CONTACTS 

SUBJECTS
CT Test Expedite Surgery Power Port Huber  Nedle Injections Contrast

2303 -
2303 -    ..
2304 - Summary/Objective
2305 -
230501 - Follow up ref SDS 55 WX6I, ref SDS 54 766K.
230502 -
230503 -
230504 -
230505 -
230507 -  ..
2306 -
2307 -
2308 - Progress
2309 -
230901 - CT Test Schedule After Surgery Power Port Prevent Injury Pain Suffering
230902 -
230903 - Follow up ref SDS 55 847I, ref SDS 54 N77H.
230905 -  ..
230906 - Background...
230908 -  ..
230909 - On 080425 Millie reported injury, pain and suffering multiple needle
230910 - punctures in her right arm over several hours to inject contrast
230911 - medium for CT testing. ref SDS 50 9W9I  This report showed recent
230912 - practice using needle punctures has become a growing problem for the
230913 - past 6 months. ref SDS 50 N074  This significantly extended a long
230914 - patient history of problems Millie suffered with needle punctures,
230915 - ref SDS 50 BC6N, which earlier was solved by using a port catheter
230916 - implanted by surgery on 040419. ref SDS 8 PPSW
230918 -  ..
230919 - This was reported to Kaiser on 080428. ref SDS 51 1H6Y  The next day,
230920 - on 080429 the primary care physician reported that Kaiser is
230921 - investigating to solve the problem using a Huber needle with Millie's
230922 - port catheter to inject contrast medium for future CT tests.
230923 - ref SDS 52 1H6Y  At that time, on 080429 research found a study,
230924 - ref SDS 52 Y86F, that indicated port catheters can be used to inject
230925 - contrast medium for CT tests. ref SDS 52 RE6F  Millie sent a letter to
230926 - UCSF asking for comment on this solution, and for discussion the next
230927 - day during at meeting at UCSF. ref SDS 53 W64T
230929 -  ..
230930 - On 080501 Millie met with the medical team at UCSF.  There was an
230931 - understanding that UCSF stopped using port catheters to inject
230932 - contrast medium for CT testing a year earlier, ref SDS 54 766K,
230933 - because a new device called a "Power Port" works better handling high
230934 - pressures created from injecting contrast medium for CT testing.
230935 - ref SDS 54 TQ6F  UCSF seemed to recommend against risks of follow up
230936 - surgery to upgrade Millie's port catheter installed 4 years ago on
230937 - 040419, to a "Power Port" that can relieve injury, pain, and
230938 - suffering. ref SDS 54 TQ8P  UCSF seemed further to suggest using the
230939 - current port catheter as a viable alternative to risks of surgery for
230940 - upgrading to a Power Port. ref SDS 54 JJ9N
230942 -  ..
230943 - The next day on 080502 at Kaiser, Millie reviewed background on this
230944 - issue with the primary care physician.  During the meeting the doctor
230945 - examined Millie's arm and found evidence of excessive (4) needle
230946 - puncture wounds required for the CT test on 080425. ref SDS 55 WX6I
230947 - During this meeting at Kaiser on 080502, the doctor sent a letter
230948 - using Kaiser's internal electronic computer system to the surgeon,
230949 - Doctor Riley-Paul, who had done the original surgery to implant
230950 - Millie's port catheter on 040419, and asking about upgrading to a
230951 - Power Port in order to solve the problem of injury from needle
230952 - penetrations for injecting contrast medium to perform CT tests.
230953 - ref SDS 55 VG5J
230955 -  ..
230956 - Later that day, Millie sent a letter on 080502 to the medical team
230957 - reporting work plans at Kaiser to get the Power Port surgery done in
230958 - time for the next CT test in 2 - 3 months, i.e., 8 to 12 weeks.
230959 - ref SDS 56 GN8P
230961 -  ..
230962 - Millie needs work on the Power Port upgrade performed in time for the
230963 - next CT test in about 10 weeks, on or about 080718, assuming UCSF
230964 - continues testing every 12 weeks, as scheduled for the last test on
230965 - 080425. ref SDS 50 9W9I  If the next test is on the former 8 week
230966 - schedule, then work needs to be coordinated for a CT test in about 6
230967 - weeks, which is on or about 080620.
230969 -  ..
230970 - Kaiser has not reported progress on this project.
230972 -  ..
230973 - Millie sent a letter, ref DIT 1 0001, to the primary care physician
230974 - through Kaiser's special email system that does not support uniform
230975 - distribution to the medical team.  The letter says...
230976 -
230977 -    1.  I logged onto Doctor Riley-Paul's website, and clicked the link
230978 -        to send her a letter [to follow up your coordination during the
230979 -        meeting with you at Kaiser on 080502. ref SDS 55 VG5J  However,
230980 -        Kaiser's system gave me you, so I'm all thumbs when it comes to
230981 -        computers. ref DIT 1 0001
230983 -         ..
230984 -    2.  This probably won't work either, but can you forward [this
230985 -        letter] to Doctor Riley-Paul to follow up our meeting at Kaiser
230986 -        this past Friday. ref SDS 55 VG5J  I have not seen her since
230987 -        meeting on 051027, when she removed tubes and reported results
230988 -        of the biopsy from surgery, ref SDS 19 0001, which you ordered
230989 -        the week before [on 051021]. ref SDS 18 EG5L, ref DIT 1 V154
230990 -
230991 -            [On 080520 Kaiser did not respond; Millie sent followed up
230992 -            letter asking Kaiser to coordinate with the Surgery
230993 -            department on expediting Power Port surgery, ref SDS 57
230994 -            GS8K, in time for next CT test expected in 4 weeks.
230995 -            ref SDS 57 TV4S
230997 -             ..
230998 -            [On 080523 Millie received a letter from Kaiser advising
230999 -            that the surgeon reports Kaiser can upgrade Millie's port
231000 -            catheter to a Power Port, and he made a referral for this
231001 -            work to be performed, ref SDS 58 MG6F; this will solve the
231002 -            problems reported on 080425 injecting contrast medium for
231003 -            CT tests. ref SDS 50 FP6F
231005 -             ..
231006 -            [On 080528 Millie reported progress to the medical team on
231007 -            Kaiser's project to upgrade the port catheter to a Power
231008 -            Port. ref SDS 59 IJ6W
231010 -             ..
231011 -            [On 080606 planning to upgrade port catheter to Power Port
231012 -            implements direction from UCSF to do the work on the right
231013 -            side opposite from the primary location of Millie's cancer
231014 -            on the left side. ref SDS 60 IT77
231016 -             ..
231017 -            [On 080608 Millie sent a letter to the surgeon using
231018 -            Kaiser's internal email system, because the doctor is not
231019 -            included in distribution for referral coordination with the
231020 -            medical team at Kaiser and UCSF; and notifying the surgeon
231021 -            of requirements to coordinate surgery to implant the Power
231022 -            Port and to access the new port with a Huber needle to
231023 -            enable CT testing within the next few days after surgery.
231024 -            ref SDS 61 XS4S
231025 -
231027 -         ..
231028 -    3.  She can see background and requirements on 080425 for upgrading
231029 -        the port to avoid further needle penetrations to perform CT
231030 -        test injections, ref SDS 50 FP6F, as we discussed at Kaiser on
231031 -        080502. ref SDS 55 WX6I, ref DIT 1 V167
231033 -         ..
231034 -    4.  I would like to meet with the doctor about doing the upgrade.
231035 -        ref DIT 1 V176
231037 -         ..
231038 -    5.  Another possibility is to research with the Image Department
231039 -        slowing down the rate of injection so the current port can be
231040 -        used safely. ref DIT 1 V177
231042 -         ..
231043 -    6.  Changes to this email system make it almost impossible to use.
231044 -        ref DIT 1 00W2
231046 -  ..
231047 - Major change to Kaiser email system is that links are now opened
231048 - within the Kaiser website within a browser session, rather than
231049 - opening a separate browser session for the link.  Kaiser has now set a
231050 - physicial limit on the internal display for links, regardless of the
231051 - browser display dimensions set by the user.  This is internal display
231052 - width is much too narrow, and so requires a reader to constantly use
231053 - the scroll bar to read each line of text.  Nobody has time to do this.
231054 -
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231056 -
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231058 -
231059 -
2311 -