CONTACTS 

SUBJECTS
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1303 -
1303 -    ..
1304 - Summary/Objective
1305 -
130501 - Follow up ref SDS 5 0000, ref SDS 2 0000.
130502 -
130503 -
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130506 -
130508 -  ..
1306 -
1307 -
1308 - Progress
1309 -
130901 - Millie submitted a letter to Doctor Rugo confirming understandings
130902 - from the meeting at UCSF on 080821. ref SDS 5 0001
130903 -
130904 -    1.  Subject:  Examination UCSF Aug 21 INR, Vacation Planning
130905 -        Date: Wed, 27 Aug 2008 09:33:23 -0700
130919 -         ..
130920 -    3.  Thanks for the "thumbs up" on my condition during examination
130921 -        at UCSF this past Thursday. ref SDS 5 YX49
130923 -         ..
130924 -    4.  I see Doctor Johnson at Kaiser on Friday, Aug 29th.
130926 -         ..
130927 -    5.  By copy to Doctor Johnson, I will request follow up review of
130928 -        the lump Lynn noted on the left side of the neck, and that the
130929 -        report for CT test planned for Sep 12th focus on this location
130930 -        as well [as planned in the meeting on 080821, ref SDS 5 4C6O].
130931 -
130932 -              [...in another record, Millie cancels vacation plans due
130933 -              to concern about new lump signaling progression of
130934 -              disease, with requirements to change treatments.
130935 -              ref SDS 9 K377
130937 -               ..
130938 -              [On 080912 report on CT test 080911 presents no findings
130939 -              in left supraclavicular. ref SDS 12 5O6N
130941 -               ..
130942 -              [On 080918 medical team reviews CT test on 080911 and
130943 -              finds no evidence of swelling in left supraclavicular.
130944 -              ref SDS 13 ST3I
130946 -               ..
130947 -              [On 081016 medical team at UCSF finds lump in left
130948 -              supraclavicular again reported by Lynn on 080821, and by
130949 -              the primary care physician at Kaiser on 080829; Doctor
130950 -              Rugo orders biopsy at Kaiser.
130952 -               ..
130953 -              [On 081022 Doctor Daamen takes biopsy at Kaiser of
130954 -              swelled lymph node in left supraclavicular, and reviews
130955 -              CT test on 080911; reports that the scans did not include
130956 -              enough of the neck to evaluate the node in the left
130957 -              supraclavicular. ref SDS 14 516F
130958 -
130960 -  ..
130961 - Vacation Planning 081027 - 081106 Shift Chemo Treatment to 081107
130962 -
130963 -
130964 -    6.  I am planning a 2 week vacation cruise in the Caribbean leaving
130965 -        on Monday Oct 27, and returning Thursday Nov 6.  Leaving on
130966 -        Monday enables getting 2 Neupogen treatments, if needed.
130967 -        Returning on Thursday, requires getting treatment at UCSF on
130968 -        Friday, rather than regularly scheduled Thursday.  Please let
130969 -        me know if this schedule is okay with the medical team.
130970 -
130971 -              [...in another record, Millie cancels vacation plans due
130972 -              to concern about new lump signaling progression of
130973 -              disease, with requirements to change treatments.
130974 -              ref SDS 9 K377
130975 -
130976 -
130978 -  ..
130979 - INR 2.9 Aligns Requirements PE Treatment with Coumadin
130980 -
130981 - Follow up ref SDS 6 K66J.
130982 -
130983 -    7.  INR 2.9 from labs at UCSF on Aug 21, continues to meet targets
130984 -        for PE management; by copy notifying Gloria at Kaiser's
130985 -        Coagulation Control Department in Martinez. ref SDS 6 PU7Y
130986 -
130987 -            [...in another record later today, Millie received a letter
130988 -            reporting that Kaiser received Millie's letter today
130989 -            reporting INR results for the blood test last week.
130990 -            ref SDS 10 VD7O
130991 -
130993 -  ..
130994 - Blood Counts Increased by Neupogen Enable Chemotherapy Tomorrow UCSF
130995 -
130996 -
130997 -    8.  I got Neupogen treatment at Kaiser on Aug 22 and 23, per
130998 -        planning to increase unexpectedly low NEUTS 0.99 (ANC 990 at
130999 -        Kaiser), ref SDS 6 QY6H, which prevented chemotherapy treatment
131000 -        last Thursday. ref SDS 5 4B84
131002 -         ..
131003 -    9.  Labs tomorrow will hopefully let me get treatment.
131004 -
131005 -
131007 -  ..
131008 - CT Test Kaiser Oakland Refuses to Perform Need Work Plan
131009 -
131010 -
131011 -   10.  Last Friday [on 080822], Arlette scheduled my CT test at Kaiser
131012 -        in Oakland on  Sep 11, ref SDS 7 N66E, following Paula's
131013 -        research showing the Oakland office has experience doing CT
131014 -        tests with Huber needle and Power Port technology [reported on
131015 -        080811, ref SDS 4 L45M, and reported to the medical team in
131016 -        Millie's letter the same day. ref SDS 4 P95U].  This was
131017 -        approved by Doctor Rugo for doing the test after my treatment
131018 -        at UCSF. ref SDS 5 MF5L
131020 -         ..
131021 -   11.  Yesterday, I got a call from Lisa in the CT Department at
131022 -        Kaiser in Walnut Creek.  She said the CT people in Oakland had
131023 -        referred the test back to the Walnut Creek office. ref SDS 8
131024 -        XF64
131026 -         ..
131027 -   12.  Lisa was not familiar with the Huber needle Power Port issues.
131028 -        She called the CT Department in Walnut Creek.  Her colleague,
131029 -        Loretta called back and related Kaiser plans to use the
131030 -        Interventionary Radiology people, ref SDS 8 HT5H, as was done
131031 -        for the test on July 18th, when work failed using this scheme.
131032 -        ref SDS 1 2U8V
131034 -         ..
131035 -   13.  I will discuss with Doctor Johnson on Friday getting a report
131036 -        showing prior problems have been identified, and a work plan to
131037 -        perform a successful test.  We need arrangements for someone
131038 -        experienced with Huber needles to access the Power Port, and
131039 -        the technicians should calculate the flow rate for injecting
131040 -        contrast medium according to manufacturer's instructions,
131041 -        which were previously submitted to Kaiser, reported on July
131042 -        18th. ref SDS 1 2U42
131044 -         ..
131045 -   14.  If the test is done on Friday Sep 12, we can solve the port
131046 -        access issue by leaving the needle from work at UCSF the day
131047 -        before in place overnight, based on Kathi's analysis on July
131048 -        18th. ref SDS 1 FL75  [see follow up planning on 080811,
131049 -        ref SDS 4 4931, and letter to medical team on implementing this
131050 -        work plan. ref SDS 4 P43Y]
131052 -         ..
131053 -   15.  Research shows there is a lot of nuance involved using Huber
131054 -        needles and Power Ports, and requires skill from routine use
131055 -        for effective application.
131056 -
131057 -           [On 080903 discuss with Kaiser CT Department in Oakland
131058 -           leaving Huber needle access Power Port for chemotherapy
131059 -           treatment at UCSF so the needle can be used again for CT
131060 -           test at Oakland; schedule attendant asks Millie to notify
131061 -           primary care p[hysician at Kaiser to request procedure.
131062 -           ref SDS 11 S289
131064 -         ..
131065 -   16.  In any case, I would like to have a nurse from the Infusion
131066 -        Clinic on hand during the test to handle exigent circumstances.
131067 -        If things go right, this is a 10 - 20 minute job.  I can go
131068 -        back to the Infusion Clinic after the test to have the port
131069 -        flushed, and the needle removed.  Note as well, that Bard has
131070 -        offered to supply a consultant free of charge to assist Kaiser
131071 -        with my next CT test, reported on Aug 1st. ref SDS 3 OW43
131073 -         ..
131074 -   17.  If the test is not performed in Oakland, then it should be done
131075 -        on Friday, Sep 12 to conform with UCSF clinical study protocol
131076 -        to test on 8 week interval, cited in Doctor Rugo's letter on
131077 -        Aug 11. ref SDS 4 4T4N  Loretta proposed advancing the date of
131078 -        the test several days to Tuesday or Wednesday.  If UCSF
131079 -        approves, this would provide more time for Kaiser to read the
131080 -        results and submit a report in time to prepare for meeting with
131081 -        the medical team on Sep 18th.
131082 -
131083 -            [On 080912 Kaiser submitted the CT test report the day
131084 -            after the test on 080911, providing ample time for review
131085 -            to prepare for meeting at UCSF on 080918. ref SDS 12 6V5I
131087 -         ..
131088 -   18.  Thanks very much for a good meeting this past Thursday.
131090 -         ..
131091 -   19.  Looking forward to treatment tomorrow, and seeing Doctor
131092 -        Johnson on Friday.  Hoping NEUTS are high and CA 15-3 from last
131093 -        week is low.
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