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 20, 2008 07:00 AM Thursday;
Rod Welch
Millie treatment #7 IBC 5th relapse sunitinib hiking Lafayette 6 miles
1...Summary/Objective
........Patient History Sunitinib Loading Dose 14 Days
2...Side Effects Sunitinib Study
3...Exercise Hiking Maintain Fitness Strengthen Immune System
4...Case Study on Pateint History Exercising
5...Side Effects Neupogen Treatments Increase May Be Chemotherapy
..............
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 69 0000. ref SDS 67 0000.
040502 -
040503 -
040504 -
040506 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 081113 Millie received sunitinib drugs from UCSF to treat the 5th
040902 - relapse of IBC.
040904 - ..
040905 - Millie began the 14 day "charging" treatment on 081114. ref SDS 61
040906 - EK7I After 14 treatments, if Millie tolerates sunitinib at the
040907 - prescribed dose, then she begins adding 2 chemotherapy drugs once a
040908 - day for 2 days a week as prescribed in the treatment protocol,
040909 - reviewed on 081017. ref SDS 47 004O
040911 - ..
040912 - Millie needs a prescription from UCSF for chemotherapy drugs, as
040913 - reported on 081117, ref SDS 64 ID7I, and prior to meeting at UCSF on
040914 - 081126, which was requested in a letter to the medical team on 081117.
040915 - ref SDS 66 FQ5I
040916 -
040918 - ..
040919 - Patient History Sunitinib Loading Dose 14 Days
040920 -
040921 - Follow up ref SDS 69 OE6K, ref SDS 67 OE6K.
040922 -
040924 - Cycle 1
040925 - Cohort: 3
040927 - ..
040928 - Sunitinib MG Cyclophos Metho
040929 - Amount Today Cum phamide trexate
040930 - Days Date Time Cycle 25 12.5 Total Total Amnt Total Amnt Total
040931 - --------------------------------------------------------------------
040932 - Follow up ref SDS 69 PA8Y, ref SDS 67 PA8Y.
040933 -
040934 - 1. 081114 0700 1 1 1 37.5 37.5 0 0 0 0 ..... ref SDS 61 OE6K
040935 - 2. 081115 0700 1 1 1 37.5 75.0 0 0 0 0 ..... ref SDS 62 OE6K
040936 - 3. 081116 0700 1 1 1 37.5 112.5 0 0 0 0 ..... ref SDS 63 OE6K
040937 - 4. 081117 0700 1 1 1 37.5 150.0 0 0 0 0 ..... ref SDS 64 OE6K
040938 - 5. 081118 0700 1 1 1 37.5 187.5 0 0 0 0 ..... ref SDS 67 OE6K
040939 - 6. 081119 0700 1 1 1 37.5 225.0 0 0 0 0 ..... ref SDS 69 OE6K
040940 - 7. 081120 0700 1 1 1 37.5 263.5 0 0 0 0 ..... ref SDS 0 OE6K
040941 -
040942 -
040943 -
040944 -
040945 -
0410 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Side Effects Sunitinib Study
050403 -
050404 - Follow up ref SDS 69 LF8M, ref SDS 67 LF8M.
050405 -
050406 - Millie reported no side effects today.
050408 - ..
050409 - Millie's record of exercising shows correlation between treatments and
050410 - exercise as an indicator of adverse side effects. ref SDS 65 8G5M
050412 - ..
050413 - Hiking today yielded unusual pulse, approximately 10% - 20% lower than
050414 - normal. Typically average pulse for 5.5 miles over 2 laps is 110,
050415 - today it was about 90. Maximum pulse is normally about 140. Today
050416 - maximum pulse only reached 122. This is a big change from patient
050417 - history for the past several years. ref SDS 0 X64F
050419 - ..
050420 - Millie also has side effects from Neupogen; but nothing for several
050421 - weeks since she stopped treatments pending evaluation with new
050422 - sunitinib treatments, reported today, shown by the study below.
050423 - ref SDS 0 XQ4L
050425 - ..
050426 - Date
050427 - Description Adverse Event Start Stop Medication
050428 - ---------------------------------------------------------
050429 - Follow up ref SDS 69 LF8M, ref SDS 67 LF8M.
050430 -
050431 - Diarea 081114 081114 Imodium........ ref SDS 61 LF8M
050432 - Low pulse 081120 081120 None........... ref SDS 0 7G8M
050433 -
050434 -
050435 -
050436 -
050437 -
0505 -
SUBJECTS
Default Null Subject Account for Blank Record
0603 -
060401 - ..
060402 - Exercise Hiking Maintain Fitness Strengthen Immune System
060403 -
060404 - Follow up ref SDS 69 3E4K, ref SDS 68 3E4K.
060405 -
060406 - Millie went hiking at Lafayette reservoir, and did 2 laps about 5.5
060407 - miles in 94.7 minutes, which is a good time for her without running.
060408 - ref SDS 0 X64F
060410 - ..
060411 - Millie has not had another attack of Cellulitis and lymphedema since
060412 - going to the emergency care unit on 080409. ref SDS 2 0001 There was
060413 - a slight flare up on 080520. ref SDS 4 OU5J
060415 - ..
060416 - Millie had her 7th treatment with sunitinib this morning at 0700.
060417 - ref SDS 0 PA8Y
060419 - ..
060420 - This morning Millie feels well rested; she slept well.
060422 - ..
060423 - On 081110, Millie complained about diffiuclty lifting herself from a
060424 - full squatting position. ref SDS 59 HX67 She has since been
060425 - exercising to strengthen her legs, and arms.
060427 - ..
060428 - This morning Millie did...
060429 -
060430 - Arm presses 3 sets of 10 leaning against bannister.
060431 - Squats 3 sets of 10 vary depth useing bannister for leverage
060433 - ..
060434 - There have been no indications of Cellulitis nor lymphedema that has
060435 - occurred previously with exercising the left arm, reported on 070607.
060436 - ref SDS 1 ZH6I
060438 - ..
060439 - Case Study on Pateint History Exercising
060440 -
060441 - Follow up ref SDS 69 X64F.
060442 -
060443 - +- s = Sunitinib
060444 - +- c = Carboplatin
060445 - +- e = Erbatex cetuximab
060446 - Time Pulse |
060447 - Location Miles Minutes Avg Max Chem Neupo Date
060448 - ----------------------------------------------------------------
060449 - Lafayette 5.50 94.7 90 122 s 081120, ref SDS 0 3E4K
060450 - San Francisco 1.00 60.0 65 75 s 081119, ref SDS 69 3E4K
060451 - Lafayette 2.75 49.2 97 130 s 081118, ref SDS 68 3E4K
060452 - Lafayette 5.50 93.6 115 138 s 081117, ref SDS 65 3E4K
060453 - Concord home s 081116, ref SDS 63 Y68J
060454 - Concord home s 081115, ref SDS 62 EK7I
060455 - Concord home s 081114, ref SDS 61 XW6H
060456 - Lafayette 5.50 94.2 115 138 081110, ref SDS 59 3E4K
060457 - Lafayette 2.75 48.4 105 128 081109, ref SDS 58 3E4K
060458 - Kaiser x 081108, ref SDS 57 UZ7K
060459 - Kaiser x 081107, ref SDS 56 UZ7K
060460 - Lafayette 5.50 90.2 120 143 081025, ref SDS 54 3E4K
060461 - Kaiser x 081025, ref SDS 54 UZ7K
060462 - Kaiser x 081024, ref SDS 53 UZ7K
060463 - UCSF c 081023, ref SDS 52 V94O
060464 - Lafayette 5.50 90.6 115 141 081021, ref SDS 51 3E4K
060465 - Lafayette 5.50 90.4 110 128 081020, ref SDS 50 3E4K
060466 - Kaiser x 081018, ref SDS 49 UZ7K
060467 - Kaiser x 081017, ref SDS 48 UZ7K
060468 - UCSF e 081016, ref SDS 46 V94O
060469 - Lafayette 5.50 90.1 115 154 081014, ref SDS 45 3E4K
060470 - Lafayette 5.50 92.7 115 138 081013, ref SDS 44 3E4K
060471 - Lafayette 8.25 146.4 180 224 081012, ref SDS 43 3E4K
060472 - Kaiser x 081011, ref SDS 42 UZ7K
060473 - Lafayette 5.50 93.3 116 138 081010, ref SDS 41 3E4K
060474 - Kaiser x 081010, ref SDS 41 UZ7K
060475 - UCSF e 081009, ref SDS 40 V94O
060476 - Lafayette 5.50 92.1 113 137 081006, ref SDS 39 3E4K
060477 - Lafayette 2.75 48.5 110 136 x 081004, ref SDS 38 3E4K
060478 - Lafayette 5.50 98.2 117 136 x 081003, ref SDS 37 3E4K
060479 - UCSF c 081002, ref SDS 36 V94O
060480 - Lafayette 5.50 94.7 115 142 080929, ref SDS 35 3E4K
060481 - Lafayette 8.25 150.4 115 135 080928, ref SDS 35 3E4K
060482 - Kaiser x 080927, ref SDS 34 UZ7K
060483 - Lafayette 5.50 90.2 120 140 x 080926, ref SDS 33 3E4K
060484 - UCSF c 080925, ref SDS 32 V94O
060485 - Lafayette 5.50 92.3 116 138 080923, ref SDS 31 3E4K
060486 - Lafayette 5.50 98.4 112 134 080922, ref SDS 31 3E4K
060487 - Lafayette 5.50 98.2 114 137 080921, ref SDS 31 3E4K
060488 - Lafayette 5.50 101.6 110 133 x 080920, ref SDS 30 3E4K
060489 - Lafayette 5.50 89.3 115 144 x 080919, ref SDS 29 3E4K
060490 - UCSF c 080918, ref SDS 28 V94O
060491 - Lafayette 2.75 46.2 117 139 080916, ref SDS 29 3E4K
060492 - Lafayette 5.50 91.8 117 142 080915, ref SDS 27 3E4K
060493 - Clayton Safeway 3.00 62.4 98 118 080914, ref SDS 26 3E4K
060494 - Lafayette 8.25 129.7 123 147 x 080913, ref SDS 25 3E4K
060495 - Lafayette 5.50 88.4 118 146 x 080912, ref SDS 24 3E4K
060496 - UCSF c 080911, ref SDS 23 V94O
060497 - Lafayette 2.75 46.8 113 140 080909
060498 - Lafayette 5.50 89.2 117 143 080908
060499 - Lafayette 5.50 92.1 115 138 080907
060500 - Lafayette 2.75 45.3 120 144 x 080906, ref SDS 22 3E4K
060501 - Lafayette 2.75 56.8 93 120 x 080905, ref SDS 21 3E4K
060502 - UCSF c 080904, ref SDS 20 V94O
060503 - Lafayette 8.25 140.4 116 131 080903
060504 - Lafayette 5.50 94.9 115 134 080902
060505 - Kaiser x 080830
060506 - Kaiser x 080829
060507 - UCSF c 080828, ref SDS 19 V94O
060508 - Lafayette 5.50 93.6 120 137 080826
060509 - Lafayette 5.50 93.2 117 138 080825
060510 - Lafayette 5.50 93.2 123 136 x 080823
060511 - Lafayette 8.25 142.5 110 131 x 080822, ref SDS 18 3E4K
060512 - UCSF e 080821, ref SDS 17 V94O
060513 - Lafayette 5.50 94.7 115 137 080820
060514 - Lafayette 5.50 94.3 115 135 080819
060515 - Lafayette 8.25 141.7 118 134 080815
060516 - UCSF e 080814, ref SDS 16 V94O
060517 - Lafayette 5.50 93.8 120 136 080813
060518 - Lafayette 5.50 94.4 116 139 080812
060519 - Lafayette 5.50 94.2 119 133 080810
060520 - Lafayette 8.25 143.6 114 132 x 080809, ref SDS 14 3E4K
060521 - Lafayette 8.25 141.1 117 135 x 080808, ref SDS 13 3E4K
060522 - UCSF c 080807, ref SDS 12 V94O
060523 - Lafayette 8.25 143.7 115 132 080805
060524 - Concord 7.00 127.6 105 118 080804
060525 - Lafayette 8.25 143.2 112 134 080802
060526 - Lafayette 5.50 93.4 115 138 080801
060527 - Lafayette 5.50 92.2 118 140 080729
060528 - Lafayette 5.50 92.6 116 137 080728
060529 - Lafayette 8.25 142.6 114 134 080727
060530 - Lafayette 5.50 91.5 120 143 080726
060531 - Lafayette 8.25 140.8 117 135 080725
060532 - Lafayette 5.50 91.8 122 141 080723
060533 - Lafayette 5.50 91.3 120 139 080722
060534 - Lafayette 8.25 143.3 115 133 080720
060535 - Lafayette 5.50 90.7 125 144 080719
060536 - Lafayette 5.50 92.4 123 142 080716
060537 - Lafayette 2.25 46.8 116 137 080715
060538 - Lafayette 8.25 141.8 116 136 080712
060539 - Lafayette 5.50 92.9 116 139 080711
060540 - Lafayette 8.25 143.3 113 137 080704
060541 - Lafayette 5.50 90.2 121 147 080630
060542 - Lafayette 8.25 142.4 116 138 080628
060543 - Lafayette 5.50 91.4 118 138 080625
060544 - Lafayette 2.25 47.9 116 136 080623
060545 - Lafayette 5.50 94.2 112 138 080622
060546 - Lafayette 5.50 94.7 115 133 080621
060547 - Lafayette 2.25 48.3 110 129 080620
060548 - Mt Diablo 7.00 129.4 130 153 080616
060549 - Lafayette 5.50 90.8 120 146 080615
060550 - Lafayette 5.50 91.3 124 144 080614
060551 - Lafayette 5.50 89.7 122 143 080613
060552 - Lafayette 2.76 45.8 120 147 080611
060553 - Lafayette 5.50 90.5 123 145 080609
060554 - Lafayette 5.50 92.7 115 138 080607
060555 - Lafayette 5.50 94.2 118 139 080602
060556 - Lafayette 5.50 96.2 110 202 080507, ref SDS 3 WO8M
060557 -
060558 -
060559 -
0606 -
SUBJECTS
Default Null Subject Account for Blank Record
0703 -
070401 - ..
070402 - Side Effects Neupogen Treatments Increase May Be Chemotherapy
070403 -
070404 - Follow up ref SDS 69 SB8I, ref SDS 68 SB8I. ref SDS 65 SB8I.
070405 -
070406 - Research on Neupogen side effects was reported on 080629. ref SDS 7
070407 - RQ9I Previous case study on Neupogen side effects listed on 081002.
070408 - ref SDS 33 SB8I
070410 - ..
070411 - Millie last reported side effects of Neupogen on 081109 experiencing
070412 - bone pain, headache, and fatigue associated with Neupogen and
070413 - chemotherapy. ref SDS 58 9V4H
070415 - ..
070416 - Millie may not need Neupogen for the sunitinib treatment begun on
070417 - 081114. ref SDS 61 505G
070419 - ..
070420 - Today, she called today and left a message for the Infusion Clinic to
070421 - cancel treatment on 081121 and 081122.
070423 - ..
070424 - Side effects of Neupogen should cease, because she has not had a
070425 - treatment since 081108, ref SDS 57 UZ7K, citing background for getting
070426 - Neupogen treatment reported in the record on 081107. ref SDS 56 1M9O
070427 -
070428 - 081109................, ref SDS 58 SB8I
070429 - 081018................, ref SDS 49 Y17L
070430 - 081011................, ref SDS 42 FL4H
070431 - 081010................, ref SDS 41 SB8I
070432 - 081006................, ref SDS 39 3E4K
070433 - 081004................, ref SDS 38 Y17L
070434 - 081002................, ref SDS 36 Y17L
070435 - 080930................, ref SDS 35 Y17L
070436 - 080923................, ref SDS 31 K16F
070437 - 080915................, ref SDS 27 9W9I
070438 - 080810................, ref SDS 15 9W9I
070439 - 080803................, ref SDS 11 9W9I
070440 - 080726................, ref SDS 10 9W9I
070441 - 080721................, ref SDS 9 9W9I
070442 - 080713................, ref SDS 8 RM94
070443 - 080629................, ref SDS 6 6Q5J
070444 - 080628................, ref SDS 5 6Q5J
070445 -
070446 -
070447 -
070448 -
070449 -
070450 -
070451 -
070452 -
0705 -