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: March 14, 2008 07:22 PM Friday; Rod Welch

Millie possible Cellulitis recurrence; begins taking Keflex again.

1...Summary/Objective
2...Cellulitis Possible Relapse No Evident Swelling No Temperature


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CONTACTS 

SUBJECTS
Cellulitis Left Arm Recurrence Slight Red Rash Inflammation No Tempe

1803 -
1803 -    ..
1804 - Summary/Objective
1805 -
180501 - Follow up ref SDS 7 0000. ref SDS 4 0000.
180502 -
180503 -
180504 -
180505 -
180506 -
180508 -  ..
1806 -
1807 -
1808 - Progress
1809 -
180901 - Cellulitis Possible Relapse No Evident Swelling No Temperature
180902 -
180903 - Follow up ref SDS 7 V45J, ref SDS 4 V45J.
180904 -
180905 - Millie completed 10-day treatment for Cellulitis yesterday.  At that
180906 - time there were no symptoms of inflammation or swelling that signal
180907 - Cellulitis and lymphedema. ref SDS 7 V45J
180909 -  ..
180910 - This evening Millie went to dinner with her friend, Janna.  We also
180911 - went hiking about 1100 at Lafayette reservoir for the 3rd time in the
180912 - past 3 days.
180914 -  ..
180915 - Later, when Millie dressed for bed, her left arm above the elbow seems
180916 - to show some slight inflammation, though this is a judgement
180917 - distinguishing Cellulitis from IBC inflammation that has infected the
180918 - left arm all of last year.  This just looks today somewhat different
180919 - from the past few days.  Could be short-term side effect of cetuximab,
180920 - reported in the clinical study protocol, received from UCSF on 070116.
180921 - ref SDS 1 MH4Q
180923 -  ..
180924 - Millie has no temperature.
180926 -  ..
180927 - Considered making further evaluation in the morning.
180929 -  ..
180930 - The general condition of her chest and IBC sites on the stomach gives
180931 - an impression of reduced intensity, i.e., improvement, just one day
180932 - after starting increased treatment with Carboplatin added to cetuximab
180933 - on the clinical trial at UCSF. ref SDS 6 TZ8I
180935 -  ..
180936 - Millie has taken Zofram according to Catherine's guidance yesterday.
180938 -  ..
180939 - She has not taken Compazine yet.
180941 -  ..
180942 - At this time there have been no apparent side effects from adding
180943 - Carboplatin.  Energy seems elevate, likely due to steriod medications
180944 - given with Carboplatin chemotherapy added to cetuximab beginning
180945 - yesterday.
180946 -
180947 -
180948 -
180949 -
180951 -  ..
1810 -
1811 -
1812 - 2208
1813 -
181301 - Millie's upper left arm still seems to show slight flush of
181302 - coloration.  There has been no rapid expansion of inflammation and
181303 - swelling that have previously occurred with Cellulitis relapse, e.g.,
181304 - on 070607 at UCSF. ref SDS 3 8H3I
181306 -  ..
181307 - She still has no temperature.  Lack of temperature and repidly
181308 - expanding rash and inflammation suggests Cellulitis relapse seems less
181309 - likely.
181311 -  ..
181312 - It is difficult to distinguish inflammation caused by Cellulitis from
181313 - inflammation caused by side effects of cetuximab treatment for cancer,
181314 - reported in the protocol received on 070116. ref SDS 1 MH4Q  On 070330
181315 - there was an error on the cautious side during examination in the
181316 - afternoon at Kaiser evaluating flushness on the upper left arm
181317 - together with elevated temperature the day after getting treatment
181318 - with Cetuximab at UCSF. ref SDS 2 7C8G  At that time, Keflex was
181319 - prescribed to treat Cellulitis. ref SDS 2 V66M  By the late evening
181320 - inflammation had subsided, and so treatment was not taken. ref SDS 2
181321 - KZ6L
181323 -  ..
181324 - Millie decided to start another cycle of treatment with Keflex, using
181325 - the backup prescription ordered by the primary care physician at
181326 - Kaiser received on 080305. ref SDS 5 5M3F
181328 -  ..
181329 - The next day, inflammation completely subsided, so Mil decided not to
181330 - continue Keflex treatment, and assume this was a flare up from
181331 - cetuximab.
181333 -  ..
181334 - Subsequently, inflammation did not return, and so treatment was not
181335 - resumed.  This record shows Millie completed a regular 10-day
181336 - treatment with Keflex yesterday, per above. ref SDS 0 V45J
181337 -
181338 -            [On 080315 Kaiser and UCSF notified possible Cellulitis
181339 -            recurrence; but by late in the afternoon inflammation
181340 -            subsided, so assume this was side effects of cetuximab.
181341 -            ref SDS 8 ZT4H
181343 -             ..
181344 -            [On 080320 Kaiser and UCSF notified treatment for
181345 -            Cellulitis ended, because symptoms subsided after 1
181346 -            treatment. ref SDS 9 IJ5V
181348 -             ..
181349 -            [On 080409 Millie suffers Cellulitis recurrence,
181350 -            ref SDS 10 5Q6G; treated in Emergency Department with
181351 -            temperature of 101.9, ref SDS 10 0P96, later released for
181352 -            home care. ref SDS 10 M49N
181353 -
181354 -
181355 -
181356 -
181357 -
181358 -
181359 -
1814 -