CG0420 -            optimized through communication that integrates Kaiser's
CG0421 -            team care model of case management with the UCSF practice
CG0422 -            of comprehensive care. ref SDS 38 685I
CG0423 -
CG0424 -
CG0425 -
CG0426 -
CG0427 -
CG0428 -
CG0429 -
CG0430 -
CG0431 -
CG05 -