CONTACTS 

SUBJECTS
Meeting Agenda Schedule 080918 Examination  Dctor Review Strategy Wo

1103 -
1103 -    ..
1104 - Summary/Objective
1105 -
110501 - Follow up ref SDS 13 0000. ref SDS 11 0000.
110502 -
110503 -
110504 -
110505 -
110507 -  ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Millie received a letter on Monday, 080915, from UCSF requesting a
110902 - copy of the report for the CT test on 080911 so that the medical team
110903 - can be prepared for the meeting with Millie on Thursday. ref SDS 13
110904 - 435O
110906 -  ..
110907 - Millie submitted ref DIT 1 0001 a letter to Jill with copies to the
110908 - medical team, including Steve and Julie at Bard, and Paula at Kaiser,
110909 - and saying...
110910 -
110911 -    1.  Thanks for your letter on Monday asking about results of the CT
110912 -        test this past Thursday at Kaiser in Oakland. ref SDS 13 435O,
110913 -        ref DIT 1 0001
110914 -
110915 -            [On 080918 Jill received the agenda for the meeting
110916 -            tomorrow; commended Millie's organization of patient
110917 -            history. ref SDS 14 QH4I
110919 -         ..
110920 -    2.  The test was performed successfully using the Power Port with
110921 -        the Huber needle access provided by Diane in the Infusion
110922 -        Clinic at UCSF. ref SDS 9 LK3R  This was a critical step,
110923 -        supported by Catherine's research to verify compatibility of
110924 -        the Lifeguard Huber needle, which is standard at UCSF, with the
110925 -        Bard Power Port used at Kaiser. ref SDS 9 N43F  All 5 issues
110926 -        that affect the test were performed smoothly, without incident.
110927 -        Angela, Kaiser's CT Technologist in Oakland, was terrific.
110928 -        ref SDS 9 SF5J, ref DIT 1 G159
110930 -         ..
110931 -    3.  Using the Power Port fully resolved CT test problems with
110932 -        conventional IV which previously injured my arm [reported by
110933 -        the primary care physician at Kaiser on 080502, ref SDS 2 WX6I,
110934 -        following CT test on 080425. ref SDS 1 FP6F].  The test took
110935 -        about 20 minutes [yesterday], instead of 3 hours required to
110936 -        find a vein for prior tests without the Power Port. [reported
110937 -        for CT testing on 080425. ref SDS 1 NF5M  Planning by primary
110938 -        care physician for referral to Surgery Department on 080502,
110939 -        and subsequent 40 follow up tasks coordinating the work,
110940 -        ref SDS 2 VG5J, yield substantial savings multiplied across
110941 -        Kaiser's expanding patient population]. ref DIT 1 G16H
110943 -         ..
110944 -    4.  Special thanks to Steve and Julie at Bard providing training
110945 -        for Angela a day or so before the test. ref SDS 9 JX60  [and
110946 -        cited by Steve in a call the next day on 080912. ref SDS 10
110947 -        VI8I], ref DIT 1 G16N
110949 -         ..
110950 -    5.  Doctor Johnson, who scheduled and facilitated getting the test
110951 -        done at Oakland, has notified Radiology at Kaiser in Walnut
110952 -        Creek about success using the Power Port.  This implements
110953 -        Paula's planning on 080829 for the Kaiser CT team in Walnut
110954 -        Creek to upgrade services. ref SDS 6 RP7S, ref DIT 1 G17K  [On
110955 -        080905 Paula discussing Millie's case with Kaiser management in
110956 -        Radiology about upgrading CT test service to support injecting
110957 -        contrast mediume with Power Port technology. ref SDS 8 6S7H]
110958 -
110959 -            [On 081015 letter to medical team on agenda to meet on
110960 -            081016 reminds about scheduling the CT test on 081107 at
110961 -            Kaiser in Walnut Creek. ref SDS 15 K354
110963 -             ..
110964 -            [On 081016 letter submits UCSF work plan to get CT test at
110965 -            Kaiser in Walnut Creek for screening patients to
110966 -            participate in the sunitinib clinical trial to treat Millie
110967 -            for the 5th relapse of IBC. ref SDS 16 J44X
110969 -             ..
110970 -            [On 081017 Paula reports further discussion with Kaiser
110971 -            management making progress on arrangements for Millie's
110972 -            next CT test on 081113 at Kaiser in Walunt Creek using
110973 -            procedures for injecting contrast medium with Power Port
110974 -            technology that was done successfully at Oakland.
110975 -            ref SDS 17 707L
110977 -             ..
110978 -            [On 081017 Kaiser in Walnut Creek investigating how Kaiser
110979 -            in Oakland handled laws about accessing a central venous
110980 -            artery with CT test equipment using a Power Port,
110981 -            ref SDS 17 8Y4N, and seemed to indicate that if legal
110982 -            issues are resolved, and the Power Port is accessed by
110983 -            qualified nurses in the Infusion Clinic, then support from
110984 -            the Power Port manufacturer is not needed. ref SDS 17 035K
110986 -             ..
110987 -            [On 081023 Millie submits letter with agenda for meeting
110988 -            with primary care physician at Kaiser to schedule CT
110989 -            test on 081107 1300 at Kaiser in Walnut Creek.
110990 -            ref SDS 18 TH9K
110992 -             ..
110993 -            [On 081024 primary care physician ordered CT test at Kaiser
110994 -            in Walnut Creek on 081107 1300, and asked Millie to
110995 -            coordinate arrangements for the CT Department to use the
110996 -            Power Port, based on success doing the prior CT at Kaiser
110997 -            in Oakland. ref SDS 19 V58K
110999 -         ..
111000 -    6.  Doctor Johnson submitted results of the CT test the next day on
111001 -        080912. ref SDS 11 6V5I  I'm grateful that testing listed in
111002 -        the record of patient history continues to show no evidence of
111003 -        distant metastasis. ref SDS 11 GM3N, ref DIT 1 G17R
111005 -         ..
111006 -    7.  Findings seem to show everything stable. ref SDS 11 OO6M,
111007 -        ref DIT 1 D59H
111008 -
111009 -            [On 080918 examination at UCSF report CT test on 080911
111010 -            findings show Millie's condition is stable, and there is no
111011 -            evidence of distant metastasis. ref SDS 14 MF9K
111013 -         ..
111014 -    8.  You can contact Arlette at Kaiser in Walnut Creek to fax a copy
111015 -        of the CT report.  Her number is 925 295 4030.  By copy I am
111016 -        alerting Arlette that you may call. ref DIT 1 G19J
111018 -         ..
111019 -    9.  As you know, we start a new cycle tomorrow on Thursday.  Blood
111020 -        draw is scheduled for 0800. ref DIT 1 G196
111022 -         ..
111023 -   10.  Please submit an order for labs that include CA 15-3 and INR -
111024 -        magnesium has been a problem sometimes.  Scope of the prior
111025 -        test starting the last cycle is listed on 080821. ref SDS 4
111026 -        075H, ref DIT 1 G19R
111028 -         ..
111029 -   11.  My energy has been high this week shown by patient history on
111030 -        080915.  Hiking farther and faster. ref SDS 12 KO6F,
111031 -        ref DIT 1 G14P
111033 -         ..
111034 -   12.  The record also relates side effects of Neupogen, which seem
111035 -        manageable at this time. ref SDS 12 VP47, ref DIT 1 G15M
111037 -         ..
111038 -   13.  Needless to say, I feel relieved that CT testing went well at
111039 -        Oakland. ref DIT 1 V66K
111041 -         ..
111042 -   14.  I'm looking forward to examination tomorrow, because when I
111043 -        feel IBC rash is rising, I visit your office and it all seems
111044 -        to look better.  Keeping my fingers crossed. ref DIT 1 G15V
111046 -         ..
111047 -   15.  Also glad that I was able to re-schedule my vacation [reported
111048 -        on 080829, ref SDS 5 F75H, I leave on Monday 081027, which
111049 -        allows time to get 2 Neupogen treatments.  I return on Thursday
111050 -        081106.  This requires bumping treatment from Thursday to
111051 -        Friday 081107.  I will miss the treatment on 081030.  Please
111052 -        coordinate the schedules in the Infusion Clinic. ref SDS 5
111053 -        GI4M, ref DIT 1 G16R
111055 -         ..
111056 -   16.  We need to schedule the next CT test for 081113, 8 weeks from
111057 -        080911. ref DIT 1 Z84F
111059 -  ..
111060 - This is a mistake, the next CT is required on 081107, which is 8
111061 - weeks from the last test on 080911.
111062 -
111063 -           [On 080918 the medical team at UCSF concurred with doing the
111064 -           next CT test on 081107. ref SDS 14 MF5L
111066 -  ..
111067 - Letter to medical team continues...
111068 -
111069 -   17.  As you know, Doctor Johnson has approved follow up treatment at
111070 -        UCSF after the current trial is no longer effective.  I want to
111071 -        discuss tomorrow planning toward this eventuality, cited in the
111072 -        letter to the medical team on 080829. ref SDS 6 RP8T,
111073 -        ref DIT 1 G23R
111074 -
111075 -           [On 080918 there was not enough time to review follow on
111076 -           treatments for progression of cancer. ref SDS 14 9W6H
111078 -            ..
111079 -           [On 081015 agenda for meeting with medical team at UCSF
111080 -           requests review of future treatments. ref SDS 15 K45V
111082 -            ..
111083 -           [On 081016 Doctor Rugo proposes follow on treatment with
111084 -           Sunitinib clinical study, ref SDS 16 J38U, which is
111085 -           another targeted chemotherapy; and additionally, Millie
111086 -           will qualify for participation in another clinical trial
111087 -           opening in about 4 months. ref SDS 16 J35X
111089 -            ..
111090 -           [On 081016 Doctor proposes FNA biopsy to check for status
111091 -           change ER PR HER2 neu, which could increase treatments for
111092 -           Millie. ref SDS 16 J36R
111094 -         ..
111095 -   18.  Thanks again very much to everyone for excellent coordination
111096 -        working through the CT test process. ref DIT 1 G23Z
111097 -
111104 -
111105 -
111106 -
111107 -
111108 -
111109 -
1112 -