CONTACTS 

SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 2 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie called Gloria at the Kaiser and reported changes in treatment
040902 - from cetuximab and Carboplatin to sunitinib, cyclophosphamide and
040903 - Methotreaxate, and also reported that the blood test this morning
040904 - shows INR climbed to 3.4. ref SDS 2 J45H
040906 -  ..
040907 - This afternoon, Millie received a letter from Gloria saying...
040908 -
040909 -    1.  Subject: INR results (high) / new dosing
040910 -        Received: 11/26/08 12:55 PM
040917 -         ..
040918 -    2.  Thank you for taking your Protime/INR blood test.
040919 -
040920 -        Your INR Result: INR 3.4 11/26/2008 (reported from UCSF)
040922 -         ..
040923 -    3.  Your INR IS SLIGHTLY HIGH: YOUR INR GOAL RANGE IS 2.0 - 3.0.
040925 -         ..
040926 -    4.  YOUR NEW WEEKLY WARFARIN DOSE IS:
040927 -
040928 -        Using Warfarin 4MG Tablet (BLUE in color):
040930 -         ..
040931 -        Take 1 TABLET (4 mg) everyday of the week.
040933 -         ..
040934 -    5.  EXCEPTION: Take 1/2 TABLET (2mg) on Wednesday 11/26/2008 ONLY
040935 -        ONE TIME
040937 -         ..
040938 -    6.  Please have your next Protime/INR blood test on: Follow up
040939 -        date: 12/3/08
040940 -
040941 -           [On 081201 Millie notified medical team of plans to get
040942 -           blood draw at Kaiser on 081204 to test INR for evaluating
040943 -           Coumadin treatments for pulmonary embolism. ref SDS 3 AT7W
040945 -            ..
040946 -           [On 081203 Millie had her blood drawn at the Kaiser
040947 -           Coagulation Control Clinic in Martinez CA for evaluating
040948 -           stability of INR blood counts that signal effectiveness of
040949 -           daily Coumadin treatments for pulmonary embolism, taken with
040950 -           daily sunitinib and cyclophosphamide treatments for cancer.
040951 -           ref SDS 4 7N82
040953 -         ..
040954 -    7.  You can test at any Kaiser Permanente lab. You do not need an
040955 -        appointment or lab slip.  We will contact you by phone or by
040956 -        mail with your results.  If you do not hear from us within 3-4
040957 -        days, please call us at the phone number below.  If at all
040958 -        possible, please do not have your INR lab done on Fridays or
040959 -        weekends unless specifically instructed to do so by the
040960 -        Anticoagulation Clinic.
040962 -         ..
040963 -    8.  Please call us to report any changes in your medications,
040964 -        diet, health, activity level, any unusual bleeding/bruising
040965 -        symptoms, any dental/surgical procedures and/or any recent
040966 -        missed/extra warfarin doses. Thank you.
040968 -         ..
040969 -    9.  Sincerely,
040970 -
040972 -         ..
040973 -        GLORIA CLOSSON PHARMD
040974 -        Kaiser Permanente Anticoagulation Service, Phone (925) 372-1628
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0410 -