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 22, 2008 07:00 AM Saturday; Rod Welch

Millie sunitinib #9 IBC 5th relapse hiking6 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


..............
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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 73 0000. ref SDS 72 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
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 63
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 49 004O
040911 -         ..
040912 -        Patient History Sunitinib Loading Dose 14 Days
040913 -
040914 -        Follow up ref SDS 73 OE6K, ref SDS 72 OE6K.
040915 -
040917 -        Cycle 1
040918 -        Cohort: 3
040920 -   ..
040921 -                             Sunitinib MG      Cyclophos    Metho
040922 -                         Amount  Today   Cum    phamide     trexate
040923 -  Days  Date  Time Cycle 25 12.5 Total  Total   Amnt Total Amnt Total
040924 -  --------------------------------------------------------------------
040925 -  Follow up ref SDS 72 PA8Y, ref SDS 71 PA8Y.
040926 -
040927 -    1.  081114 0700   1   1   1  37.5    37.5    0     0    0     0 ..... ref SDS 61 OE6K
040928 -    2.  081115 0700   1   1   1  37.5    75.0    0     0    0     0 ..... ref SDS 62 OE6K
040929 -    3.  081116 0700   1   1   1  37.5   112.5    0     0    0     0 ..... ref SDS 63 OE6K
040930 -    4.  081117 0700   1   1   1  37.5   150.0    0     0    0     0 ..... ref SDS 64 OE6K
040931 -    5.  081118 0700   1   1   1  37.5   187.5    0     0    0     0 ..... ref SDS 67 OE6K
040932 -    6.  081119 0700   1   1   1  37.5   225.0    0     0    0     0 ..... ref SDS 69 OE6K
040933 -    7.  081120 0700   1   1   1  37.5   263.5    0     0    0     0 ..... ref SDS 70 OE6K
040934 -    8.  081121 0700   1   1   1  37.5   301.0    0     0    0     0 ..... ref SDS 72 OE6K
040935 -    9.  081122 0700   1   1   1  37.5   338.5    0     0    0     0 ..... ref SDS 0 OE6K
040936 -
040937 -
040938 -
040939 -
040940 -
040941 -
0410 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Side Effects Sunitinib Study
050403 -
050404 - Follow up ref SDS 73 LF8M, ref SDS 72 LF8M.
050405 -
050406 - Sunitinib side effects are listed in the study Consent document,
050407 - reviewed on 081017. ref SDS 49 4G7G
050409 -  ..
050410 - Millie reports again minor fatigue, side effects listed for sunitinib
050411 - on 081017. ref SDS 49 4G7G
050413 -  ..
050414 - Millie's record of exercising shows correlation between treatments and
050415 - exercise that indicates mild effects so far.  Recently, Millie has
050416 - reduced exercise from 3 to only 2 laps. ref SDS 0 X64F  She plans
050417 - continued hiking to work through side effects.
050419 -  ..
050420 - Blood pressure seems to be rising today toward normal.  Today, there
050421 - seemed to be increase in pulse while hiking, ref SDS 0 X64F, showing
050422 - some improvement to generally a 30 point drop in patient profile for
050423 - pulse while hiking, reported yesterday on 081121. ref SDS 73 X64F
050425 -  ..
050426 - Millie also has side effects from Neupogen; but nothing for several
050427 - weeks since she stopped treatments pending evaluation with new
050428 - sunitinib treatments, reported on 081120. ref SDS 72 SB8I
050430 -     ..
050431 -                                   Date
050432 -    Description Adverse Event   Start  Stop     Medication
050433 -    ---------------------------------------------------------
050434 -    Follow up ref SDS 73 LF8M, ref SDS 72 LF8M.
050435 -
050436 -    Diarea                      081114 081114   Imodium........ ref SDS 63 LF8M
050437 -    Low pulse                   081120 081120   None........... ref SDS 72 LF8M
050438 -    Low pulse                   081121 081121   None........... ref SDS 73 7G8M
050439 -    BP 144 84 Pules 48          081121 081121   Hiking......... ref SDS 73 LF8M
050440 -    Joint pain minor            081121 081121   Hiking......... ref SDS 73 LF8M
050441 -    Fatigue minor               081121 081121   Hiking......... ref SDS 73 LF8M
050442 -    Low pulse                   081122 081122   None........... ref SDS 0 7G8M
050443 -    Fatigue minor               081122 081122   Hiking......... ref SDS 0 LF8M
050444 -
050445 -
050446 -
050447 -
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 73 3E4K, ref SDS 72 3E4K.
060405 -
060406 - Millie went hiking at Lafayette reservoir, and did 2 laps about 5.5
060407 - miles in 92.8 minutes, showing increased pace without running.
060408 - ref SDS 0 X64F  Pulse seems to be rising today, more toward patient
060409 - history norms, possibly correcting significantly lower pulse the past
060410 - few days, reported yesterday. ref SDS 73 7G8M
060412 -  ..
060413 - Millie has not had another attack of Cellulitis and lymphedema since
060414 - going to the emergency care unit on 080409. ref SDS 4 0001  There was
060415 - a slight flare up on 080520. ref SDS 6 OU5J
060417 -  ..
060418 - Millie had her 9th treatment with sunitinib this morning at 0700.
060419 - ref SDS 0 PA8Y
060421 -  ..
060422 - This morning Millie reports not sleeping well last night.
060424 -  ..
060425 - On 081110, Millie complained about diffiuclty lifting herself from a
060426 - full squatting position. ref SDS 61 HX67  She has since been
060427 - exercising to strengthen her legs, and arms.
060429 -  ..
060430 - This morning Millie did...
060431 -
060432 -        Arm presses 3 sets of 10 leaning against bannister.
060433 -        Squats 3 sets of 10 vary depth useing bannister for leverage
060435 -  ..
060436 - There have been no indications of Cellulitis nor lymphedema that has
060437 - occurred previously with exercising the left arm, reported on 070607.
060438 - ref SDS 3 ZH6I
060439 -
060441 -  ..
060442 - Case Study on Pateint History Exercising
060443 -
060444 - Follow up ref SDS 73 X64F, ref SDS 72 X64F.
060445 -
060446 -                                          +- s = Sunitinib
060447 -                                          +- c = Carboplatin
060448 -                                          +- e = Erbatex cetuximab
060449 -                           Time     Pulse |
060450 -    Location        Miles Minutes  Avg Max  Chem Neupo  Date
060451 -    ----------------------------------------------------------------
060452 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS 0 3E4K
060453 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS 73 3E4K
060454 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS 72 3E4K
060455 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS 71 3E4K
060456 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS 70 3E4K
060457 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 67 3E4K
060458 -    Concord home                              s         081116, ref SDS 65 Y68J
060459 -    Concord home                              s         081115, ref SDS 64 EK7I
060460 -    Concord home                              s         081114, ref SDS 63 XW6H
060461 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 61 3E4K
060462 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 60 3E4K
060463 -    Kaiser                                         x    081108, ref SDS 59 UZ7K
060464 -    Kaiser                                         x    081107, ref SDS 58 UZ7K
060465 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 56 3E4K
060466 -    Kaiser                                         x    081025, ref SDS 56 UZ7K
060467 -    Kaiser                                         x    081024, ref SDS 55 UZ7K
060468 -    UCSF                                     c          081023, ref SDS 54 V94O
060469 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 53 3E4K
060470 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 52 3E4K
060471 -    Kaiser                                         x    081018, ref SDS 51 UZ7K
060472 -    Kaiser                                         x    081017, ref SDS 50 UZ7K
060473 -    UCSF                                     e          081016, ref SDS 48 V94O
060474 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 47 3E4K
060475 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 46 3E4K
060476 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 45 3E4K
060477 -    Kaiser                                         x    081011, ref SDS 44 UZ7K
060478 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 43 3E4K
060479 -    Kaiser                                         x    081010, ref SDS 43 UZ7K
060480 -    UCSF                                      e         081009, ref SDS 42 V94O
060481 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 41 3E4K
060482 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 40 3E4K
060483 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 39 3E4K
060484 -    UCSF                                      c         081002, ref SDS 38 V94O
060485 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 37 3E4K
060486 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 37 3E4K
060487 -    Kaiser                                         x    080927, ref SDS 36 UZ7K
060488 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 35 3E4K
060489 -    UCSF                                      c         080925, ref SDS 34 V94O
060490 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 33 3E4K
060491 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 33 3E4K
060492 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 33 3E4K
060493 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 32 3E4K
060494 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 31 3E4K
060495 -    UCSF                                      c         080918, ref SDS 30 V94O
060496 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 31 3E4K
060497 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 29 3E4K
060498 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 28 3E4K
060499 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 27 3E4K
060500 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 26 3E4K
060501 -    UCSF                                      c         080911, ref SDS 25 V94O
060502 -    Lafayette        2.75   46.8   113 140              080909
060503 -    Lafayette        5.50   89.2   117 143              080908
060504 -    Lafayette        5.50   92.1   115 138              080907
060505 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 24 3E4K
060506 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 23 3E4K
060507 -    UCSF                                      c         080904, ref SDS 22 V94O
060508 -    Lafayette        8.25  140.4   116 131              080903
060509 -    Lafayette        5.50   94.9   115 134              080902
060510 -    Kaiser                                         x    080830
060511 -    Kaiser                                         x    080829
060512 -    UCSF                                      c         080828, ref SDS 21 V94O
060513 -    Lafayette        5.50   93.6   120 137              080826
060514 -    Lafayette        5.50   93.2   117 138              080825
060515 -    Lafayette        5.50   93.2   123 136         x    080823
060516 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 20 3E4K
060517 -    UCSF                                      e         080821, ref SDS 19 V94O
060518 -    Lafayette        5.50   94.7   115 137              080820
060519 -    Lafayette        5.50   94.3   115 135              080819
060520 -    Lafayette        8.25  141.7   118 134              080815
060521 -    UCSF                                      e         080814, ref SDS 18 V94O
060522 -    Lafayette        5.50   93.8   120 136              080813
060523 -    Lafayette        5.50   94.4   116 139              080812
060524 -    Lafayette        5.50   94.2   119 133              080810
060525 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 16 3E4K
060526 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 15 3E4K
060527 -    UCSF                                      c         080807, ref SDS 14 V94O
060528 -    Lafayette        8.25  143.7   115 132              080805
060529 -    Concord          7.00  127.6   105 118              080804
060530 -    Lafayette        8.25  143.2   112 134              080802
060531 -    Lafayette        5.50   93.4   115 138              080801
060532 -    Lafayette        5.50   92.2   118 140              080729
060533 -    Lafayette        5.50   92.6   116 137              080728
060534 -    Lafayette        8.25  142.6   114 134              080727
060535 -    Lafayette        5.50   91.5   120 143              080726
060536 -    Lafayette        8.25  140.8   117 135              080725
060537 -    Lafayette        5.50   91.8   122 141              080723
060538 -    Lafayette        5.50   91.3   120 139              080722
060539 -    Lafayette        8.25  143.3   115 133              080720
060540 -    Lafayette        5.50   90.7   125 144              080719
060541 -    Lafayette        5.50   92.4   123 142              080716
060542 -    Lafayette        2.25   46.8   116 137              080715
060543 -    Lafayette        8.25  141.8   116 136              080712
060544 -    Lafayette        5.50   92.9   116 139              080711
060545 -    Lafayette        8.25  143.3   113 137              080704
060546 -    Lafayette        5.50   90.2   121 147              080630
060547 -    Lafayette        8.25  142.4   116 138              080628
060548 -    Lafayette        5.50   91.4   118 138              080625
060549 -    Lafayette        2.25   47.9   116 136              080623
060550 -    Lafayette        5.50   94.2   112 138              080622
060551 -    Lafayette        5.50   94.7   115 133              080621
060552 -    Lafayette        2.25   48.3   110 129              080620
060553 -    Mt Diablo        7.00  129.4   130 153              080616
060554 -    Lafayette        5.50   90.8   120 146              080615
060555 -    Lafayette        5.50   91.3   124 144              080614
060556 -    Lafayette        5.50   89.7   122 143              080613
060557 -    Lafayette        2.76   45.8   120 147              080611
060558 -    Lafayette        5.50   90.5   123 145              080609
060559 -    Lafayette        5.50   92.7   115 138              080607
060560 -    Lafayette        5.50   94.2   118 139              080602
060561 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 5 WO8M
060562 -
060563 -
060564 -
060565 -
060566 -
060567 -
060568 -
060569 -
060570 -
0606 -