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: November 7, 2008 02:00 PM Friday;
Rod Welch
Millie 1st Neupgogen at Kaiser preparing start sunitinib treatment at 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...Side Effects Neupogen Treatments Increase May Be Chemotherapy
..............
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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 B3 0000. ref SDS A9 0000.
150502 -
150503 -
150504 -
150505 -
150507 - ..
1506 -
1507 -
1508 - Progress
1509 -
150901 - Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
150902 -
150903 - Follow up ref SDS B3 9W9I, ref SDS A9 9W9I.
150904 -
150905 - Background on missing treatment at UCSF due to low blood counts, and
150906 - requirements for Neupogen are reported in the record on 081016.
150907 - ref SDS A0 OK67
150909 - ..
150910 - Case study on 060809 shows Millie has often received chemotherapy when
150911 - blood counts are below the standard for safe treatments, and on some
150912 - occassions has received Neupogen to increase blood counts. ref SDS 9
150913 - HV45
150915 - ..
150916 - Research on neutropenia was reported on 070301, ref SDS 10 O59H, when
150917 - Doctor Rugo was concerned about holding blood counts with weekly
150918 - Carboplatin treatments. ref SDS 10 VF6O
150920 - ..
150921 - Millie had chemotherapy Carboplatin on 081023 at UCSF. ref SDS A6 V94O
150923 - ..
150924 - That was the last treatment on the cetuximab Carboplatin clinical
150925 - study. On 081023, the doctor diagnosed progression of disease based
150926 - on an FNA biopsy performed the day before that was positive for
150927 - cancer. ref SDS A7 D65G The next day on 081024 the primary care
150928 - physician ordered change of treatment in the medical chart citing
150929 - referral care at UCSF in sunitinib clinical study. ref SDS B2 XZ8W
150931 - ..
150932 - The UCSF work plan on 081029 calls for Millie to start treatment with
150933 - sunitinib clinical study on 081113. ref SDS B5 0U8N
150935 - ..
150936 - There has been no guidance on continuing Neupogen. General guidance
150937 - has been to skip Neupogen when Millie has not been treated with
150938 - chemotherapy.
150940 - ..
150941 - Blood counts on 081023 were NEUTS 1.65. ref SDS A6 PU6K The report
150942 - for the test today was NEUTS 1.67. ref SDS B6 PU6K
150944 - ..
150945 - Consideration today of past difficulties holding blood counts that
150946 - maintain the immune system, Millie decided today to get Neupogen
150947 - treatment in order to be prepared for starting a new treatment on
150948 - sunitinib next week on 081113, called out in the work plan on 081029.
150949 - ref SDS B5 0U8N
150951 - ..
150952 - Anne was Millie's nurse today, because she accessed the Power Port at
150953 - 1230, ref SDS B7 58A5, for the CT test at 1300. When Millie returned
150954 - to the Infusion Clinic after the CT test, Anne removed the Huber
150955 - needle, and then she gave Millie 2 injections required for the 1st
150956 - Neupogen treatment prescribed this week...
150957 -
150958 - Neupogen 480 mcg SQ on D2 3 3 carbo
150959 -
150960 - ...as shown in UCSF Chemotherapy Order on 080918, ref SDS 83 PWSY, and
150961 - ordered by primary care physician at Kaiser on 080609. ref SDS 38 L16I
150963 - ..
150964 - Prior instructions describe Kaiser protocol calls for 480 mcg be given
150965 - with 2 injections, discussed on 080801 ref SDS 58 9W9I, and originally
150966 - presented by Laura on 080628. ref SDS 43 Q74G
150967 -
150968 -
150969 -
150970 -
1510 -
SUBJECTS
Default Null Subject Account for Blank Record
1603 -
160401 - ..
160402 - Schedule Neupogen Treatments Extended through August
160403 -
160404 - Follow up ref SDS B3 WJ4O, ref SDS A9 WJ4O.
160405 -
160406 - Millie's schedule for was last updated on 081018. ref SDS A3 WJ4O
160407 -
160408 -
160409 -
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 B3 3E4K, ref SDS A9 3E4K.
170405 -
170406 - Millie could not go hiking today, because of medical meetings and
170407 - tests all day, beginning at UCSF.
170409 - ..
170410 - She has been on vacation for several weeks, and so will begin hiking
170411 - tomorrow.
170413 - ..
170414 - Hiking will be reduced this coming week, because of meetings getting
170415 - setu for changing treatments.
170416 -
170417 - +- c = Carboplatin
170418 - +- e = Erbatex cetuximab
170419 - Time Pulse |
170420 - Location Miles Minutes Avg Max Chem Neupo Date
170421 - ----------------------------------------------------------------
170422 - Kaiser x 081107, ref SDS 0 UZ7K
170423 - Lafayette 5.50 90.2 120 143 081025, ref SDS B3 3E4K
170424 - Kaiser x 081025, ref SDS B3 UZ7K
170425 - Kaiser x 081024, ref SDS A9 UZ7K
170426 - UCSF c 081023, ref SDS A6 V94O
170427 - Lafayette 5.50 90.6 115 141 081021, ref SDS A5 3E4K
170428 - Lafayette 5.50 90.4 110 128 081020, ref SDS A4 3E4K
170429 - Kaiser x 081018, ref SDS A3 UZ7K
170430 - Kaiser x 081017, ref SDS A2 UZ7K
170431 - UCSF e 081016, ref SDS A0 V94O,
170432 - Lafayette 5.50 90.1 115 154 081014, ref SDS 99 3E4K
170433 - Lafayette 5.50 92.7 115 138 081013, ref SDS 98 3E4K
170434 - Lafayette 8.25 146.4 180 224 081012, ref SDS 97 3E4K
170435 - Kaiser x 081011, ref SDS 96 UZ7K
170436 - Lafayette 5.50 93.3 116 138 081010, ref SDS 95 3E4K
170437 - Kaiser x 081010, ref SDS 95 UZ7K
170438 - UCSF e 081009, ref SDS 94 V94O
170439 - Lafayette 5.50 92.1 113 137 081006, ref SDS 93 3E4K
170440 - Lafayette 2.75 48.5 110 136 x 081004, ref SDS 92 3E4K
170441 - Lafayette 5.50 98.2 117 136 x 081003, ref SDS 91 3E4K
170442 - UCSF c 081002, ref SDS 90 V94O
170443 - Lafayette 5.50 94.7 115 142 080929, ref SDS 89 3E4K
170444 - Lafayette 8.25 150.4 115 135 080928, ref SDS 89 3E4K
170445 - Kaiser x 080927, ref SDS 88 UZ7K
170446 - Lafayette 5.50 90.2 120 140 x 080926, ref SDS 87 3E4K
170447 - UCSF c 080925, ref SDS 86 V94O
170448 - Lafayette 5.50 92.3 116 138 080923, ref SDS 85 3E4K
170449 - Lafayette 5.50 98.4 112 134 080922, ref SDS 85 3E4K
170450 - Lafayette 5.50 98.2 114 137 080921, ref SDS 85 3E4K
170451 - Lafayette 5.50 101.6 110 133 x 080920, ref SDS 84 3E4K
170452 - Lafayette 5.50 89.3 115 144 x 080919, ref SDS 83 3E4K
170453 - UCSF c 080918, ref SDS 82 V94O
170454 - Lafayette 2.75 46.2 117 139 080916, ref SDS 83 3E4K
170455 - Lafayette 5.50 91.8 117 142 080915, ref SDS 81 3E4K
170456 - Clayton Safeway 3.00 62.4 98 118 080914, ref SDS 80 3E4K
170457 - Lafayette 8.25 129.7 123 147 x 080913, ref SDS 79 3E4K
170458 - Lafayette 5.50 88.4 118 146 x 080912, ref SDS 78 3E4K
170459 - UCSF c 080911, ref SDS 77 V94O
170460 - Lafayette 2.75 46.8 113 140 080909
170461 - Lafayette 5.50 89.2 117 143 080908
170462 - Lafayette 5.50 92.1 115 138 080907
170463 - Lafayette 2.75 45.3 120 144 x 080906, ref SDS 76 3E4K
170464 - Lafayette 2.75 56.8 93 120 x 080905, ref SDS 75 3E4K
170465 - UCSF c 080904, ref SDS 74 V94O
170466 - Lafayette 8.25 140.4 116 131 080903
170467 - Lafayette 5.50 94.9 115 134 080902
170468 - Kaiser x 080830
170469 - Kaiser x 080829
170470 - UCSF c 080828, ref SDS 71 V94O
170471 - Lafayette 5.50 93.6 120 137 080826
170472 - Lafayette 5.50 93.2 117 138 080825
170473 - Lafayette 5.50 93.2 123 136 x 080823
170474 - Lafayette 8.25 142.5 110 131 x 080822, ref SDS 69 3E4K
170475 - UCSF e 080821, ref SDS 68 V94O
170476 - Lafayette 5.50 94.7 115 137 080820
170477 - Lafayette 5.50 94.3 115 135 080819
170478 - Lafayette 8.25 141.7 118 134 080815
170479 - UCSF e 080814, ref SDS 65 V94O
170480 - Lafayette 5.50 93.8 120 136 080813
170481 - Lafayette 5.50 94.4 116 139 080812
170482 - Lafayette 5.50 94.2 119 133 080810
170483 - Lafayette 8.25 143.6 114 132 x 080809, ref SDS 62 3E4K
170484 - Lafayette 8.25 141.1 117 135 x 080808, ref SDS 61 3E4K
170485 - UCSF c 080807, ref SDS 60 V94O
170486 - Lafayette 8.25 143.7 115 132 080805
170487 - Concord 7.00 127.6 105 118 080804
170488 - Lafayette 8.25 143.2 112 134 080802
170489 - Lafayette 5.50 93.4 115 138 080801
170490 - Lafayette 5.50 92.2 118 140 080729
170491 - Lafayette 5.50 92.6 116 137 080728
170492 - Lafayette 8.25 142.6 114 134 080727
170493 - Lafayette 5.50 91.5 120 143 080726
170494 - Lafayette 8.25 140.8 117 135 080725
170495 - Lafayette 5.50 91.8 122 141 080723
170496 - Lafayette 5.50 91.3 120 139 080722
170497 - Lafayette 8.25 143.3 115 133 080720
170498 - Lafayette 5.50 90.7 125 144 080719
170499 - Lafayette 5.50 92.4 123 142 080716
170500 - Lafayette 2.25 46.8 116 137 080715
170501 - Lafayette 8.25 141.8 116 136 080712
170502 - Lafayette 5.50 92.9 116 139 080711
170503 - Lafayette 8.25 143.3 113 137 080704
170504 - Lafayette 5.50 90.2 121 147 080630
170505 - Lafayette 8.25 142.4 116 138 080628
170506 - Lafayette 5.50 91.4 118 138 080625
170507 - Lafayette 2.25 47.9 116 136 080623
170508 - Lafayette 5.50 94.2 112 138 080622
170509 - Lafayette 5.50 94.7 115 133 080621
170510 - Lafayette 2.25 48.3 110 129 080620
170511 - Mt Diablo 7.00 129.4 130 153 080616
170512 - Lafayette 5.50 90.8 120 146 080615
170513 - Lafayette 5.50 91.3 124 144 080614
170514 - Lafayette 5.50 89.7 122 143 080613
170515 - Lafayette 2.76 45.8 120 147 080611
170516 - Lafayette 5.50 90.5 123 145 080609
170517 - Lafayette 5.50 92.7 115 138 080607
170518 - Lafayette 5.50 94.2 118 139 080602
170519 - Lafayette 5.50 96.2 110 202 080507, ref SDS 30 WO8M
170520 -
170521 -
170522 -
170523 -
1706 -
SUBJECTS
Default Null Subject Account for Blank Record
1803 -
180401 - ..
180402 - Side Effects Neupogen Treatments Increase May Be Chemotherapy
180403 -
180404 - Follow up ref SDS B3 SB8I, ref SDS A9 SB8I.
180405 -
180406 - Research on Neupogen side effects was reported on 080629. ref SDS 44
180407 - RQ9I Previous case study on Neupogen side effects listed on 081002.
180408 - ref SDS 87 SB8I
180410 - ..
180411 - She had another long day starting at 0530 leaving for a meeting with
180412 - UCSF in San Francisco. She signed Consent documents and discussed
180413 - scope of sunitinib clinical study starting treatment on 081113. She
180414 - then had laboratory work performed on the 5th floor in the Infusion
180415 - clinic. Millie returned to Kaiser in Walnut Creek for a meeting with
180416 - the Kaiser in the Infuson Clinic to access her Power Port. She then
180417 - met with the CT Department for a test, which was very tiring and
180418 - stressful. ref SDS B8 GR9K Millie then returned to the Infusion
180419 - Clinic on the 2nd floor to have a nurse remove the Huber needle and
180420 - maintain the Power Port. ref SDS B7 W8DG She then received a Neupogen
180421 - treatment reported in this record. ref SDS 0 UZ7K After the Neupogen
180422 - treatment, Millie went to the Head and Neck Department at 1600 on the
180423 - 3rd floor for a core biopsy procedure. ref SDS B9 7P5O
180425 - ..
180426 - Despite all of this emotional activity, Millie did not complain of
180427 - specific bone pain, fatigue, nor headache, which are side effects of
180428 - chemotherapy and Neupogen.
180430 - ..
180431 - Millie last reported side effects on 081018 experiencing bone pain,
180432 - headache, and fatigue associated with Neupogen and chemotherapy.
180433 - ref SDS A3 Y17L
180435 - ..
180436 - Side effects of Neupogen may be increasing, reported on...
180437 -
180438 - 081018................, ref SDS A3 Y17L
180439 - 081011................, ref SDS 96 FL4H
180440 - 081010................, ref SDS 95 SB8I
180441 - 081006................, ref SDS 93 3E4K
180442 - 081004................, ref SDS 92 Y17L
180443 - 081002................, ref SDS 90 Y17L
180444 - 080930................, ref SDS 89 Y17L
180445 - 080923................, ref SDS 85 K16F
180446 - 080915................, ref SDS 81 9W9I
180447 - 080810................, ref SDS 63 9W9I
180448 - 080803................, ref SDS 59 9W9I
180449 - 080726................, ref SDS 56 9W9I
180450 - 080721................, ref SDS 54 9W9I
180451 - 080713................, ref SDS 48 RM94
180452 - 080629................, ref SDS 43 6Q5J
180453 - 080628................, ref SDS 41 6Q5J
180454 -
180455 -
180456 -
180457 -
180458 -
180459 -
180460 -
1805 -