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: December 1, 2008 07:00 AM Monday;
Rod Welch
Millie sunitinib #18 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 84 0000. ref SDS 83 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 84 505G, ref SDS 83 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 until next Friday on 081205.
040926 -
040928 - ..
040929 - Sunitinib Cyclophosmaide Methotrexate Patient History
040930 -
040931 - Follow up ref SDS 84 OE6K, ref SDS 83 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 84 PA8Y, ref SDS 83 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 1 50 1 5 ... ref SDS 81 OE6K
040959 - 16. 081129 0700 1 2 601.0 2 100 2 10 ... ref SDS 83 OE6K
040960 - 17. 081130 0700 1 3 638.5 3 150 2 10 ... ref SDS 84 OE6K
040961 - 18. 081201 0700 1 4 676.0 4 200 2 10 ... ref SDS 0 OE6K
040962 -
040963 -
040964 -
040965 -
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 84 LF8M, ref SDS 83 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 improved today, but has declined considerably the past few days
050411 - shown by Millie's record of declining exercise. ref SDS 0 X64F After
050412 - staying in bed yesterday, Millie went hiking today. She did 2 laps,
050413 - about 5.5 miles, but the last .5 mile required slowing down
050414 - considerably. ref SDS 0 3E4K Millie complains of no leg pain, loss of
050415 - breath, or similar ailment that slows hiking and running. Her general
050416 - feeling is loss of energy.
050417 -
050418 - [On 081202 Millie's letter to the medical team cites rising
050419 - fatigue, ref SDS 85 AT8U, and asks about requirements for labs
050420 - to evaluate blood counts, including NEUTS (ANC at Kaiser).
050421 - ref SDS 85 AT8X
050423 - ..
050424 - [On 081203 blood draw ordered by Gloria for INR was
050425 - expanded by primary care physician to test for broad
050426 - response to treatment, including CBC that evaluates
050427 - requirements for Neupogen to maintain immune system while
050428 - getting daily treatments with sunitinib and chemotherapy
050429 - with cyclophosphamide. ref SDS 86 TG8M
050431 - ..
050432 - Vitals after getting up from bed, and before hiking was...
050433 -
050434 - BP 136 79 Pulse 46
050436 - ..
050437 - There was no report of heartburn nor upset stomach today.
050439 - ..
050440 - Prilosec prescribed for heartburn has still not been taken.
050442 - ..
050443 - Millie reports reduced taste from food today. Study consent documents
050444 - reviewed on 081017 list "altered taste as a side effect of sunitinib.
050445 - ref SDS 49 6T5H
050446 -
050448 - ..
050449 - Date
050450 - Description Adverse Event Start Stop Medication
050451 - ---------------------------------------------------------
050452 - Follow up ref SDS 84 MV5H, ref SDS 83 MV5H.
050453 -
050454 - Diarea 081114 081114 Imodium........ ref SDS 63 LF8M
050455 - Low pulse 081120 081120 None........... ref SDS 72 LF8M
050456 - Low pulse 081121 081121 None........... ref SDS 73 7G8M
050457 - BP 144 84 Pulse 48 081121 081121 Hiking......... ref SDS 73 LF8M
050458 - Joint pain minor 081121 081121 Hiking......... ref SDS 73 LF8M
050459 - Fatigue minor 081121 081121 Hiking......... ref SDS 73 LF8M
050460 - Low pulse 081122 081122 None........... ref SDS 74 7G8M
050461 - Fatigue minor 081122 081122 Hiking......... ref SDS 74 LF8M
050462 - Low pulse 081123 081122 None........... ref SDS 75 7G8M
050463 - BP 121 74 Pulse 53 081123 081123 Hiking......... ref SDS 75 LF8M
050464 - Fatigue minor 081123 081122 Hiking......... ref SDS 75 LF8M
050465 - Joint pain minor 081124 081124 Hiking......... ref SDS 76 LF8M
050466 - Fatigue minor 081124 081124 Hiking......... ref SDS 76 LF8M
050467 - Heartburn 081124 081124 None........... ref SDS 76 HS9K
050468 - BP 144 78 Pulse 52 081125 081125 Hiking......... ref SDS 77 LF8M
050469 - Joint pain minor 081125 081125 Hiking......... ref SDS 77 LF8M
050470 - Fatigue minor 081125 081125 Hiking......... ref SDS 77 LF8M
050471 - Heartburn 081125 081125 None........... ref SDS 77 HS9K
050472 - Heartburn 081126 081126 None........... ref SDS 78 HS9K
050473 - Heartburn 081127 081127 None........... ref SDS 80 HS9K
050474 - BP 135 73 Pulse 48 081128 081128 Hiking......... ref SDS 81 5X6K
050475 - Upset stomach 081128 081128 Hiking......... ref SDS 81 T76O
050476 - BP 140 75 Pulse 50 081129 081129 Hiking......... ref SDS 83 5X6K
050477 - Heartburn 081129 081129 None........... ref SDS 83 HS9K
050478 - Fatigue 081129 081129 Rest........... ref SDS 83 LF8M
050479 - Fatigue 081130 081130 Rest........... ref SDS 84 LF8M
050480 - BP 136 79 Pulse 46 081201 081201 Hiking......... ref SDS 0 5X6K
050481 - Fatigue 081201 081201 Rest........... ref SDS 0 LF8M
050482 - Taste altered 081201 081201 Rest........... ref SDS 0 VP4G
050483 -
050484 -
050485 -
050486 -
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 84 3E4K, ref SDS 83 3E4K.
060405 -
060406 - Millie went hiking at Lafayette reservoir, and did 2 laps, about 5.50
060407 - miles in 102.3 minutes. ref SDS 0 X64F The first lap was a good time
060408 - of about 47 minutes. The 2nd lap went well until the last half mile,
060409 - when fatigue caused very slow pace to complete the hike in about 55
060410 - minutes. Slower time reflects rising side effects of fatigue from
060411 - adding cyclophosphamide to sunitinib, per above. ref SDS 0 LF8M
060413 - ..
060414 - Millie complains of no leg pain, loss of breath, or similar ailment
060415 - that slows hiking and running. Her general feeling is loss of energy.
060417 - ..
060418 - Millie had her 18th treatment with sunitinib this morning at 0700.
060419 - ref SDS 0 PA8Y This is the 4th day of the 1st cycle that includes
060420 - sunitinib and cyclophosphmaide. Weekly treatment with methotrexate
060421 - ended Saturday.
060423 - ..
060424 - On 081110, Millie complained about difficulty lifting herself from a
060425 - full squatting position. ref SDS 61 HX67 She has since been
060426 - exercising to strengthen legs, and arms.
060428 - ..
060429 - This morning Millie did...
060430 -
060431 - Arm presses 3 sets of 10 leaning against bannister.
060432 - Squats 3 sets of 10 vary depth useing bannister for leverage
060433 -
060435 - ..
060436 - Case Study on Pateint History Exercising
060437 -
060438 - Follow up ref SDS 84 X64F, ref SDS 83 X64F.
060439 -
060440 - +- scm = Sunitinib Cyclophosphmaide Methotrexate
060441 - +- sc = Sunitinib Cyclophosphmaide
060442 - Time Pulse |
060443 - Location Miles Minutes Avg Max Chem Neupo Date
060444 - ----------------------------------------------------------------
060445 - Lafayette 5.50 102.3 95 122 sc 081201, ref SDS 0 3E4K
060446 - Concord home sc 081130, ref SDS 84 3E4K
060447 - Lafayette 2.75 56.7 90 115 scm 081129, ref SDS 83 3E4K
060448 - Lafayette 2.75 46.5 100 128 scm 081128, ref SDS 81 3E4K
060449 - Lafayette 5.50 93.3 100 122 s 081127, ref SDS 80 3E4K
060450 - Concord home s 081126, ref SDS 78 3E4K
060451 - Lafayette 4.00 73.7 105 127 s 081125, ref SDS 77 3E4K
060452 - Lafayette 5.50 91.4 100 129 s 081124, ref SDS 76 3E4K
060453 - Concord home s 081123, ref SDS 75 3E4K
060454 - Lafayette 5.50 92.8 95 122 s 081122, ref SDS 74 3E4K
060455 - Lafayette 5.50 94.4 85 112 s 081121, ref SDS 73 3E4K
060456 - Lafayette 5.50 94.7 90 122 s 081120, ref SDS 72 3E4K
060457 - San Francisco 1.00 60.0 65 75 s 081119, ref SDS 71 3E4K
060458 - Lafayette 2.75 49.2 97 130 s 081118, ref SDS 70 3E4K
060459 - Lafayette 5.50 93.6 115 138 s 081117, ref SDS 67 3E4K
060460 - Concord home s 081116, ref SDS 65 Y68J
060461 - Concord home s 081115, ref SDS 64 EK7I
060462 - Concord home s 081114, ref SDS 63 XW6H
060463 - Lafayette 5.50 94.2 115 138 081110, ref SDS 61 3E4K
060464 - Lafayette 2.75 48.4 105 128 081109, ref SDS 60 3E4K
060465 - Kaiser x 081108, ref SDS 59 UZ7K
060466 - Kaiser x 081107, ref SDS 58 UZ7K
060467 - Lafayette 5.50 90.2 120 143 081025, ref SDS 56 3E4K
060468 - Kaiser x 081025, ref SDS 56 UZ7K
060469 - Kaiser x 081024, ref SDS 55 UZ7K
060470 - UCSF c 081023, ref SDS 54 V94O
060471 - Lafayette 5.50 90.6 115 141 081021, ref SDS 53 3E4K
060472 - Lafayette 5.50 90.4 110 128 081020, ref SDS 52 3E4K
060473 - Kaiser x 081018, ref SDS 51 UZ7K
060474 - Kaiser x 081017, ref SDS 50 UZ7K
060475 - UCSF e 081016, ref SDS 48 V94O
060476 - Lafayette 5.50 90.1 115 154 081014, ref SDS 47 3E4K
060477 - Lafayette 5.50 92.7 115 138 081013, ref SDS 46 3E4K
060478 - Lafayette 8.25 146.4 180 224 081012, ref SDS 45 3E4K
060479 - Kaiser x 081011, ref SDS 44 UZ7K
060480 - Lafayette 5.50 93.3 116 138 081010, ref SDS 43 3E4K
060481 - Kaiser x 081010, ref SDS 43 UZ7K
060482 - UCSF e 081009, ref SDS 42 V94O
060483 - Lafayette 5.50 92.1 113 137 081006, ref SDS 41 3E4K
060484 - Lafayette 2.75 48.5 110 136 x 081004, ref SDS 40 3E4K
060485 - Lafayette 5.50 98.2 117 136 x 081003, ref SDS 39 3E4K
060486 - UCSF c 081002, ref SDS 38 V94O
060487 - Lafayette 5.50 94.7 115 142 080929, ref SDS 37 3E4K
060488 - Lafayette 8.25 150.4 115 135 080928, ref SDS 37 3E4K
060489 - Kaiser x 080927, ref SDS 36 UZ7K
060490 - Lafayette 5.50 90.2 120 140 x 080926, ref SDS 35 3E4K
060491 - UCSF c 080925, ref SDS 34 V94O
060492 - Lafayette 5.50 92.3 116 138 080923, ref SDS 33 3E4K
060493 - Lafayette 5.50 98.4 112 134 080922, ref SDS 33 3E4K
060494 - Lafayette 5.50 98.2 114 137 080921, ref SDS 33 3E4K
060495 - Lafayette 5.50 101.6 110 133 x 080920, ref SDS 32 3E4K
060496 - Lafayette 5.50 89.3 115 144 x 080919, ref SDS 31 3E4K
060497 - UCSF c 080918, ref SDS 30 V94O
060498 - Lafayette 2.75 46.2 117 139 080916, ref SDS 31 3E4K
060499 - Lafayette 5.50 91.8 117 142 080915, ref SDS 29 3E4K
060500 - Clayton Safeway 3.00 62.4 98 118 080914, ref SDS 28 3E4K
060501 - Lafayette 8.25 129.7 123 147 x 080913, ref SDS 27 3E4K
060502 - Lafayette 5.50 88.4 118 146 x 080912, ref SDS 26 3E4K
060503 - UCSF c 080911, ref SDS 25 V94O
060504 - Lafayette 2.75 46.8 113 140 080909
060505 - Lafayette 5.50 89.2 117 143 080908
060506 - Lafayette 5.50 92.1 115 138 080907
060507 - Lafayette 2.75 45.3 120 144 x 080906, ref SDS 24 3E4K
060508 - Lafayette 2.75 56.8 93 120 x 080905, ref SDS 23 3E4K
060509 - UCSF c 080904, ref SDS 22 V94O
060510 - Lafayette 8.25 140.4 116 131 080903
060511 - Lafayette 5.50 94.9 115 134 080902
060512 - Kaiser x 080830
060513 - Kaiser x 080829
060514 - UCSF c 080828, ref SDS 21 V94O
060515 - Lafayette 5.50 93.6 120 137 080826
060516 - Lafayette 5.50 93.2 117 138 080825
060517 - Lafayette 5.50 93.2 123 136 x 080823
060518 - Lafayette 8.25 142.5 110 131 x 080822, ref SDS 20 3E4K
060519 - UCSF e 080821, ref SDS 19 V94O
060520 - Lafayette 5.50 94.7 115 137 080820
060521 - Lafayette 5.50 94.3 115 135 080819
060522 - Lafayette 8.25 141.7 118 134 080815
060523 - UCSF e 080814, ref SDS 18 V94O
060524 - Lafayette 5.50 93.8 120 136 080813
060525 - Lafayette 5.50 94.4 116 139 080812
060526 - Lafayette 5.50 94.2 119 133 080810
060527 - Lafayette 8.25 143.6 114 132 x 080809, ref SDS 16 3E4K
060528 - Lafayette 8.25 141.1 117 135 x 080808, ref SDS 15 3E4K
060529 - UCSF c 080807, ref SDS 14 V94O
060530 - Lafayette 8.25 143.7 115 132 080805
060531 - Concord 7.00 127.6 105 118 080804
060532 - Lafayette 8.25 143.2 112 134 080802
060533 - Lafayette 5.50 93.4 115 138 080801
060534 - Lafayette 5.50 92.2 118 140 080729
060535 - Lafayette 5.50 92.6 116 137 080728
060536 - Lafayette 8.25 142.6 114 134 080727
060537 - Lafayette 5.50 91.5 120 143 080726
060538 - Lafayette 8.25 140.8 117 135 080725
060539 - Lafayette 5.50 91.8 122 141 080723
060540 - Lafayette 5.50 91.3 120 139 080722
060541 - Lafayette 8.25 143.3 115 133 080720
060542 - Lafayette 5.50 90.7 125 144 080719
060543 - Lafayette 5.50 92.4 123 142 080716
060544 - Lafayette 2.25 46.8 116 137 080715
060545 - Lafayette 8.25 141.8 116 136 080712
060546 - Lafayette 5.50 92.9 116 139 080711
060547 - Lafayette 8.25 143.3 113 137 080704
060548 - Lafayette 5.50 90.2 121 147 080630
060549 - Lafayette 8.25 142.4 116 138 080628
060550 - Lafayette 5.50 91.4 118 138 080625
060551 - Lafayette 2.25 47.9 116 136 080623
060552 - Lafayette 5.50 94.2 112 138 080622
060553 - Lafayette 5.50 94.7 115 133 080621
060554 - Lafayette 2.25 48.3 110 129 080620
060555 - Mt Diablo 7.00 129.4 130 153 080616
060556 - Lafayette 5.50 90.8 120 146 080615
060557 - Lafayette 5.50 91.3 124 144 080614
060558 - Lafayette 5.50 89.7 122 143 080613
060559 - Lafayette 2.76 45.8 120 147 080611
060560 - Lafayette 5.50 90.5 123 145 080609
060561 - Lafayette 5.50 92.7 115 138 080607
060562 - Lafayette 5.50 94.2 118 139 080602
060563 - Lafayette 5.50 96.2 110 202 080507, ref SDS 5 WO8M
060564 -
060565 -
060566 -
060567 -
060568 -
060569 -
0606 -