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: August 22, 2008 02:00 PM Friday; Rod Welch

Millie 1st Neupgogen at Kaiser for 1st treatment 7th cycle UCSF.

1...Summary/Objective
2...Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
3...Schedule Neupogen Treatments Extended through August
4...Exercise Hiking Maintain Fitness Strengthen Immune System
5...CT Test Scheduled Oakland Kaiser 080911 0130 Huber Needle Power Port


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CONTACTS 

SUBJECTS
Neupogen Side Effects Bone Pain Fatigue No Headache Suffered Today A

1503 -
1503 -    ..
1504 - Summary/Objective
1505 -
150501 - Follow up ref SDS 57 0000. ref SDS 56 0000.
150502 -
150503 -
150504 -
150505 -
150506 -
150508 -  ..
1506 -
1507 -
1508 - Progress
1509 -
150901 - Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
150902 -
150903 - Follow up ref SDS 57 9W9I, ref SDS 56 9W9I.
150904 -
150905 - Yesterday on 080821 Millie had the 1st treatment with cetuximab for
150906 - the 7th cycle in the 2nd arm of the clinical study at UCSF.  Blood
150907 - counts were too low for treatment with Carboplatin chemotherapy.
150908 - Doctor Rugo approved treatment with Neupogen at Kaiser today and
150909 - tomorrow, even though Millie received no Carboplatin due to low blood
150910 - counts. ref SDS 59 ON5M
150912 -  ..
150913 - Florida was the nurse again today for Millie's Neupogen treatment, and
150914 - used 2 injections, implementing Kaiser protocols discussed on 080801
150915 - ref SDS 52 9W9I, originally presented by Laura on 080628. ref SDS 37
150916 - Q74G
150917 -
150918 -
150919 -
1510 -

SUBJECTS
Default Null Subject Account for Blank Record

1603 -
160401 -  ..
160402 - Schedule Neupogen Treatments Extended through August
160403 -
160404 - Follow up ref SDS 57 WJ4O, ref SDS 42 RW3F.
160405 -
160406 - Treatments for September were scheduled by Donna on 080809.
160407 - ref SDS 57 NQ4O
160409 -  ..
160410 - Today, Kaiser's computer was out of service, when Millie checked in at
160411 - the front desk.  As a result, the clerk could not submit Millie's
160412 - current schedule of work at Kaiser, which is normally provided each
160413 - time a patient visits the hospital.
160415 -  ..
160416 - After being admitted to the Infusion Clinic, Millie asked Florida to
160417 - check the schedule for Neupogen treatments.  Florida was able to print
160418 - a list using another part of the Kaiser computer system.
160420 -  ..
160421 - Florida said the computer has a mistake.
160423 -  ..
160424 - There is no treatment scheduled for tomorrow on 080823.  The August
160425 - schedule was issued by Kaiser on 080726. ref SDS 51 BS5H
160426 -
160427 -          [On 080823 schedule computer mistake moves treatment on
160428 -          080905 to 080908. ref SDS 60 5T6N
160430 -  ..
160431 - Millie had reported this problem a few weeks ago on 080809.  At that
160432 - time, Donna entered a correction in the computer schedule system.
160433 - ref SDS 57 C24J
160434 -
160435 -          [On 080823 the next day, Hazel discovered the computer
160436 -          mysteriously changed the schedule received today 080822,
160437 -          causing 2 new problems scheduling Millie's Neupogen
160438 -          treatments. ref SDS 60 5T6N
160440 -  ..
160441 - Florida scheduled Millie's treatment tomorrow at 1330.  This will give
160442 - Millie time in the morning to go hiking.
160443 -
160444 -
160445 -                                                        UCSF Chemo
160446 -        Date    Time   Provider         Services      Cycle Treatmnt
160447 -        080815  0900   Infusion Nurse   Neupogen        6     4
160448 -        080816  0900   Infusion Nurse   Neupogen        6     4
160449 -        080822  0900   Infusion Nurse   Neupogen        7     1
160450 -        080823  1330   Infusion Nurse   Neupogen        7     1
160451 -        080829  0900   Infusion Nurse   Neupogen        7     2
160452 -        080830  0900   Infusion Nurse   Neupogen        7     2
160453 -        080905  0900   Infusion Nurse   Neupogen        7     3
160454 -        080906  0900   Infusion Nurse   Neupogen        7     3
160455 -        080912  0900   Infusion Nurse   Neupogen        7     4
160456 -        080913  0900   Infusion Nurse   Neupogen        7     4
160457 -        080919  0900   Infusion Nurse   Neupogen        8     1
160458 -        080920  0900   Infusion Nurse   Neupogen        8     1
160459 -        080926  0900   Infusion Nurse   Neupogen        8     2
160460 -        080927  0900   Infusion Nurse   Neupogen        8     2
160461 -
160462 -
160463 -
1605 -

SUBJECTS
Default Null Subject Account for Blank Record

1703 -
170401 -  ..
170402 - Exercise Hiking Maintain Fitness Strengthen Immune System
170403 -
170404 - Follow up ref SDS 57 3E4K.
170405 -
170406 - Millie hiked about 8.25 miles at Lafayette Reservoir before treatment
170407 - today.
170408 -
170409 -
170410 -
1705 -

SUBJECTS
Default Null Subject Account for Blank Record

1803 -
180401 -  ..
180402 - CT Test Scheduled Oakland Kaiser 080911 0130 Huber Needle Power Port
180403 -
180404 - Follow up ref SDS 58 0001.
180405 -
180406 - While Millie was getting Neupogen treatment, Talked to Arlette.
180408 -  ..
180409 - Arlette recieved a copy of Millie's letter to the medical team on
180410 - 080811 coordinating plans for the next CT test.  Arlette advised today
180411 - that, before going on vacation, the doctor ordered the test, as
180412 - planned in the letter on 080811, ref SDS 58 P94I, and implementing
180413 - discussion with Sheree earlier that day. ref SDS 58 P68J
180415 -  ..
180416 - She will check the Kaiser computer to see if the test has been
180417 - scheduled, which Sheree planned to do when she called last week on
180418 - 080811. ref SDS 58 L45M
180419 -
180421 -  ..
1805 -
1806 -
1807 - 1415
1808 -
180801 - Arlette has checked the computer and found there is no record of
180802 - Millie being scheduled for a CT test.  This seems conflicting with
180803 - Sheree's call on 080811, when she indicated Kaiser would schedule the
180804 - test on 080912, and if the date needed to be adjusted, this could be
180805 - accomplished. ref SDS 58 L556
180807 -  ..
180808 - She will call the CT Department in Oakland and try to schedule Millie
180809 - for a CT test on 080911 at 1330 or at the latest 1400, so that Millie
180810 - can stop at Kaiser in Oakland on the way home from getting treatment
180811 - at UCSF, and get the CT test, as set out in Millie's letter on 080811.
180812 - ref SDS 58 P96Q
180814 -  ..
180815 - Arlette noted there could be a problem getting the CT test scheduled
180816 - on 080911 at 1330 or 1400, because today is short notice for
180817 - requesting a specific test date and time.
180819 -  ..
180820 - Arlette recalled that Kaiser was notified nearly 2 weeks ago to
180821 - schedule the work. ref SDS 58 P96Q  She apologized that sometimes
180822 - things slip through the cracks.
180824 -  ..
180825 - Discussed Arlette ordering Gastrografin.
180827 -  ..
180828 - Arlette plans to order the contrast medium treatment patients drink to
180829 - prepare for the CT test, reported on 080617 when Kaiser schedule
180830 - Millie's prior test. ref SDS 34 DF64  Arlette advised that Kaiser has
180831 - changed the contrast medium treatment from Gastrografin used for
180832 - Millie's prior tests.  The new treatment is...
180833 -
180834 -            Banana Smoothie
180835 -            Readicat 2
180836 -            Barium Sulfate Suspension
180838 -         ..
180839 -        [On 080825 Millie went to Sheridan Pharmacy and picked up the
180840 -        Barium Sulfate suspension solution for contrast medium required
180841 -        for Millie's CT test. ref SDS 61 W35I
180842 -
180843 -
180844 -
180846 -  ..
1809 -
1810 -
1811 - 1504
1812 -
181201 - Arrived home from Kaiser after Millie got Neupogen treatments, and
181202 - after meeting with Arlette.
181204 -  ..
181205 - There was a telephone message from Arlette.
181207 -  ..
181208 - Arlette advised that Millie is now scheduled for the CT test in
181209 - Oakland on 080911 at 1330, per planning in Millie's letter to the
181210 - medical team on 080811. ref SDS 58 P96Q
181211 -
181212 -            [On 080826 Kaiser CT Department in Walnut Creek called and
181213 -            advised that the Kaiser CT Department in Oakland sent
181214 -            Millie's case back to the CT Department at Kaiser in Walnut
181215 -            Creek. ref SDS 62 VG6N
181217 -  ..
181218 - Arlette said she has ordered Barrium Sulfate Suspension medication for
181219 - the contrast medium, which Millie has to take an hour or so before the
181220 - CT test on 080911.  Millie can get the medication from the Sheridan
181221 - Pharmacy at the Kaiser Park Shadelands clinic in Walnut Creek.
181222 -
181223 -        [On 080825 Millie went to Sheridan Pharmacy and picked up the
181224 -        Barium Sulfate suspension solution for contrast medium required
181225 -        for Millie's CT test. ref SDS 61 W35I
181227 -         ..
181228 -        [On 080911 after the CT test, and through the evening new
181229 -        contrast medium may cause upset stomach. ref SDS 63 S59G
181230 -
181231 -
181232 -
181233 -
181234 -
181235 -
181236 -
1813 -