CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 0000, ref SDS 5 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - During the meeting with the medical team at UCSF this morning, Tara
040902 - submitted a prescription prepared by Doctor Rugo yesterday on 081125
040903 - for Millie to get cyclophosphmaide and methotrexate for the next 3
040904 - weeks.  These drugs are required for Millie to start the full protocol
040905 - on the sunitinib metronomic treatment for Millie's 5th relapse of IBC,
040906 - as called out in the clincial study Consent documents, reviewed on
040907 - 081017. ref SDS 1 YX6N
040909 -  ..
040910 - This morning, at UCSF, Tara explained that the sunitinib clinical
040911 - study treatment protocol requires Millie to take cyclophosphamide
040912 - everyday with sunitinib, beginning on Friday, 081128, and to take
040913 - methotrexate twice-a-day on Friday, 081128, and again the next day on
040914 - Saturday, 081129.
040915 -
040916 -            [...below, in the record today on 081126, the Kaiser
040917 -            Pharmacist advises the drugs may be available on Friday by
040918 -            noon, or the following Monday or Tuesday. ref SDS 0 GM93
040920 -  ..
040921 - Tara further advised that taking methotrexate twice-a-day should be
040922 - done about 12 hours apart.  Millie should continue her schedule taking
040923 - sunitinib at 0700.  Cyclophosphamide and Methotrexate should be taken
040924 - at that time on Friday.  The 2nd treatment of Methotrexate should
040925 - therefore be taken at 1900 in the evening on Friday and Saturday.
040927 -  ..
040928 - Millie notified the medical team on 081117 to order drugs in time to
040929 - avoid delaying treatment on Friday 081128. ref SDS 3 ES6O  On 081121
040930 - Millie submitted a follow up letter reminding the team to order drugs
040931 - from the pharmacy that aligns with the protocol schedule. ref SDS 4
040932 - FQ5I  Yesterday, on 081125 Millie requested early procurement of drugs
040933 - in order to avoid delays, and noted that starting treatment on Monday
040934 - or Tuesday of next week might be necessary, if delivery of drugs is
040935 - delayed.
040937 -  ..
040938 - Since Glenna was in another meeting, she could not provide research
040939 - coordination for the medical team meeting with Millie this morning.
040940 - Tara did not have time to collaborate with Glenna on ordering the
040941 - drugs.  She assumed that UCSF coordinated with Kaiser to order drugs
040942 - from the Pharmacy, as discussed in Millie's notices to UCSF and to
040943 - Kaiser the past several weeks, per above. ref SDS 0 GM6V  This
040944 - scenario commonly occurs where communication problems arise despite
040945 - robust and redundant systems are in place, shown by experience at
040946 - Kaiser during Millie's CT test on 081107. ref SDS 2 2E42
040948 -  ..
040949 - On the way home after meeting at UCSF in San Francisco, Millie stopped
040950 - at the Kaiser Park Shadelands Clinic in Walnut Creek to fill the
040951 - prescription.
040953 -  ..
040954 - The attendant at the Sequoia Pharmacy took the prescription received
040955 - from Tara at UCSF.  After about 30 minutes, the attendant said that
040956 - Kaiser does not stock cyclophosphmaide in this area, as prescribed by
040957 - UCSF.  None of Kaiser's pharmacies at Park Shadelands, at the hospital
040958 - in Walnut Creek, nor the clinic in Martinez can fill the prescription.
040959 - Kaiser ordered the prescription, and the order may be delivered on
040960 - Friday.
040962 -  ..
040963 - Millie explained the doctor has prescribed her treatment to begin on
040964 - Friday, per above. ref SDS 0 GM7W
040966 -  ..
040967 - The attendant said to go next door to the Yosemite Pharmacy in the
040968 - same Kaiser Park Shadelands complex, and submit the UCSF prescription
040969 - again.  She has already called and notified the pharmacist of the
040970 - problem.
040972 -  ..
040973 - Millie went to the Yosemite Pharmacy about 30 yards down the street in
040974 - the same Kaiser Park Shadelands facility.
040976 -  ..
040977 - Talked to the Pharmacist, Wesley DeGuzman
040979 -  ..
040980 - Wes took the prescription for cyclophosphamide and methotrexate, which
040981 - was signed by Doctor Rugo on 081125, and received from Tara at UCSF
040982 - this morning.  Wes made a copy for Millie's records.
040984 -  ..
040985 - Millie asked if there is any record of instructions from the medical
040986 - team coordinating procurement of prescribed drugs, noted by Tara at
040987 - UCSF earlier today, per above? ref SDS 0 EG8O
040989 -  ..
040990 - Wes said there is nothing in Kaiser's records showing the drugs have
040991 - been ordered, similar to the CT test at Kaiser on 081107. ref SDS 2
040992 - 2E35
040994 -  ..
040995 - Wes will order the drugs today.  He feels Kaiser may get delivery on
040996 - Friday, but the Pharmacy will be closed at 1200 on Friday.  Wes
040997 - suggested that Millie come by about 1100 to give the delivery truck
040998 - time to arrive and for stocking.  He said things are always hectic on
040999 - Friday after Thanksgiving, because everybody is anxious to go
041000 - Christmas shopping.  If the order is not received on Friday, then
041001 - Millie can pick it up Monday or Tuesday of next week at the latest.
041003 -  ..
041004 - It was unclear if Millie could get the drugs from Kaiser on Saturday.
041005 - Wes said that this might possible if Millie goes to the Kaiser
041006 - Pharmacy in Walnut Creek on Saturday.
041007 -
041008 -        [On 081126 Millie called and canceled trip to visit family
041009 -        on Thanksgiving weekend, in order to standby for drugs to
041010 -        start cancer treatments, delayed filling prescription at
041011 -        pharmacy. ref SDS 7 UD7N
041013 -  ..
041014 - Wes apologized for conflicts with the treatment protocol, per above,
041015 - ref SDS 0 GM7W, and explained that patients should not wait to the
041016 - last minute to order drugs, especially during the holiday season.
041017 -
041018 -        [On 081128 Millie went back to the Kaiser Parkshadelands
041019 -        pharmacy and Kaiser filled the prescription for cyclophosmaide
041020 -        and methotrexate Millie needs for the sunitinib protocol.
041021 -        ref SDS 8 GM5J
041022 -
041023 -
041024 -
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041026 -
041027 -
041028 -
041029 -
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0411 -