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 5, 2008 08:54 AM Friday; Rod Welch

Millie letter to UCSF notifying low blood counts.

1...Summary/Objective


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SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 3 0000. ref SDS 1 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie notified medical team on 081202 about symptoms of weak immune
040902 - system, chronic fatigue, sniffles, ect. ref SDS 1 AT8U
040903 -
040904 -    1.  Subject: Blood Counts Low Neupogen Treatment Today
040905 -        Date: Fri, 05 Dec 2008 09:06:22 -0800
040915 -         ..
040916 -    2.  The letter to the medical team on 081202 asked about
040917 -        requirements for Neupogen treatments? ref SDS 1 AT8U  Doctor
040918 -        Johnson ordered a blood test.  It was performed at Kaiser on
040919 -        081203. ref SDS 2 TG8M  Kaiser does not present ANC (NEUTS) in
040920 -        its online reporting.
040922 -         ..
040923 -    3.  WBC 2.4 is well below the range of 3.5 - 12.5; platelets 109 is
040924 -        below the range 140 - 400. ref SDS 3 075H
040925 -
040926 -            [On 081205 UCSF advises that platelets 109 is mildly low,
040927 -            but not worrisome. ref SDS 5 SS4F
040928 -
040929 -            [On 081210 follow up blood test shows platelets 67, about
040930 -            60% below the target range of 104. ref SDS 7 DM6J
040932 -             ..
040933 -            [On 081211 Millie letter to medical team asks about effects
040934 -            on health care with platelets falling below 60% of the
040935 -            target range. ref SDS 8 S28P
040937 -             ..
040938 -            [On 081218 labs at UCSF for examination starting 2nd cycle
040939 -            of sunitinib protocol show CBC blood counts again very low,
040940 -            ref SDS 9 075H, with platelets 67, ref SDS 9 7Z6N,
040941 -            attributed for causing new sunitinib side effect of
040942 -            nosebleed, ref SDS 10 GF4S, and NEUTS 0.74 have again
040943 -            fallen substantially, ref SDS 9 QY6H; as a result treatment
040944 -            regimen changed; all treatment was paused for 7 days until
040945 -            081226; Methotrexate ended entirely; consideration will be
040946 -            made to reduce dose for sunitinib. ref SDS 10 GF4V
040948 -         ..
040949 -    4.  I have Neupogen treatments scheduled today and tomorrow at
040950 -        Kaiser.  These have been canceled the past several weeks after
040951 -        stopping prior chemotherapy treatment on 081023.
040953 -         ..
040954 -    5.  I will therefore come in today for scheduled Neupogen
040955 -        treatment, and will get a copy of the full lab report for
040956 -        submission to UCSF.
040957 -
040958 -           [On 081205 Kaiser calculates NEUTS 0.624, ref SDS 4 CH40,
040959 -           and so treats Millie with Neupogen to increase blood counts.
040960 -           ref SDS 4 CH6X
040962 -            ..
040963 -           [On 081205 UCSF notifies that Neupogen is needed with low
040964 -           neutrophils. ref SDS 5 JE5I
040966 -            ..
040967 -           [On 081205 Millie gets Neupogen treatment at Kaiser prior to
040968 -           receiving Doctor Rugo's letter today. ref SDS 4 CH6X
040970 -            ..
040971 -           [On 081206 Millie submitted the complete lab to UCSF.
040972 -           ref SDS 6 2K4U
040973 -
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0410 -