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 4, 2008 07:00 AM Thursday;
Rod Welch
Millie sunitinib #21 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 89 0000. ref SDS 87 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Sunitinib Metronomic Treatment Loading Dose Clinical Study UCSF
040902 -
040903 - Follow up ref SDS 89 505G, ref SDS 87 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 89 OE6K, ref SDS 87 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 89 PA8Y, ref SDS 87 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 85 OE6K
040962 - 19. 081202 0700 1 5 713.5 5 250 2 10 ... ref SDS 87 OE6K
040963 - 20. 081203 0700 1 6 751.0 6 300 2 10 ... ref SDS 89 OE6K
040964 - 21. 081204 0700 1 7 788.5 7 350 2 10 ... ref SDS 0 OE6K
040965 -
040966 -
040967 -
040968 -
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 89 LF8M, ref SDS 87 LF8M.
050405 -
050406 - Fatigue is a likely side effect of sunitinib with cyclophosphamide,
050407 - listed in the Consent document reviewed on 081017. ref SDS 49 4G7G
050409 - ..
050410 - Energy improved a little yesterday, but has declined the past week,
050411 - shown by declining exercise. ref SDS 0 X64F After staying in bed on
050412 - 081130, Millie went hiking on 081201, and did well, but had severe
050413 - loss of energy at the end if the hike. ref SDS 85 3E4K On 081202,
050414 - Millie did aerobics in the gym, but was too tired for hiking.
050415 - ref SDS 87 3E4K Yesterday, on 081203 she did one lap very slow.
050416 - ref SDS 89 AG3J
050418 - ..
050419 - On 081202 Millie's letter to the medical team cites rising fatigue,
050420 - ref SDS 86 AT8U, and asks about requirements for labs to evaluate
050421 - blood counts, including NEUTS (ANC at Kaiser). ref SDS 86 AT8X
050423 - ..
050424 - Glenna reported in a telephone call yesterday, responding to Millie's
050425 - letter on 081202, that other patients treated with the sunitinib
050426 - protocol also experience fatigue. ref SDS 89 XN43
050428 - ..
050429 - On 081203 blood draw ordered by Gloria for INR was expanded by primary
050430 - care physician to test for broad response to treatment, including CBC
050431 - that evaluates requirements for Neupogen to maintain immune system
050432 - while getting daily treatments with sunitinib and chemotherapy with
050433 - cyclophosphamide. ref SDS 88 TG8M
050435 - ..
050436 - Vitals after getting up from bed, and before hiking was...
050437 -
050438 - BP 133 72 Pulse 45
050440 - ..
050441 - Millie reported minor heartburn today, and no upset stomach.
050443 - ..
050444 - Prilosec prescribed for heartburn has still not been taken.
050446 - ..
050447 - Millie reports improved taste from some foods today (e.g., soup),
050448 - cited in study consent documents, reviewed on 081017. ref SDS 49 6T5H
050449 -
050451 - ..
050452 - Date
050453 - Description Adverse Event Start Stop Medication
050454 - ---------------------------------------------------------
050455 - Follow up ref SDS 89 MV5H, ref SDS 87 MV5H.
050456 -
050457 - Diarea 081114 081114 Imodium........ ref SDS 63 LF8M
050458 - Low pulse 081120 081120 None........... ref SDS 72 LF8M
050459 - Low pulse 081121 081121 None........... ref SDS 73 7G8M
050460 - BP 144 84 Pulse 48 081121 081121 Hiking......... ref SDS 73 LF8M
050461 - Joint pain minor 081121 081121 Hiking......... ref SDS 73 LF8M
050462 - Fatigue minor 081121 081121 Hiking......... ref SDS 73 LF8M
050463 - Low pulse 081122 081122 None........... ref SDS 74 7G8M
050464 - Fatigue minor 081122 081122 Hiking......... ref SDS 74 LF8M
050465 - Low pulse 081123 081122 None........... ref SDS 75 7G8M
050466 - BP 121 74 Pulse 53 081123 081123 Hiking......... ref SDS 75 LF8M
050467 - Fatigue minor 081123 081122 Hiking......... ref SDS 75 LF8M
050468 - Joint pain minor 081124 081124 Hiking......... ref SDS 76 LF8M
050469 - Fatigue minor 081124 081124 Hiking......... ref SDS 76 LF8M
050470 - Heartburn 081124 081124 None........... ref SDS 76 HS9K
050471 - BP 144 78 Pulse 52 081125 081125 Hiking......... ref SDS 77 LF8M
050472 - Joint pain minor 081125 081125 Hiking......... ref SDS 77 LF8M
050473 - Fatigue minor 081125 081125 Hiking......... ref SDS 77 LF8M
050474 - Heartburn 081125 081125 None........... ref SDS 77 HS9K
050475 - Heartburn 081126 081126 None........... ref SDS 78 HS9K
050476 - Heartburn 081127 081127 None........... ref SDS 80 HS9K
050477 - BP 135 73 Pulse 48 081128 081128 Hiking......... ref SDS 81 5X6K
050478 - Upset stomach 081128 081128 Hiking......... ref SDS 81 T76O
050479 - BP 140 75 Pulse 50 081129 081129 Hiking......... ref SDS 83 5X6K
050480 - Heartburn 081129 081129 None........... ref SDS 83 HS9K
050481 - Fatigue 081129 081129 Rest........... ref SDS 83 LF8M
050482 - Fatigue 081130 081130 Rest........... ref SDS 84 LF8M
050483 - BP 136 79 Pulse 46 081201 081201 Hiking......... ref SDS 85 5X6K
050484 - Fatigue 081201 081201 Rest........... ref SDS 85 LF8M
050485 - Taste altered 081201 081201 Rest........... ref SDS 85 VP4G
050486 - BP 141 77 Pulse 46 081202 081202 Aerobics gym... ref SDS 87 5X6K
050487 - Fatigue 081202 081202 Rest........... ref SDS 87 LF8M
050488 - Taste altered 081202 081202 Rest........... ref SDS 87 VP4G
050489 - BP 138 77 Pulse 48 081203 081203 Hiking......... ref SDS 89 5X6K
050490 - Fatigue 081203 081203 Rest........... ref SDS 89 LF8M
050491 - Taste altered 081203 081203 Rest........... ref SDS 89 VP4G
050492 - BP 133 72 Pulse 45 081204 081204 Rest........... ref SDS 0 5X6K
050493 - Fatigue 081204 081204 Rest........... ref SDS 0 LF8M
050494 - Taste altered 081204 081204 Rest........... ref SDS 0 VP4G
050495 -
050496 -
050497 -
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 89 3E4K, ref SDS 87 3E4K.
060405 -
060406 - Millie did no go hiking today.
060408 - ..
060409 - Reducing exercise reflects rising side effects of fatigue from adding
060410 - cyclophosphamide to sunitinib, per above. ref SDS 89 LF8M
060412 - ..
060413 - Her general feeling is loss of energy.
060415 - ..
060416 - Glenna reported in a telephone call on 081203 that other patients
060417 - treated with the sunitinib protocol also experience fatigue.
060418 - ref SDS 89 XN43
060420 - ..
060421 - Millie had her 21st treatment with sunitinib this morning at 0700.
060422 - ref SDS 0 PA8Y This is the 7th day of the 1st cycle that includes
060423 - sunitinib and cyclophosphmaide. Weekly treatment with methotrexate
060424 - start again tomorrow.
060426 - ..
060427 - On 081110, Millie complained about difficulty lifting herself from a
060428 - full squatting position. ref SDS 61 HX67 She has since been
060429 - exercising to strengthen legs, and arms.
060431 - ..
060432 - This morning Millie did...
060433 -
060434 - Arm presses 3 sets of 10 leaning against bannister.
060435 - Squats 3 sets of 10 vary depth useing bannister for leverage
060436 -
060438 - ..
060439 - Case Study on Pateint History Exercising
060440 -
060441 - Follow up ref SDS 89 X64F, ref SDS 87 X64F.
060442 -
060443 - +- scm = Sunitinib Cyclophosphmaide Methotrexate
060444 - +- sc = Sunitinib Cyclophosphmaide
060445 - Time Pulse |
060446 - Location Miles Minutes Avg Max Chem Neupo Date
060447 - ----------------------------------------------------------------
060448 - Concord home sc 081204, ref SDS 0 3E4K
060449 - Lafayette 2.75 62.7 90 117 sc 081203, ref SDS 89 3E4K
060450 - Concord home (gym) sc 081202, ref SDS 87 3E4K
060451 - Lafayette 5.50 102.3 95 122 sc 081201, ref SDS 85 3E4K
060452 - Concord home sc 081130, ref SDS 84 3E4K
060453 - Lafayette 2.75 56.7 90 115 scm 081129, ref SDS 83 3E4K
060454 - Lafayette 2.75 46.5 100 128 scm 081128, ref SDS 81 3E4K
060455 - Lafayette 5.50 93.3 100 122 s 081127, ref SDS 80 3E4K
060456 - Concord home s 081126, ref SDS 78 3E4K
060457 - Lafayette 4.00 73.7 105 127 s 081125, ref SDS 77 3E4K
060458 - Lafayette 5.50 91.4 100 129 s 081124, ref SDS 76 3E4K
060459 - Concord home s 081123, ref SDS 75 3E4K
060460 - Lafayette 5.50 92.8 95 122 s 081122, ref SDS 74 3E4K
060461 - Lafayette 5.50 94.4 85 112 s 081121, ref SDS 73 3E4K
060462 - Lafayette 5.50 94.7 90 122 s 081120, ref SDS 72 3E4K
060463 - San Francisco 1.00 60.0 65 75 s 081119, ref SDS 71 3E4K
060464 - Lafayette 2.75 49.2 97 130 s 081118, ref SDS 70 3E4K
060465 - Lafayette 5.50 93.6 115 138 s 081117, ref SDS 67 3E4K
060466 - Concord home s 081116, ref SDS 65 Y68J
060467 - Concord home s 081115, ref SDS 64 EK7I
060468 - Concord home s 081114, ref SDS 63 XW6H
060469 - Lafayette 5.50 94.2 115 138 081110, ref SDS 61 3E4K
060470 - Lafayette 2.75 48.4 105 128 081109, ref SDS 60 3E4K
060471 - Kaiser x 081108, ref SDS 59 UZ7K
060472 - Kaiser x 081107, ref SDS 58 UZ7K
060473 - Lafayette 5.50 90.2 120 143 081025, ref SDS 56 3E4K
060474 - Kaiser x 081025, ref SDS 56 UZ7K
060475 - Kaiser x 081024, ref SDS 55 UZ7K
060476 - UCSF c 081023, ref SDS 54 V94O
060477 - Lafayette 5.50 90.6 115 141 081021, ref SDS 53 3E4K
060478 - Lafayette 5.50 90.4 110 128 081020, ref SDS 52 3E4K
060479 - Kaiser x 081018, ref SDS 51 UZ7K
060480 - Kaiser x 081017, ref SDS 50 UZ7K
060481 - UCSF e 081016, ref SDS 48 V94O
060482 - Lafayette 5.50 90.1 115 154 081014, ref SDS 47 3E4K
060483 - Lafayette 5.50 92.7 115 138 081013, ref SDS 46 3E4K
060484 - Lafayette 8.25 146.4 180 224 081012, ref SDS 45 3E4K
060485 - Kaiser x 081011, ref SDS 44 UZ7K
060486 - Lafayette 5.50 93.3 116 138 081010, ref SDS 43 3E4K
060487 - Kaiser x 081010, ref SDS 43 UZ7K
060488 - UCSF e 081009, ref SDS 42 V94O
060489 - Lafayette 5.50 92.1 113 137 081006, ref SDS 41 3E4K
060490 - Lafayette 2.75 48.5 110 136 x 081004, ref SDS 40 3E4K
060491 - Lafayette 5.50 98.2 117 136 x 081003, ref SDS 39 3E4K
060492 - UCSF c 081002, ref SDS 38 V94O
060493 - Lafayette 5.50 94.7 115 142 080929, ref SDS 37 3E4K
060494 - Lafayette 8.25 150.4 115 135 080928, ref SDS 37 3E4K
060495 - Kaiser x 080927, ref SDS 36 UZ7K
060496 - Lafayette 5.50 90.2 120 140 x 080926, ref SDS 35 3E4K
060497 - UCSF c 080925, ref SDS 34 V94O
060498 - Lafayette 5.50 92.3 116 138 080923, ref SDS 33 3E4K
060499 - Lafayette 5.50 98.4 112 134 080922, ref SDS 33 3E4K
060500 - Lafayette 5.50 98.2 114 137 080921, ref SDS 33 3E4K
060501 - Lafayette 5.50 101.6 110 133 x 080920, ref SDS 32 3E4K
060502 - Lafayette 5.50 89.3 115 144 x 080919, ref SDS 31 3E4K
060503 - UCSF c 080918, ref SDS 30 V94O
060504 - Lafayette 2.75 46.2 117 139 080916, ref SDS 31 3E4K
060505 - Lafayette 5.50 91.8 117 142 080915, ref SDS 29 3E4K
060506 - Clayton Safeway 3.00 62.4 98 118 080914, ref SDS 28 3E4K
060507 - Lafayette 8.25 129.7 123 147 x 080913, ref SDS 27 3E4K
060508 - Lafayette 5.50 88.4 118 146 x 080912, ref SDS 26 3E4K
060509 - UCSF c 080911, ref SDS 25 V94O
060510 - Lafayette 2.75 46.8 113 140 080909
060511 - Lafayette 5.50 89.2 117 143 080908
060512 - Lafayette 5.50 92.1 115 138 080907
060513 - Lafayette 2.75 45.3 120 144 x 080906, ref SDS 24 3E4K
060514 - Lafayette 2.75 56.8 93 120 x 080905, ref SDS 23 3E4K
060515 - UCSF c 080904, ref SDS 22 V94O
060516 - Lafayette 8.25 140.4 116 131 080903
060517 - Lafayette 5.50 94.9 115 134 080902
060518 - Kaiser x 080830
060519 - Kaiser x 080829
060520 - UCSF c 080828, ref SDS 21 V94O
060521 - Lafayette 5.50 93.6 120 137 080826
060522 - Lafayette 5.50 93.2 117 138 080825
060523 - Lafayette 5.50 93.2 123 136 x 080823
060524 - Lafayette 8.25 142.5 110 131 x 080822, ref SDS 20 3E4K
060525 - UCSF e 080821, ref SDS 19 V94O
060526 - Lafayette 5.50 94.7 115 137 080820
060527 - Lafayette 5.50 94.3 115 135 080819
060528 - Lafayette 8.25 141.7 118 134 080815
060529 - UCSF e 080814, ref SDS 18 V94O
060530 - Lafayette 5.50 93.8 120 136 080813
060531 - Lafayette 5.50 94.4 116 139 080812
060532 - Lafayette 5.50 94.2 119 133 080810
060533 - Lafayette 8.25 143.6 114 132 x 080809, ref SDS 16 3E4K
060534 - Lafayette 8.25 141.1 117 135 x 080808, ref SDS 15 3E4K
060535 - UCSF c 080807, ref SDS 14 V94O
060536 - Lafayette 8.25 143.7 115 132 080805
060537 - Concord 7.00 127.6 105 118 080804
060538 - Lafayette 8.25 143.2 112 134 080802
060539 - Lafayette 5.50 93.4 115 138 080801
060540 - Lafayette 5.50 92.2 118 140 080729
060541 - Lafayette 5.50 92.6 116 137 080728
060542 - Lafayette 8.25 142.6 114 134 080727
060543 - Lafayette 5.50 91.5 120 143 080726
060544 - Lafayette 8.25 140.8 117 135 080725
060545 - Lafayette 5.50 91.8 122 141 080723
060546 - Lafayette 5.50 91.3 120 139 080722
060547 - Lafayette 8.25 143.3 115 133 080720
060548 - Lafayette 5.50 90.7 125 144 080719
060549 - Lafayette 5.50 92.4 123 142 080716
060550 - Lafayette 2.25 46.8 116 137 080715
060551 - Lafayette 8.25 141.8 116 136 080712
060552 - Lafayette 5.50 92.9 116 139 080711
060553 - Lafayette 8.25 143.3 113 137 080704
060554 - Lafayette 5.50 90.2 121 147 080630
060555 - Lafayette 8.25 142.4 116 138 080628
060556 - Lafayette 5.50 91.4 118 138 080625
060557 - Lafayette 2.25 47.9 116 136 080623
060558 - Lafayette 5.50 94.2 112 138 080622
060559 - Lafayette 5.50 94.7 115 133 080621
060560 - Lafayette 2.25 48.3 110 129 080620
060561 - Mt Diablo 7.00 129.4 130 153 080616
060562 - Lafayette 5.50 90.8 120 146 080615
060563 - Lafayette 5.50 91.3 124 144 080614
060564 - Lafayette 5.50 89.7 122 143 080613
060565 - Lafayette 2.76 45.8 120 147 080611
060566 - Lafayette 5.50 90.5 123 145 080609
060567 - Lafayette 5.50 92.7 115 138 080607
060568 - Lafayette 5.50 94.2 118 139 080602
060569 - Lafayette 5.50 96.2 110 202 080507, ref SDS 5 WO8M
060570 -
060571 -
060572 -
060573 -
060574 -
060575 -
0606 -