CONTACTS 

SUBJECTS
Power Port Notify Medical Team Surgery Successful Follow Up Tasks Re

2503 -
2503 -    ..
2504 - Summary/Objective
2505 -
250501 - Follow up ref SDS 29 0000. ref SDS 27 0000.
250502 -
250503 -
250504 -
250505 -
250506 -
250508 -  ..
2506 -
2507 -
2508 - Progress
2509 -
250901 - Neupogen 2nd Treatment at Kaiser for 3rd Chemotherapy 5th Cycle UCSF
250902 -
250903 - Follow up ref SDS 29 IT77, ref SDS 27 IT77.
250904 -
250905 - Millie went to the Infusion Clinic at Kaiser in Walnut Creek to get
250906 - the 2nd treatment with Neupogen, following up work yesterday getting
250907 - the 1st treatment. ref SDS 29 IT77
250909 -  ..
250910 - Cesi, the Charge Nurse, provided Neupogen injection treatment today.
250912 -  ..
250913 - She gave Millie a single injection of 480 mcg for Neupogen.
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250918 -
250919 -
2510 -

SUBJECTS
Default Null Subject Account for Blank Record

2603 -
260401 -  ..
260402 - Infusion Clinic No Planning Millie's CT Test With Power Port on 080718
260403 -
260404 - Follow up ref SDS 29 OC9G.
260405 -
260406 - Cesi asked about results of "chatting" with the CT Test Department
260407 - yesterday, which Paula had suggested in order to verify arrangements
260408 - have been made to use Millie's Power Port for the test on 080718?
260409 - ref SDS 29 RF6K
260411 -  ..
260412 - Cesi asked if everything is all lined up?
260414 -  ..
260415 - Millie reported the CT Test Department indicated not being aware that
260416 - the test on 080718 required coordination with the Infusion Clinic to
260417 - inject contrast medium through Millie's Power Port. ref SDS 29 JQ49
260418 - Evidently, the department did not get communications coordinating the
260419 - work the past 3 months. ref SDS 29 7K8I
260421 -  ..
260422 - Cesi said the Infusion Clinic did not get any correspondence on
260423 - Millie's CT test either.
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260426 -
260427 -
260428 -
2605 -

SUBJECTS
Default Null Subject Account for Blank Record

2703 -
270401 -  ..
270402 - Power Port Worked Well at UCSF Ready for CT Test on 080718
270403 -
270404 - Follow up ref SDS 29 2P3N.
270405 -
270406 - Millie submitted a letter to the primary care physician at Kaiser
270407 - with copies to the medical team...
270408 -
270409 -    1.  Subject: CT Test 080718 Requires Focused Support
270410 -        Date: Sat, 12 Jul 2008 17:09:40 -0700
270418 -         ..
270419 -    3.  Power Port worked well for drawing blood and infusion on
270420 -        080710, following surgery on 080708.  Doctor Riley-Paull's
270421 -        planning to access the port with a Huber needle was successful.
270422 -        Catherine had no problems removing stitches to remove the
270423 -        needle after treatment.  This indicates the Power Port is ready
270424 -        to go for the CT test on 080710.
270425 -
270427 -  ..
270428 - Neupogen Treatments Effective Opportunity for Cost Containment
270429 -
270430 -
270431 -    4.  Labs for treatment at UCSF on 080710 showed ANC 5120 (NEUTS
270432 -        5.12 at UCSF). ref SDS 28 PU6K
270434 -         ..
270435 -        There was consideration of skipping one or both Neupogen tests
270436 -        this week, since this is the 3rd week in a row blood counts
270437 -        have increased.  The medical team was not available for
270438 -        consultation.  I went ahead with 2 prescribed Neupogen
270439 -        treatments. ref SDS 28 V57F  Got 1 injection yesterday, and
270440 -        Cecsi gave me the 2nd Neupogen this morning at 0900.
270441 -
270442 -
270444 -  ..
270445 - Coordinate Millie's CT Test on 080718 Infusion Clinic Access Port
270446 - CT Test 080718 Access Port Infusion Clinic Asks About Assignments
270447 -
270448 -
270449 -    5.  After Neupogen treatment yesterday, I met with Cesi, the Charge
270450 -        Nurse, Bella, the Assistant Charge Nurse, and Paula, who is the
270451 -        Director of Services for the Infusion Clinic. ref SDS 29 OC9G
270452 -        We reviewed planning for the CT test next Friday on 080718.
270453 -        Paula was worried nothing is scheduled for someone to go to the
270454 -        CT Test department to support the Power Port "certificate"
270455 -        issue, ref SDS 29 RF6K, which you discussed with Bella on
270456 -        080627.  Paula suggested I coordinate with the CT Test
270457 -        Department to verify arrangements. ref SDS 29 RN5O
270458 -
270459 -
270461 -  ..
270462 - CT Test Department Not Prepared Needs Proactive Management
270463 -
270464 -
270465 -    6.  I walked over to the CT Test Department and talked to Ike.
270466 -        ref SDS 29 2P3N
270468 -         ..
270469 -    7.  Ike indicated the department is beginning to think about
270470 -        developing a protocol for performing CT Tests with a Power
270471 -        Port, ref SDS 29 JQ55, but this will not be available in time
270472 -        for my test on 080718.  He proposed delaying the test a few
270473 -        weeks, or using a conventional IV. ref SDS 29 JR30
270475 -         ..
270476 -    8.  We reviewed planning beginning on 080502 to do the test with
270477 -        the Power Port.  Ike took your phone number and Paula's number
270478 -        in the Infusion Clinic.  He plans to work the issue and report
270479 -        progress next Wednesday.  There may be a number of scenarios
270480 -        that enable doing the CT test on 080718 with the Power Port [As
270481 -        listed in the record on 080711...] ref SDS 29 JR7Y
270483 -         ..
270484 -    9.  Accomplishing this objective requires proactive support for the
270485 -        CT Test Department to get everything lined up in time for the
270486 -        test on 080718.  At a minimum, the department should review
270487 -        "Instructions for Use" for Power Injections, listed in product
270488 -        literature received from Kaiser on 080708. ref SDS 26 JE7N
270489 -
270490 -           [On 080715 Arlette called and reported the doctor solved
270491 -           coordination problems by arranging for a nurse in radiology
270492 -           with certificate to support CT testing with Power Ports;
270493 -           Millie's CT test is good to go on 080718. ref SDS 31 RB4N
270495 -            ..
270496 -           [On 080716 Ike called and confirmed that Kaiser has made
270497 -           arrangements for Millie to get a CT test using her Power
270498 -           Port. ref SDS 32 PZ4L
270500 -            ..
270501 -           [On 080718 Nora with Kaiser Interventionary Radiology
270502 -           assigned to access Power Port for Millie's CT test,
270503 -           ref SDS 34 2U8V; during procedure, Nora requests
270504 -           manufacturer's Instructions for Use on Power Injection of
270505 -           contrast medium, ref SDS 34 NM5V, which was submitted to
270506 -           Kaiser on 080709, review was requested on 080712,
270507 -           ref SDS 30 K13Q, and again on 080715, ref SDS 31 RB3T;
270508 -           complications occurred on power injection, contrast medium
270509 -           overflowed Power Port, CT test failed. ref SDS 34 LK3R
270510 -
270512 -  ..
270513 - Cat Bite Slight Inflammation Quickly Subsided
270514 -
270515 -
270516 -   10.  I had a cat bite a few days ago.  There was a slight flare up
270517 -        in the evening on my left arm where there is IBC disease, and
270518 -        where cat bites have previously led to Cellulitis and
270519 -        lymphedema.  This seems to have subsided without treatment with
270520 -        Keflex; there may still be a delayed reaction.
270521 -
270522 -
270524 -  ..
270525 - Reaction to Chemotherapy Patient Distrissed Another Died Today
270526 -
270527 -
270528 -   11.  Two weeks ago, a patient suddenly suffered significant distress
270529 -        while getting chemotherapy treatment in the Infusion Clinic.
270530 -        UCSF staff stabilized her condition.  We were told the problem
270531 -        was a "reaction to chemotherapy."  This past Thursday,
270532 -        Catherine asked how many treatments with Carboplatin I have
270533 -        had, and indicated there have been problems of "reaction to
270534 -        chemotherapy" with Carboplatin.  So far, I seem okay.  I went
270535 -        hiking today and did 8+ miles after Neupogen treatment.  A news
270536 -        reporter died today evidently from "reaction to chemotherapy,"
270537 -        so I am wondering how this is monitored in my case?
270538 -
270540 -  ..
270541 - CA 15-3 142 Cancer Marker Escalates Results May be Incorrect
270542 - Treatment Options Requested Following Cetuximab Carboplatin
270543 -
270544 - On 080709 Millie requested Kaiser submit results of labs on 080708 for
270545 - the Power Port surgery. ref SDS 27 TR6W  The doctor submitted the
270546 - results earlier today using Kaiser's internal Knowledge Management
270547 - system.  The lab blood test results were entered in the record of the
270548 - test on 080708. ref SDS 26 075H
270550 -  ..
270551 - Millie's letter to the medical team continues...
270552 -
270553 -   12.  CA 15-3 142 reported from Kaiser labs on 080708 for surgery is
270554 -        another concern.
270556 -  ..
270557 - As shown in the last summary of the cancer marker on 070524, CA 15-3
270558 - 142 is 40% higher than any previous result for this test. ref SDS 7
270559 - 087J
270561 -  ..
270562 - Note Kaiser's lab report on 080708 has a comment that the blood sample
270563 - was slightly hemolyzed.  Results may be affected. ref SDS 26 05YW
270565 -  ..
270566 - Millie's letter to the medical team continues...
270567 -
270568 -   13.  IBC rash continues to improve and remains better than when the
270569 -        doctor determined progression of disease on 080306.  We will
270570 -        get a second read on CA 15-3 in 2 weeks when we start the next
270571 -        cycle on 080724.  The CT test on 080718 will provide additional
270572 -        data.  I would like to get a list of treatment options for
270573 -        consideration following the clinical study for cetuximab and
270574 -        Carboplatin.  In the meeting on 070130 Doctor Rugo indicated
270575 -        UCSF has further studies, ref SDS 6 436J, that supplement
270576 -        treatment ideas proposed in the report by Doctor Benz on
270577 -        060821.
270578 -
270579 -            [On 080716 Millie asked primary care physician about this
270580 -            issue again. ref SDS 33 IT77
270582 -         ..
270583 -   14.  Have any new clinical studies or treatments come to light since
270584 -        the meeting at UCSF on 070130?  Have any drugs proven effective
270585 -        that were in clinical studies the past few years, and which can
270586 -        now be used for my treatment at Kaiser?
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