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 30, 2008 07:00 AM Sunday; Rod Welch

Millie sunitinib #17 treatment IBC 5th relapse hiking 3 miles.

1...Summary/Objective
2...Sunitinib Metronomic Treatment Loading Dose Clinical Study UCSF
3...Sunitinib Cyclophosmaide Methotrexate Patient History
4...Side Effects Sunitinib Study with Cyclophosphamide Methotrexate
5...Exercise Hiking Maintain Fitness Strengthen Immune System
6...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 83 0000. ref SDS 81 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Sunitinib Metronomic Treatment Loading Dose Clinical Study UCSF
040902 -
040903 - Follow up ref SDS 83 505G, ref SDS 81 505G.
040904 -
040905 - On 081113 Millie received sunitinib drugs from UCSF to treat the 5th
040906 - relapse of IBC.
040908 -  ..
040909 - Millie began the 14 day "charging" treatment on 081114. ref SDS 63
040910 - EK7I  After 14 treatments ending on 081127, ref SDS 80 6D63, Millie
040911 - tolerated sunitinib well at the prescribed dose.
040913 -  ..
040914 - During the meeting at UCSF on 081126, UCSF prescribed adding
040915 - chemotherapy treatment with cyclophosphamide each day with sunitinib,
040916 - and also adding 2 treatments of methotrexate twice a day for 2 days a
040917 - week as prescribed in the treatment protocol, reviewed on 081017.
040918 - ref SDS 49 004O
040920 -  ..
040921 - These supplemental treatments started on 081128. ref SDS 81 VR57
040923 -  ..
040924 - Millie continues with sunitinib and cyclophosphmaide; methotrexate
040925 - stops today until next Friday.
040926 -
040928 -  ..
040929 - Sunitinib Cyclophosmaide Methotrexate Patient History
040930 -
040931 - Follow up ref SDS 83 OE6K, ref SDS 81 OE6K.
040932 -
040934 -        Cycle 1  begin 081128 after 14 treatmenst sunitinib alone
040935 -        Cohort: 3
040937 -        ..
040938 -                                          Cyclophos  Metho
040939 -                               Sunitinib   phamide   trexate
040940 -       Days  Date  Time  Cycle    37.5       50        5
040941 -       =======================================================
040942 -       Follow up ref SDS 83 PA8Y, ref SDS 81 PA8Y.
040943 -
040944 -        1.  081114 0700  Load    37.5        0        0 ... ref SDS 63 OE6K
040945 -        2.  081115 0700  Load    75.0        0        0 ... ref SDS 64 OE6K
040946 -        3.  081116 0700  Load   112.5        0        0 ... ref SDS 65 OE6K
040947 -        4.  081117 0700  Load   150.0        0        0 ... ref SDS 66 OE6K
040948 -        5.  081118 0700  Load   187.5        0        0 ... ref SDS 69 OE6K
040949 -        6.  081119 0700  Load   225.0        0        0 ... ref SDS 71 OE6K
040950 -        7.  081120 0700  Load   263.5        0        0 ... ref SDS 72 OE6K
040951 -        8.  081121 0700  Load   301.0        0        0 ... ref SDS 73 OE6K
040952 -        9.  081122 0700  Load   338.5        0        0 ... ref SDS 74 OE6K
040953 -       10.  081123 0700  Load   376.0        0        0 ... ref SDS 75 OE6K
040954 -       11.  081124 0700  Load   413.5        0        0 ... ref SDS 76 OE6K
040955 -       12.  081125 0700  Load   451.0        0        0 ... ref SDS 77 OE6K
040956 -       13.  081126 0700  Load   488.5        0        0 ... ref SDS 78 OE6K
040957 -       14.  081127 0700  Load   526.0        0        0 ... ref SDS 79 OE6K
040958 -       15.  081128 0700  1  1   563.5       50   2    5 ... ref SDS 81 OE6K
040959 -       16.  081129 0700  1  2   601.0      100   4   10 ... ref SDS 83 OE6K
040960 -       17.  081130 0700  1  3   638.5      150   4   10 ... ref SDS 0 OE6K
040961 -
040962 -
040963 -
040964 -
0410 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Side Effects Sunitinib Study with Cyclophosphamide Methotrexate
050403 -
050404 - Follow up ref SDS 83 LF8M, ref SDS 81 LF8M.
050405 -
050406 - Fatigue is a likely side effect of sunitinib listed in the Consent
050407 - document reviewed on 081017. ref SDS 49 4G7G
050409 -  ..
050410 - Energy has declined considerably the past few days shown by Millie's
050411 - record of declining exercise the past few days. ref SDS 0 X64F  She
050412 - plans continued hiking to work through side effects, but did not go
050413 - hiking today.  Spent day in bed recuperating.
050415 -  ..
050416 - There was no report of heartburn nor upset stomach today.
050418 -     ..
050419 -                                   Date
050420 -    Description Adverse Event   Start  Stop     Medication
050421 -    ---------------------------------------------------------
050422 -    Follow up ref SDS 83 MV5H, ref SDS 81 MV5H.
050423 -
050424 -    Diarea                      081114 081114   Imodium........ ref SDS 63 LF8M
050425 -    Low pulse                   081120 081120   None........... ref SDS 72 LF8M
050426 -    Low pulse                   081121 081121   None........... ref SDS 73 7G8M
050427 -    BP 144 84 Pulse 48          081121 081121   Hiking......... ref SDS 73 LF8M
050428 -    Joint pain minor            081121 081121   Hiking......... ref SDS 73 LF8M
050429 -    Fatigue minor               081121 081121   Hiking......... ref SDS 73 LF8M
050430 -    Low pulse                   081122 081122   None........... ref SDS 74 7G8M
050431 -    Fatigue minor               081122 081122   Hiking......... ref SDS 74 LF8M
050432 -    Low pulse                   081123 081122   None........... ref SDS 75 7G8M
050433 -    BP 121 74 Pulse 53          081123 081123   Hiking......... ref SDS 75 LF8M
050434 -    Fatigue minor               081123 081122   Hiking......... ref SDS 75 LF8M
050435 -    Joint pain minor            081124 081124   Hiking......... ref SDS 76 LF8M
050436 -    Fatigue minor               081124 081124   Hiking......... ref SDS 76 LF8M
050437 -    Heartburn                   081124 081124   None........... ref SDS 76 HS9K
050438 -    BP 144 78 Pulse 52          081125 081125   Hiking......... ref SDS 77 LF8M
050439 -    Joint pain minor            081125 081125   Hiking......... ref SDS 77 LF8M
050440 -    Fatigue minor               081125 081125   Hiking......... ref SDS 77 LF8M
050441 -    Heartburn                   081125 081125   None........... ref SDS 77 HS9K
050442 -    Heartburn                   081126 081126   None........... ref SDS 78 HS9K
050443 -    Heartburn                   081127 081127   None........... ref SDS 80 HS9K
050444 -    BP 135 73 Pulse 48          081128 081128   Hiking......... ref SDS 81 5X6K
050445 -    Upset stomach               081128 081128   Hiking......... ref SDS 81 T76O
050446 -    BP 140 75 Pulse 50          081129 081129   Hiking......... ref SDS 83 5X6K
050447 -    Heartburn                   081129 081129   None........... ref SDS 83 HS9K
050448 -    Fatigue                     081129 081129   Rest........... ref SDS 83 LF8M
050449 -    Fatigue                     081130 081130   Rest........... ref SDS 0 LF8M
050450 -
050451 -
050452 -
050453 -
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 83 3E4K, ref SDS 81 3E4K.
060405 -
060406 - Millie did not go hiking at Lafayette reservoir due to fatigue from
060407 - rising side effects of sunitinib treatment with cyclophosphamide and
060408 - methotrexate, per above. ref SDS 0 RE9K
060410 -  ..
060411 - Millie had her 17th treatment with sunitinib this morning at 0700.
060412 - ref SDS 83 PA8Y  This is the 3rd day of the 1st cycle that includes
060413 - sunitinib and cyclophosphmaide.  Weekly treatment with methotrexate
060414 - ended yesterday.
060416 -  ..
060417 - On 081110, Millie complained about difficulty lifting herself from a
060418 - full squatting position. ref SDS 61 HX67  She has since been
060419 - exercising to strengthen legs, and arms.
060421 -  ..
060422 - This morning Millie did...
060423 -
060424 -        Arm presses 3 sets of 10 leaning against bannister.
060425 -        Squats 3 sets of 10 vary depth useing bannister for leverage
060426 -
060428 -  ..
060429 - Case Study on Pateint History Exercising
060430 -
060431 - Follow up ref SDS 83 X64F, ref SDS 81 X64F.
060432 -
060433 -                                              +- scm = Sunitinib Cyclophosphmaide Methotrexate
060434 -                                              +- sc  = Sunitinib Cyclophosphmaide
060435 -                           Time     Pulse     |
060436 -    Location        Miles Minutes  Avg Max  Chem  Neupo  Date
060437 -    ----------------------------------------------------------------
060438 -    Concord home                              sc        081130, ref SDS 0 3E4K
060439 -    Lafayette        2.75   56.7    90 115    scm       081129, ref SDS 83 3E4K
060440 -    Lafayette        2.75   46.5   100 128    scm       081128, ref SDS 81 3E4K
060441 -    Lafayette        5.50   93.3   100 122    s         081127, ref SDS 80 3E4K
060442 -    Concord home                              s         081126, ref SDS 78 3E4K
060443 -    Lafayette        4.00   73.7   105 127    s         081125, ref SDS 77 3E4K
060444 -    Lafayette        5.50   91.4   100 129    s         081124, ref SDS 76 3E4K
060445 -    Concord home                              s         081123, ref SDS 75 3E4K
060446 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS 74 3E4K
060447 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS 73 3E4K
060448 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS 72 3E4K
060449 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS 71 3E4K
060450 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS 70 3E4K
060451 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 67 3E4K
060452 -    Concord home                              s         081116, ref SDS 65 Y68J
060453 -    Concord home                              s         081115, ref SDS 64 EK7I
060454 -    Concord home                              s         081114, ref SDS 63 XW6H
060455 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 61 3E4K
060456 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 60 3E4K
060457 -    Kaiser                                         x    081108, ref SDS 59 UZ7K
060458 -    Kaiser                                         x    081107, ref SDS 58 UZ7K
060459 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 56 3E4K
060460 -    Kaiser                                         x    081025, ref SDS 56 UZ7K
060461 -    Kaiser                                         x    081024, ref SDS 55 UZ7K
060462 -    UCSF                                      c         081023, ref SDS 54 V94O
060463 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 53 3E4K
060464 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 52 3E4K
060465 -    Kaiser                                         x    081018, ref SDS 51 UZ7K
060466 -    Kaiser                                         x    081017, ref SDS 50 UZ7K
060467 -    UCSF                                      e         081016, ref SDS 48 V94O
060468 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 47 3E4K
060469 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 46 3E4K
060470 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 45 3E4K
060471 -    Kaiser                                         x    081011, ref SDS 44 UZ7K
060472 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 43 3E4K
060473 -    Kaiser                                         x    081010, ref SDS 43 UZ7K
060474 -    UCSF                                      e         081009, ref SDS 42 V94O
060475 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 41 3E4K
060476 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 40 3E4K
060477 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 39 3E4K
060478 -    UCSF                                      c         081002, ref SDS 38 V94O
060479 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 37 3E4K
060480 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 37 3E4K
060481 -    Kaiser                                         x    080927, ref SDS 36 UZ7K
060482 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 35 3E4K
060483 -    UCSF                                      c         080925, ref SDS 34 V94O
060484 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 33 3E4K
060485 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 33 3E4K
060486 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 33 3E4K
060487 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 32 3E4K
060488 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 31 3E4K
060489 -    UCSF                                      c         080918, ref SDS 30 V94O
060490 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 31 3E4K
060491 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 29 3E4K
060492 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 28 3E4K
060493 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 27 3E4K
060494 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 26 3E4K
060495 -    UCSF                                      c         080911, ref SDS 25 V94O
060496 -    Lafayette        2.75   46.8   113 140              080909
060497 -    Lafayette        5.50   89.2   117 143              080908
060498 -    Lafayette        5.50   92.1   115 138              080907
060499 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 24 3E4K
060500 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 23 3E4K
060501 -    UCSF                                      c         080904, ref SDS 22 V94O
060502 -    Lafayette        8.25  140.4   116 131              080903
060503 -    Lafayette        5.50   94.9   115 134              080902
060504 -    Kaiser                                         x    080830
060505 -    Kaiser                                         x    080829
060506 -    UCSF                                      c         080828, ref SDS 21 V94O
060507 -    Lafayette        5.50   93.6   120 137              080826
060508 -    Lafayette        5.50   93.2   117 138              080825
060509 -    Lafayette        5.50   93.2   123 136         x    080823
060510 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 20 3E4K
060511 -    UCSF                                      e         080821, ref SDS 19 V94O
060512 -    Lafayette        5.50   94.7   115 137              080820
060513 -    Lafayette        5.50   94.3   115 135              080819
060514 -    Lafayette        8.25  141.7   118 134              080815
060515 -    UCSF                                      e         080814, ref SDS 18 V94O
060516 -    Lafayette        5.50   93.8   120 136              080813
060517 -    Lafayette        5.50   94.4   116 139              080812
060518 -    Lafayette        5.50   94.2   119 133              080810
060519 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 16 3E4K
060520 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 15 3E4K
060521 -    UCSF                                      c         080807, ref SDS 14 V94O
060522 -    Lafayette        8.25  143.7   115 132              080805
060523 -    Concord          7.00  127.6   105 118              080804
060524 -    Lafayette        8.25  143.2   112 134              080802
060525 -    Lafayette        5.50   93.4   115 138              080801
060526 -    Lafayette        5.50   92.2   118 140              080729
060527 -    Lafayette        5.50   92.6   116 137              080728
060528 -    Lafayette        8.25  142.6   114 134              080727
060529 -    Lafayette        5.50   91.5   120 143              080726
060530 -    Lafayette        8.25  140.8   117 135              080725
060531 -    Lafayette        5.50   91.8   122 141              080723
060532 -    Lafayette        5.50   91.3   120 139              080722
060533 -    Lafayette        8.25  143.3   115 133              080720
060534 -    Lafayette        5.50   90.7   125 144              080719
060535 -    Lafayette        5.50   92.4   123 142              080716
060536 -    Lafayette        2.25   46.8   116 137              080715
060537 -    Lafayette        8.25  141.8   116 136              080712
060538 -    Lafayette        5.50   92.9   116 139              080711
060539 -    Lafayette        8.25  143.3   113 137              080704
060540 -    Lafayette        5.50   90.2   121 147              080630
060541 -    Lafayette        8.25  142.4   116 138              080628
060542 -    Lafayette        5.50   91.4   118 138              080625
060543 -    Lafayette        2.25   47.9   116 136              080623
060544 -    Lafayette        5.50   94.2   112 138              080622
060545 -    Lafayette        5.50   94.7   115 133              080621
060546 -    Lafayette        2.25   48.3   110 129              080620
060547 -    Mt Diablo        7.00  129.4   130 153              080616
060548 -    Lafayette        5.50   90.8   120 146              080615
060549 -    Lafayette        5.50   91.3   124 144              080614
060550 -    Lafayette        5.50   89.7   122 143              080613
060551 -    Lafayette        2.76   45.8   120 147              080611
060552 -    Lafayette        5.50   90.5   123 145              080609
060553 -    Lafayette        5.50   92.7   115 138              080607
060554 -    Lafayette        5.50   94.2   118 139              080602
060555 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 5 WO8M
060556 -
060557 -
060558 -
060559 -
060560 -
060561 -
0606 -