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: July 17, 2008 08:00 AM Thursday;
Rod Welch
Millie 4th treatment 5th cycle cetuximab Carboplatin 4th relapse IBC.
1...Summary/Objective
...Taxotere Capecitabine 2nd Relapse IBC Treatment After Mastectomy
...Cetuxiab Alone Clinical Study
...Cetuxiab with Carboplatin Clinical Study 2nd Arm
2...Access Power Port Procedures Record Support CT Test at Kaiser Tomorrow
3...Labs Blood Test
4...NEUTS Decrease Neupogen Not Prescribed Because Blood Counts Still Good
..............
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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 B7 0000. ref SDS B4 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on Millie's treatment in the clinical study is reported on
040902 - 080508. ref SDS 93 TZ8I
040904 - ..
040905 - Taxotere Capecitabine 2nd Relapse IBC Treatment After Mastectomy
040906 -
040907 - Follow up ref SDS B7 X33O, ref SDS B4 X33O.
040908 -
040909 - Millie had left mastectomy on 051021. Biopsy at that time reported
040910 - no findings of cancer. Approximately 8 months later on 060707 the
040911 - doctor diagnosed IBC relapse and prescribed treatment. ref SDS 3
040912 - PF3O
040913 -
040914 - 1. Cycle 09 and 01 ................... 060721, ref SDS 4 407N
040915 - 2. Cycle 10 and 02 ................... 060814, ref SDS 6 LY6O
040916 - 3. Cycle 11 and 03 ................... 060908, ref SDS 6 407N
040917 - 4. Cycle 12 and 04 ................... 060929, ref SDS 6 407N
040918 - 5. Cycle 13 and 05 ................... 061020, ref SDS 7 407N
040919 - 6. Cycle 14 and 06 ................... 061110, ref SDS 8 407N
040920 - 7. Cycle 15 and 07 ................... 061201, ref SDS 9 407N
040922 - ..
040923 - Cetuxiab Alone Clinical Study
040924 -
040925 - Follow up ref SDS B7 356I, ref SDS B4 356I.
040926 -
040927 - Total Cetuximab
040928 - 8. Cycle 01 and 08 and 01 01.......... 070201, ref SDS 11 SG8I
040929 - 9. Cycle 01 and 08 and 02 02.......... 070208, ref SDS 12 SG8I
040930 - 10. Cycle 01 and 08 and 03 03.......... 070215, ref SDS 13 SG8I
040931 - 11. Cycle 01 and 08 and 04 04.......... 070222, ref SDS 14 SG8I
040932 - 12. Cycle 02 and 09 and 01 05.......... 070301, ref SDS 15 SG8I
040933 - 13. Cycle 02 and 09 and 02 06.......... 070308, ref SDS 17 7T3H
040934 - 14. Cycle 02 and 09 and 03 07.......... 070315, ref SDS 18 7T3H
040935 - 15. Cycle 02 and 09 and 04 08.......... 070322, ref SDS 19 7T3H
040936 - 16. Cycle 03 and 10 and 01 09.......... 070329, ref SDS 20 7T3H
040937 - 17. Cycle 03 and 10 and 02 10.......... 070405, ref SDS 21 7T3H
040938 - 18. Cycle 03 and 10 and 03 11.......... 070412, ref SDS 22 7T3H
040939 - 19. Cycle 03 and 10 and 04 12.......... 070419, ref SDS 23 7T3H
040940 - 20. Cycle 04 and 11 and 01 13.......... 070426, ref SDS 24 7T3H
040941 - 21. Cycle 04 and 11 and 02 14.......... 070503, ref SDS 25 7T3H
040942 - 22. Cycle 04 and 11 and 03 15.......... 070510, ref SDS 26 7T3H
040943 - 23. Cycle 04 and 11 and 04 16.......... 070517, ref SDS 27 7T3H
040944 - 24. Cycle 05 and 12 and 01 17.......... 070524, ref SDS 28 7T3H
040945 - 25. Cycle 05 and 12 and 02 18.......... 070531, ref SDS 29 7T3H
040946 - 26. Cycle 05 and 12 and 03 19.......... 070607, ref SDS 30 7T3H
040947 - 27. Cycle 05 and 12 and 04 20.......... 070614, ref SDS 31 0001
040948 - 28. Cycle 06 and 13 and 01 21.......... 070621, ref SDS 32 0001
040949 - 29. Cycle 06 and 13 and 02 22.......... 070628, ref SDS 33 0001
040950 - 30. Cycle 06 and 13 and 03 23.......... 070705, ref SDS 34 0001
040951 - 31. Cycle 06 and 13 and 04 24.......... 070712, ref SDS 34 0001
040952 - 32. Cycle 07 and 14 and 01 25.......... 070719, ref SDS 35 0001
040953 - 33. Cycle 07 and 14 and 02 26.......... 070726, ref SDS 33 0001
040954 - 34. Cycle 07 and 14 and 03 27.......... 070802, ref SDS 34 0001
040955 - 35. Cycle 07 and 14 and 04 28.......... 070809, ref SDS 36 0001
040956 - 36. Cycle 08 and 15 and 01 29.......... 070816, ref SDS 37 0001
040957 - 37. Cycle 08 and 15 and 02 30.......... 070823, ref SDS 38 0001
040958 - 38. Cycle 08 and 15 and 03 31.......... 070830, ref SDS 38 0001
040959 - 39. Cycle 08 and 15 and 04 32.......... 070906, ref SDS 39 0001
040960 - 40. Cycle 09 and 16 and 01 33.......... 070920, ref SDS 40 0001
040961 - 41. Cycle 09 and 16 and 02 34.......... 070927, ref SDS 41 0001
040962 - 42. Cycle 09 and 16 and 03 35.......... 071004, ref SDS 42 0001
040963 - 43. Cycle 09 and 16 and 04 36.......... 071011, ref SDS 43 0001
040964 - 44. Cycle 10 and 17 and 01 37.......... 071018, ref SDS 44 0001
040965 - 45. Cycle 10 and 17 and 02 38.......... 071025, ref SDS 45 0001
040966 - 46. Cycle 10 and 17 and 03 39.......... 071101, ref SDS 31 0001
040967 - 47. Cycle 10 and 17 and 04 40.......... 071108, ref SDS 46 0001
040968 - 48. Cycle 11 and 18 and 01 41.......... 071115, ref SDS 47 0001
040969 - 49. Cycle 11 and 18 and 02 42.......... 071122, ref SDS 33 0001
040970 - 50. Cycle 11 and 18 and 03 43.......... 071129, ref SDS 49 0001
040971 - 51. Cycle 11 and 18 and 04 44.......... 071206, ref SDS 50 0001
040972 - 52. Cycle 12 and 19 and 01 45.......... 071213, ref SDS 53 0001
040973 - 53. Cycle 12 and 19 and 02 46.......... 071220, ref SDS 56 0001
040974 - 54. Cycle 12 and 19 and 03 47.......... 071227, ref SDS 57 0001
040975 - 55. Cycle 12 and 19 and 04 48.......... 080103, ref SDS 58 0001
040976 - 56. Cycle 13 and 20 and 01 49.......... 080110, ref SDS 61 0001
040977 - 57. Cycle 13 and 20 and 02 50.......... 080117, ref SDS 62 0001
040978 - 58. Cycle 13 and 20 and 03 51.......... 080124, ref SDS 63 0001
040979 - 59. Cycle 13 and 20 and 04 52.......... 080131, ref SDS 65 0001
040980 - 60. Cycle 14 and 21 and 01 53.......... 080207, ref SDS 69 0001
040981 - 61. Cycle 14 and 21 and 02 54.......... 080214, ref SDS 70 0001
040982 - 62. Cycle 14 and 21 and 03 55.......... 080221, ref SDS 34 0001
040983 - 63. Cycle 14 and 21 and 04 56.......... 080228, ref SDS 75 0001
040984 - 64. Cycle 15 and 22 and 01 57 01 00... 080306, ref SDS 78 TZ8I
040986 - ..
040987 - Cetuxiab with Carboplatin Clinical Study 2nd Arm
040988 -
040989 - Follow up ref SDS B7 5B6J, ref SDS B4 5B6J.
040990 -
040991 - On 080207 doctor reports IBC may be spreading. ref SDS 68 GH5H
040992 - Follow up examination on 080219 Doctor Rugo diagnosed progression of
040993 - disease. ref SDS 88 3J4I Photographs show spread of IBC rash,
040994 -
040995 - 2nd
040996 - Arm Cetuximab Carboplatin
040997 - 65. Cycle 01 15 and 22 and 02 58 02 01... 080313, ref SDS 79 TZ8I
040998 - 66. Cycle 01 15 and 22 and 03 59 03 01... 080320, ref SDS 80 TZ8I
040999 - 67. Cycle 01 15 and 22 and 04 60 04 01... 080327, ref SDS 81 TZ8I
041000 - 68. Cycle 02 16 and 23 and 01 61 05 02... 080403, ref SDS 82 TZ8I
041001 - 69. Cycle 02 16 and 23 and 02 62 06 03... 080410, ref SDS 85 TZ8I
041002 - 70. Cycle 02 16 and 23 and 03 63 07 03... 080417, ref SDS 87 TZ8I
041003 - 71. Cycle 02 16 and 23 and 04 64 08 03... 080424, ref SDS 89 TZ8I
041004 - 72. Cycle 03 17 and 24 and 01 65 09 04... 080501, ref SDS 91 5B6J
041005 - 73. Cycle 03 17 and 24 and 02 66 10 05... 080508, ref SDS 93 5B6J
041006 - 74. Cycle 03 17 and 24 and 03 67 11 05... 080515, ref SDS 94 5B6J
041007 - 75. Cycle 03 17 and 24 and 04 68 12 05... 080522, ref SDS 95 5B6J
041008 - 76. Cycle 04 18 and 25 and 01 69 13 06... 080529, ref SDS 98 5B6J
041009 - 77. Cycle 04 18 and 25 and 02 70 14 07... 080605, ref SDS 99 5B6J
041010 - 78. Cycle 04 18 and 25 and 03 71 15 08... 080612, ref SDS A2 5B6J
041011 - 79. Cycle 04 18 and 25 and 04 72 16 08... 080619, ref SDS A5 5B6J
041012 - 80. Cycle 05 19 and 26 and 01 73 17 09... 080626, ref SDS B0 5B6J
041013 - 81. Cycle 05 19 and 26 and 02 74 18 10... 080703, ref SDS B4 5B6J
041014 - 82. Cycle 05 19 and 26 and 03 75 19 11... 080710, ref SDS B7 5B6J
041015 - 83. Cycle 05 19 and 26 and 04 76 20 11... 080717, ref SDS 0 5B6J
041017 - ..
041018 - Millie has had a total of 83 treatments with cetuximab beginning on
041019 - 070201. Today is the 4th treatment of the 5th cycle with cetuximab
041020 - and Carboplatin together. This is the 20th treatment overall with
041021 - cetuximab on the 2nd arm of the clinical study, but is only the 11th
041022 - treatment with Carboplatin due to low blood counts.
041023 -
041024 - [On 080723 CT test on 080718 reports findings of
041025 - Interstitional Lung disease a serious condition and rare
041026 - side effect of cetuximab. ref SDS C5 TS4J
041028 - ..
041029 - [On 080723 case study shows patient history interstitional
041030 - lung disease. ref SDS C5 7W6F
041032 - ..
041033 - [On 080821 meeting with medical team, there was no
041034 - discssion of CT test performed 080718 finding
041035 - Interstitial lung disease. ref SDS C7 056G
041037 - ..
041038 - [On 080829 during a meeting at Kaiser the primary care
041039 - physician used the computer in the Examination room to
041040 - open files for the CT test on 080718; after examination
041041 - CT scan files the doctor commented that Interstitional
041042 - lung disease reported on 080723, ref SDS C5 TS4J, appears
041043 - very mild and not a significant side effect of cetuximab
041044 - treatment for Millie's cancer. ref SDS C9 RP4X
041046 - ..
041047 - [On 080912 report on follow up CT test the day before on
041048 - 080911 makes no findings of "Interstitional lung
041049 - disease," but may be reported with different language.
041050 - ref SDS C0 TS4J
041052 - ..
041053 - [On 081112 CT test on 0811107 finds Interstitional disease
041054 - at higher levels than shown by CT test on 080718.
041055 - ref SDS D1 TS4J
041056 -
041057 -
041058 -
0411 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Access Power Port Procedures Record Support CT Test at Kaiser Tomorrow
050403 -
050404 - Catherine is Millie's nurse today.
050406 - ..
050407 - Millie has a CT test tomorrow on 080718 1100 at Kaiser using the Power
050408 - Port for injecting contrast medium, scheduled on 080617. At that
050409 - time, Kaiser planned for a nurse in the Oncology Infusion Clinic to
050410 - access the port, and Millie would then go to the CT Department for the
050411 - test. After the test, Millie would return to the Infusion Clinic for
050412 - a nurse to remove the needle and flush the port, per manufacturer's
050413 - instructions for use. ref SDS A4 DF55
050415 - ..
050416 - On 080711 Kaiser reported the CT Department was not trained to use the
050417 - new Power Port technology. ref SDS B8 JQ55, and so wanted the nurse in
050418 - the Oncology Department Infusion Clinic to come to the CT Department
050419 - on 080718 with Millie to ensure having the right skill-set on hand for
050420 - using complex technology the first time to perform Millie's CT test.
050421 - ref SDS B8 JQ98 On 080715 the Oncology Department reported that the
050422 - Infusion Clinic is short-staffed. There is not enough time for the to
050423 - spare qualified staff to assist the CT Department perform the test
050424 - ordered by Oncology, which entails using new technology for the first
050425 - time. ref SDS C1 PQ6P
050427 - ..
050428 - The CT Department called on 080716 and reported having found someone
050429 - who can support the CT test on 080718 (tomorrow) using the new Power
050430 - Port technology for Millie's test. ref SDS C2 RA9H
050432 - ..
050433 - Since arrangements for the test tomorrow seem tenuous, Millie noted
050434 - procedures to access the Port today....
050436 - ..
050437 - Catherine accessed the Power Port with a Huber needle for blood draws
050438 - and treatment this morning. She has many years experience doing this
050439 - work.
050440 -
050441 - [On 080718 CT test using Power Port failed at Kaiser;
050442 - initial analysis indicates Huber needle may not have been
050443 - correctly seated, ref SDS C3 LK41, and/or injection flow
050444 - rate may been incorrect, ref SDS C3 WI7G, Huber needle
050445 - poped loose, contrast medium flows into right chest,
050446 - shoulder and arm areas, ref SDS C3 4S5L; Kaiser relied on
050447 - Millie's memory of patient history explaining procedures at
050448 - UCSF accessing the Power Port with a Huber needle.
050449 - ref SDS C3 IC6F
050451 - ..
050452 - [On 080719 Julie in Infusion Clinic access port in about 1
050453 - minute, and without incident to test operability following
050454 - events the day before; blood flows "beautifully"; port was
050455 - maintained with saline and Heprin flush. ref SDS C4 V36O
050456 -
050458 - ..
050459 - Catherine explained that it is difficult to feel with fingers the
050460 - three raised palpation points beneath the skin and on top of the port
050461 - for centering needle insertion, cited in manufacturer's documentation,
050462 - reported on 080708. ref SDS B5 JE7N She has learned to press the skin
050463 - firmly to feel the triangular shape of the Power Port, also noted in
050464 - Bard's Instructions for Use. ref SDS B5 EF3F
050466 - ..
050467 - After locating the Power Port beneath the skin, Catherine seems to use
050468 - fingers of the left hand to grip the perimiter of the port beneath the
050469 - skin, so that it protrudes slightly presenting a target, and then
050470 - inserts the Huber needle centered by eye in the middle of the gripped
050471 - skin area. She noted the nurse can recognizes the Huber needle is
050472 - fully seated because the bottom of the port is metal and so the needle
050473 - cannot be pushed further. After a few tries, this becomes easy to
050474 - feel.
050476 - ..
050477 - [On 080718 Kaiser nurse requests patient history accessing
050478 - Power Port at UCSF for guidance on 2nd attempt to use Power
050479 - Port for injecting CT test contrast medium; swelling from
050480 - extravisasion during 1st attempt to access the Power Port
050481 - prevented finding Power Port, and so effort abandoned.
050482 - ref SDS C3 IC6F
050484 - ..
050485 - As a result, it took less than a minute for Catherine to access
050486 - Millie's Power Port today.
050488 - ..
050489 - Discussed evaluating port access today, and if there is difficulty,
050490 - then UCSF might call Kaiser this morning, as UCSF did last week on
050491 - 080710, ref SDS B7 EE4O, to ask again about leaving the port in place
050492 - for the CT test tomorrow, even though yesterday on 080716 Ike said
050493 - "absolutely not," when this solution was presented to the Kaiser CT
050494 - Department. ref SDS C2 I73F Catherine noted that Kaiser did not
050495 - object to UCSF using port access on 080710, ref SDS B7 TZ6H, made by
050496 - Kaiser on 080708. ref SDS B5 BF4K The emotional reaction yesterday on
050497 - 080716, presenting considerations for Kaiser to use port access by
050498 - UCSF, ref SDS C2 053S, increases concern about inexperience using a
050499 - new protocol for the first time. ref SDS C2 K140
050501 - ..
050502 - Catherine indicated that accessing the port today was so simple, that
050503 - calling Kaiser to suggest again leaving the Huber needle in place for
050504 - the CT test tomorrow seems like extra effort that is unnecessary
050505 - overkill, and would risk complaints from cross-cultural resistance;
050506 - so, no effort was made to avoid problems tomorrow with Kaiser trying a
050507 - new protocol for the first time in the CT Department.
050509 - ..
050510 - [On 080718 Power Port use failed at Kaiser for the CT test
050511 - due to port access issues, ref SDS C3 LK3R; Huber needle
050512 - may not have been correctly seated, ref SDS C3 LK41;
050513 - contrast medium flows into and swells upper right chest,
050514 - shoulder and arm, ref SDS C3 NW5M; using the Huber needle
050515 - that accessed the Power Port for treatment at UCSF the day
050516 - before would have reduced risks of mistakes at Kaiser for
050517 - the CT test, ref SDS C3 FL75; communication mixup caused
050518 - extra cost, pain, stress, and anxiety for the patient and
050519 - staff. ref SDS C3 FL83
050521 - ..
050522 - [On 080821 difficulties drawing blood at UCSF Infusion
050523 - Clinic with Huber needle and Power Port, was resolved by
050524 - another more experienced nurse; indicates regular use of
050525 - this procedure essential to maintain skills for mission
050526 - critical tasks like blood draws, and injecting contract
050527 - medium for CT tests. ref SDS C8 04GH
050529 - ..
050530 - Discussed Catherine helping Millie recognize the location of the port
050531 - with palpation, and, further, marking the skin where needle insertion
050532 - is made into the Power Port for Millie's treatment today. This would
050533 - provide a guide for the Kaiser people tomorrow.
050535 - ..
050536 - Catherine examined the wound for the surgical incision implanting the
050537 - Power Port on 080708, per planning last week on 080710. ref SDS B7
050538 - DQ7I She indicated the wound seems to be healing well; she decided
050539 - to wait another week before removing the tape.
050540 -
050541 - [On 080719 as a result of complications from CT test on
050542 - 080718 causing bleeding throught surgical wound, Julie in
050543 - Kaiser Infusion Clinic removed the original surgical tape
050544 - from the Power Port incision wound; inspection shows
050545 - healing, but possible compromise with slight gap from the
050546 - bleeding; fresh surgical tape was placed to dress the
050547 - wound. ref SDS C4 LD87
050549 - ..
050550 - Catherine received Millie's letter to the medical team on 080709. She
050551 - ordered the INR blood test today requested by Gloria on 080708 for the
050552 - Kaiser Coagulation Control Clinic to perform case management of
050553 - pulmonary embolism, ref SDS B5 WO5Y, and cited in Millie's letter on
050554 - 080709. ref SDS B6 TR8W
050555 -
050556 - [On 080724 mixup omitted INR from blood test starting next
050557 - cycle, was mitigate by having done INR this week to recover
050558 - from pause in Coumadin for surgery, ref SDS C6 IU8H, INR
050559 - was later added to blood test, and results were 2.4, within
050560 - the target range. ref SDS C6 K66J
050562 - ..
050563 - Catherine also ordered a test for Creatinine, which is needed for the
050564 - CT test tomorrow at Kaiser, noted by Ike during the meeting last week
050565 - on 080711. ref SDS B8 JQ4U The test today provides backup in case
050566 - results were affected due to specimen grossly hemolyzed reported for
050567 - the test at Kaiser the week before on 080708. ref SDS B5 8U4N
050568 -
050569 -
050570 -
050571 -
050572 -
0506 -
SUBJECTS
Default Null Subject Account for Blank Record
0603 -
0604 - 0800
060501 - ..
060502 - Labs Blood Test
060503 -
060504 - Follow up ref SDS B7 FW5N, ref SDS B4 FW5N.
060505 -
060506 - Adding Carboplatin to the treatment protocol now requires weekly blood
060507 - tests to determine if the immune system is strong enough for safe
060508 - chemotherapy treatment, reported on 070201, ref SDS 11 XR40, and citing
060509 - the clinical study protocol received from UCSF on 070116. ref SDS 10
060510 - 5U7Z
060512 - ..
060513 - During treatment, Catherine submitted results of the test.
060514 -
060529 - ..
060530 - Log#: 080717 08:30
060531 - <----------------------- U C S F -----------------------> <------------- Kaiser -------------->
060532 - Type Results Units Normal ACRO Type Units Normal
060533 - ..
060534 - CBC with DIFF & PLT CT CBCD
060535 - ..
060536 - WBC COUNT 5.0 x10E9/L 3.4 - 10 WBC WBC x10-3 K/uL 3.4 - 10.0
060537 - RBC COUNT L 3.60 x10E12/L 4 - 5.2 RBC RBC x10-6 M/uL 3.60 - 5.70
060538 - HEMOGLOBIN 12.3 g/dL 12 - 15.5 HGB Hemoglobin g/dL 11.5 - 15.0
060539 - HEMATOCRIT L 35.5 PERCENT 36 - 46 HCT Hematocrit % 34.0 - 46.0
060540 - MCV 99 fL 80 - 100 MCV MCV fL 80.0 - 100.0
060541 - MCH H 34.1 pg 26 - 34 MCH
060542 - MCHC 34.6 g/dL 31 - 36 MCHC
060543 - PLATELETS 231 x10E9/L 140 - 450 PLT Plt x10-3 K/uL 140 - 400
060544 -
060545 - Performed at Mt Zion Clinic Lab, 1600 Divisadero, San
060546 - Francisco, CA 94115
060547 - ..
060548 - (NEUTS x 1000 = ANC for Kaiser)
060549 - NEUTS 2.47 x10E9/L 1.8 - 6.8 N-A ANC 1500
060550 - Neutrophils Not Reported Neutrophils % 50 - 70
060552 - ..
060553 - LYMPHS 1.71 x10E9/L 0.9 - 2.9 L-A Lymphocytes % 20 - 50
060554 - MONOS 0.41 x10E9/L 0.1 - 0.6 M-A Monocyte % 0 - 11
060555 - EOS 0.29 x10E9/L 0 - 0.4 E-A Esoinophils % 1 - 5
060556 - BASOS 0.09 x10E9/L 0 - 0.1 B-A Basophil % 0 - 2
060558 - ..
060559 - <----------------------- U C S F -----------------------> <------------- Kaiser -------------->
060560 - Type Results Units Normal ACRO Type Units Normal
060561 - PT H 26.8 s 12.0 - 14.1 PT PT, patient sec 8.9 - 11.1
060562 - INL NRM Ratio H 2.4 0.9 - 1.1 INR INR 2.0 - 3.0
060563 -
060564 - Performed at Mt Zion Clinic Lab, 1600 Divisadero, San
060565 - Francisco, CA 94115
060567 - ..
060568 - PARTIAL
060569 - THROMBOPLASTIN H 36.7 s 22.2 - 34.2 PTT
060570 -
060571 - Performed at Mt Zion Clinic Lab, 1600 Divisadero, San
060572 - Francisco, CA 94115
060574 - ..
060575 - FIBRINOGEN 387 mg/dL 202 - 430 FIB
060577 - ..
060578 - CREAT with eGFR
060579 - CREATININE 0.42 mg/dL 0.42 - 1.06 CR Creatinine mg/dL 0.6 - 1.2
060580 -
060581 - Note: Creatinine assay changed to IDMS standardization on
060582 - February 4, 2008 causing decrease in results of approximately
060583 - 0.09 mg/dL
060585 - ..
060586 - eGFR if Caucasian >60 mL/min GFRC
060587 - eGFR if African Amer >60 mL/min GFRA
060588 -
060589 - eGFR corrected for 1.73 sq meters of body surface area
060590 - Note: eGFR is only an estimation. Please see online Lab Manual
060591 - for potential limitations.
060592 - Performed at Mt Zion Clin Lab, 1600 Divisadero, San Francisco,
060593 - CA 94115
060594 -
060596 - ..
060597 - NEUTS Decrease Neupogen Not Prescribed Because Blood Counts Still Good
060598 -
060599 - Follow up ref SDS B7 PU6K, ref SDS B4 PU6K.
060600 -
060601 - Blood counts decreased significantly after rising the past 3 weeks
060602 - shown by Lab report today with NEUTS 2.47, ref SDS 0 QY6H, compared
060603 - with NEUTS 5.12 last week on 080710, ref SDS B7 QY6H Significant drop
060604 - in blood counts with Carboplatin chemotherapy treatment last week,
060605 - seems conflicting with 3 consecutive weeks rising labs while getting 2
060606 - treatments with Neupogen, including this week at the Kaiser Infusion
060607 - Clinic, reported on 080712. ref SDS B9 IT77 Supports Brigid's
060608 - instructions for Millie to continue with 2 Neupogen treatments per
060609 - week of treatment with Carboplating during this cycle, reported for
060610 - the meeting at UCSF on 080626, ref SDS A9 QJ4H, even though
060611 - Chemotherapy Orders to do not prescribe Neupogen. ref SDS B0 PWSY
060613 - ..
060614 - Catherine called for Brigid about whether Neupogen treatments are
060615 - needed this week in light of significant drop in blood counts. When
060616 - Millie left the clinic about 1120, Brigid had not called back.
060617 - Catherine suggested Neupogen is not needed this week, because despite
060618 - significant decrease this week, NEUTS 2.47 are still well above
060619 - requirements of 1.87. ref SDS 0 QY6H Since Millie was not treated
060620 - with Carboplatin chemotherapy because this is the bye week in the
060621 - cycle, there is no reason for blood counts to continue decreasing, and
060622 - so Neupogen to increase counts should not be needed.
060624 - ..
060625 - Side effects of Neupogen reported on 080628, ref SDS B1 6Q5J, and
060626 - again on 080629, ref SDS B3 6Q5J, have been less severe the past week
060627 - even though Neupogen treatments have continued at 2 per week.
060629 - ..
060630 - On 080713 Millie reported recurrence of Neupogen side effects.
060631 - ref SDS C0 RM94
060632 -
060633 -
060634 -
060635 -
060636 -
060637 -
060638 -
060639 -
060640 -
060641 -
060642 -
060643 -
0607 -