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 6, 2008 07:00 AM Saturday;
Rod Welch
Millie sunitinib #23 treatment IBC 5th relapse recovering well.
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 C0 0000. ref SDS B9 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 C0 505G, ref SDS B9 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 91
040910 - EK7I After 14 treatments ending on 081127, ref SDS A9 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 75 004O
040920 - ..
040921 - These supplemental treatments started on 081128. ref SDS B0 VR57
040923 - ..
040924 - Millie continues with sunitinib and cyclophosphmaide; methotrexate
040925 - was taken yesterday and today.
040927 - ..
040928 - NEUTs blood tests show patient[history neutropenia from chemotherapy
040929 - everyday with cyclophosphamide reported in case study on 081205.
040930 - ref SDS C0 EC5N
040931 -
040933 - ..
040934 - Sunitinib Cyclophosmaide Methotrexate Patient History
040935 -
040936 - Follow up ref SDS C0 OE6K, ref SDS B9 OE6K.
040937 -
040939 - Cycle 1 begin 081128 after 14 treatmenst sunitinib alone
040940 - Cohort: 3
040942 - ..
040943 - Cyclophos Metho
040944 - Sunitinib phamide trexate
040945 - Days Date Time Cycle 37.5 50 5
040946 - =======================================================
040947 - Follow up ref SDS C0 PA8Y, ref SDS B9 PA8Y.
040948 -
040949 - 1. 081114 0700 Load 37.5 0 0 ... ref SDS 91 OE6K
040950 - 2. 081115 0700 Load 75.0 0 0 ... ref SDS 92 OE6K
040951 - 3. 081116 0700 Load 112.5 0 0 ... ref SDS 93 OE6K
040952 - 4. 081117 0700 Load 150.0 0 0 ... ref SDS 94 OE6K
040953 - 5. 081118 0700 Load 187.5 0 0 ... ref SDS 97 OE6K
040954 - 6. 081119 0700 Load 225.0 0 0 ... ref SDS 99 OE6K
040955 - 7. 081120 0700 Load 263.5 0 0 ... ref SDS A0 OE6K
040956 - 8. 081121 0700 Load 301.0 0 0 ... ref SDS A1 OE6K
040957 - 9. 081122 0700 Load 338.5 0 0 ... ref SDS A2 OE6K
040958 - 10. 081123 0700 Load 376.0 0 0 ... ref SDS A3 OE6K
040959 - 11. 081124 0700 Load 413.5 0 0 ... ref SDS A4 OE6K
040960 - 12. 081125 0700 Load 451.0 0 0 ... ref SDS A5 OE6K
040961 - 13. 081126 0700 Load 488.5 0 0 ... ref SDS A6 OE6K
040962 - 14. 081127 0700 Load 526.0 0 0 ... ref SDS A8 OE6K
040963 - 15. 081128 0700 1 1 563.5 1 50 1 5 ... ref SDS B0 OE6K
040964 - 16. 081129 0700 1 2 601.0 2 100 2 10 ... ref SDS B2 OE6K
040965 - 17. 081130 0700 1 3 638.5 3 150 2 10 ... ref SDS B3 OE6K
040966 - 18. 081201 0700 1 4 676.0 4 200 2 10 ... ref SDS B4 OE6K
040967 - 19. 081202 0700 1 5 713.5 5 250 2 10 ... ref SDS B6 OE6K
040968 - 20. 081203 0700 1 6 751.0 6 300 2 10 ... ref SDS B8 OE6K
040969 - 081203 0730 NEUTS 0.624... ...... .......... ref SDS 0 QY6H
040970 - 21. 081204 0700 1 7 788.5 7 350 2 10 ... ref SDS B9 OE6K
040971 - ..
040972 - 22. 081205 0700 1 8 826.0 8 400 3 15 ... ref SDS C0 OE6K
040973 - 23. 081206 0700 1 9 863.5 9 450 4 20 ... ref SDS 0 OE6K
040974 -
040975 -
040976 -
040977 -
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 C0 LF8M, ref SDS B9 LF8M.
050405 -
050406 - Fatigue is a likely side effect of sunitinib with cyclophosphamide,
050407 - listed in the Consent document reviewed on 081017. ref SDS 75 4G7G
050409 - ..
050410 - Energy continues to decline shown by declining exercise. ref SDS 0
050411 - X64F
050413 - ..
050414 - Low blood counts NEUTS 0.624 reported yesterday at Kaiser, ref SDS C0
050415 - QY6H, for the blood test on 081203, ref SDS B7 7N82, may reflect
050416 - rising fatigue.
050418 - ..
050419 - NEUTs blood tests show patient[history neutropenia from chemotherapy
050420 - everyday with cyclophosphamide reported in case study on 081205.
050421 - ref SDS C0 EC5N
050423 - ..
050424 - Millie slept most of the day.
050426 - ..
050427 - On 081202 Millie's letter to the medical team reports rising fatigue,
050428 - ref SDS B5 AT8U, and asks about labs to evaluate blood counts,
050429 - including NEUTS (ANC at Kaiser). ref SDS B5 AT8X The primary care
050430 - physician ordered tests, which were performed the next day on 081203,
050431 - ref SDS B7 TG8M Results of labs on 081203 were reported on 081205
050432 - showing NEUTS 0.624 (ANC 624 at Kaiser), ref SDS C0 QY6H, which is
050433 - very low. This aligns with rising fatigue.
050435 - ..
050436 - Glenna reported in a telephone call on 081203, responding to Millie's
050437 - letter on 081202, that other patients treated with the sunitinib
050438 - protocol also experience fatigue. ref SDS B8 XN43
050440 - ..
050441 - Vitals were not reported today...
050442 -
050443 - BP *** ** Pulse **
050445 - ..
050446 - Millie reported minor heartburn today, and no upset stomach.
050448 - ..
050449 - Prilosec prescribed for heartburn has still not been taken.
050451 - ..
050452 - Millie reports improved taste from some foods today (e.g., soup),
050453 - cited in study consent documents, reviewed on 081017. ref SDS 75 6T5H
050454 -
050456 - ..
050457 - Date
050458 - Description Adverse Event Start Stop Medication
050459 - ---------------------------------------------------------
050460 - Follow up ref SDS C0 MV5H, ref SDS B9 MV5H.
050461 -
050462 - Diarrhea 081114 081114 Imodium........ ref SDS 91 LF8M
050463 - Low pulse 081120 081120 None........... ref SDS A0 LF8M
050464 - Low pulse 081121 081121 None........... ref SDS A1 7G8M
050465 - BP 144 84 Pulse 48 081121 081121 Hiking......... ref SDS A1 LF8M
050466 - Joint pain minor 081121 081121 Hiking......... ref SDS A1 LF8M
050467 - Fatigue minor 081121 081121 Hiking......... ref SDS A1 LF8M
050468 - Low pulse 081122 081122 None........... ref SDS A2 7G8M
050469 - Fatigue minor 081122 081122 Hiking......... ref SDS A2 LF8M
050470 - Low pulse 081123 081122 None........... ref SDS A3 7G8M
050471 - BP 121 74 Pulse 53 081123 081123 Hiking......... ref SDS A3 LF8M
050472 - Fatigue minor 081123 081122 Hiking......... ref SDS A3 LF8M
050473 - Joint pain minor 081124 081124 Hiking......... ref SDS A4 LF8M
050474 - Fatigue minor 081124 081124 Hiking......... ref SDS A4 LF8M
050475 - Heartburn 081124 081124 None........... ref SDS A4 HS9K
050476 - BP 144 78 Pulse 52 081125 081125 Hiking......... ref SDS A5 LF8M
050477 - Joint pain minor 081125 081125 Hiking......... ref SDS A5 LF8M
050478 - Fatigue minor 081125 081125 Hiking......... ref SDS A5 LF8M
050479 - Heartburn 081125 081125 None........... ref SDS A5 HS9K
050480 - Heartburn 081126 081126 None........... ref SDS A6 HS9K
050481 - Heartburn 081127 081127 None........... ref SDS A9 HS9K
050482 - BP 135 73 Pulse 48 081128 081128 Hiking......... ref SDS B0 5X6K
050483 - Upset stomach 081128 081128 Hiking......... ref SDS B0 T76O
050484 - BP 140 75 Pulse 50 081129 081129 Hiking......... ref SDS B2 5X6K
050485 - Heartburn 081129 081129 None........... ref SDS B2 HS9K
050486 - Fatigue 081129 081129 Rest........... ref SDS B2 LF8M
050487 - Fatigue 081130 081130 Rest........... ref SDS B3 LF8M
050488 - BP 136 79 Pulse 46 081201 081201 Hiking......... ref SDS B4 5X6K
050489 - Fatigue 081201 081201 Rest........... ref SDS B4 LF8M
050490 - Taste altered 081201 081201 Rest........... ref SDS B4 VP4G
050491 - BP 141 77 Pulse 46 081202 081202 Aerobics gym... ref SDS B6 5X6K
050492 - Fatigue 081202 081202 Rest........... ref SDS B6 LF8M
050493 - Taste altered 081202 081202 Rest........... ref SDS B6 VP4G
050494 - BP 138 77 Pulse 48 081203 081203 Hiking......... ref SDS B8 5X6K
050495 - Fatigue 081203 081203 Rest........... ref SDS B8 LF8M
050496 - Taste altered 081203 081203 Rest........... ref SDS B8 VP4G
050497 - NEUTS (ANC) 0.624 081203 081203 Neupogen.......
050498 - BP 133 72 Pulse 45 081204 081204 Rest........... ref SDS B9 5X6K
050499 - Fatigue 081204 081204 Rest........... ref SDS B9 LF8M
050500 - Taste altered 081204 081204 Rest........... ref SDS B9 VP4G
050501 - BP 138 76 Pulse 49 081205 081205 Rest........... ref SDS C0 5X6K
050502 - Diarrhea 081205 081114 Imodium........ ref SDS C0 Q67F
050503 - Fatigue 081205 081205 Rest........... ref SDS C0 LF8M
050504 - Taste altered 081205 081205 Rest........... ref SDS C0 VP4G
050505 - BP *** ** Pulse ** 081206 081206 Rest........... ref SDS 0 5X6K
050506 - Fatigue 081206 081206 Rest........... ref SDS 0 LF8M
050507 -
050508 -
050509 -
050510 -
050511 -
0506 -
SUBJECTS
Default Null Subject Account for Blank Record
0603 -
060401 - ..
060402 - Exercise Hiking Maintain Fitness Strengthen Immune System
060403 -
060404 - Follow up ref SDS C0 3E4K, ref SDS B9 3E4K.
060405 -
060406 - Millie did no go hiking today due to rising fatigue.
060408 - ..
060409 - Reducing exercise reflects rising side effects of fatigue from adding
060410 - cyclophosphamide to sunitinib, per above. ref SDS B8 LF8M
060412 - ..
060413 - Her general feeling is loss of energy, reflected by low blood counts
060414 - reported yesterday on 081205, ref SDS C0 QY6H, for the blood test on
060415 - 081203. ref SDS B7 TG8M
060417 - ..
060418 - Glenna reported in a telephone call on 081203 that other patients
060419 - treated with the sunitinib protocol also experience fatigue.
060420 - ref SDS B8 XN43
060422 - ..
060423 - NEUTs blood tests show patient[history neutropenia from chemotherapy
060424 - everyday with cyclophosphamide reported in case study on 081205.
060425 - ref SDS C0 EC5N
060427 - ..
060428 - Getting Neupogen treatment yesterday, ref SDS C1 KV84, and today may
060429 - increase energy?? ref SDS C3 BI4J
060431 - ..
060432 - Millie had her 23rd treatment with sunitinib this morning at 0700.
060433 - ref SDS 0 PA8Y This is the 9th day of the 1st cycle that includes
060434 - sunitinib and cyclophosphmaide. Today is the 2nd day of treatment
060435 - with methotrexate for the 2nd week of the 1st cycle. There will no
060436 - more treatments until next Friday, 081212.
060438 - ..
060439 - On 081110, Millie complained about difficulty lifting herself from a
060440 - full squatting position. ref SDS 89 HX67 She has since been
060441 - exercising to strengthen legs, and arms.
060443 - ..
060444 - This morning Millie did...
060445 -
060446 - Arm presses 3 sets of 10 leaning against bannister.
060447 - Squats 3 sets of 10 vary depth useing bannister for leverage
060448 -
060450 - ..
060451 - Case Study on Pateint History Exercising
060452 -
060453 - Follow up ref SDS C0 X64F, ref SDS B9 X64F.
060454 -
060455 - +- scm = Sunitinib Cyclophosphmaide Methotrexate
060456 - +- sc = Sunitinib Cyclophosphmaide
060457 - Time Pulse |
060458 - Location Miles Minutes Avg Max Chem Neupo Date
060459 - ----------------------------------------------------------------
060460 - Concord home scm 081206, ref SDS 0 3E4K
060461 - Concord home scm 081205, ref SDS C0 3E4K
060462 - Concord home sc 081204, ref SDS B9 3E4K
060463 - Lafayette 2.75 62.7 90 117 sc 081203, ref SDS B8 3E4K
060464 - Concord home (gym) sc 081202, ref SDS B6 3E4K
060465 - Lafayette 5.50 102.3 95 122 sc 081201, ref SDS B4 3E4K
060466 - Concord home sc 081130, ref SDS B3 3E4K
060467 - Lafayette 2.75 56.7 90 115 scm 081129, ref SDS B2 3E4K
060468 - Lafayette 2.75 46.5 100 128 scm 081128, ref SDS B0 3E4K
060469 - Lafayette 5.50 93.3 100 122 s 081127, ref SDS A9 3E4K
060470 - Concord home s 081126, ref SDS A6 3E4K
060471 - Lafayette 4.00 73.7 105 127 s 081125, ref SDS A5 3E4K
060472 - Lafayette 5.50 91.4 100 129 s 081124, ref SDS A4 3E4K
060473 - Concord home s 081123, ref SDS A3 3E4K
060474 - Lafayette 5.50 92.8 95 122 s 081122, ref SDS A2 3E4K
060475 - Lafayette 5.50 94.4 85 112 s 081121, ref SDS A1 3E4K
060476 - Lafayette 5.50 94.7 90 122 s 081120, ref SDS A0 3E4K
060477 - San Francisco 1.00 60.0 65 75 s 081119, ref SDS 99 3E4K
060478 - Lafayette 2.75 49.2 97 130 s 081118, ref SDS 98 3E4K
060479 - Lafayette 5.50 93.6 115 138 s 081117, ref SDS 95 3E4K
060480 - Concord home s 081116, ref SDS 93 Y68J
060481 - Concord home s 081115, ref SDS 92 EK7I
060482 - Concord home s 081114, ref SDS 91 XW6H
060483 - Lafayette 5.50 94.2 115 138 081110, ref SDS 89 3E4K
060484 - Lafayette 2.75 48.4 105 128 081109, ref SDS 88 3E4K
060485 - Kaiser x 081108, ref SDS 87 UZ7K
060486 - Kaiser x 081107, ref SDS 86 UZ7K
060487 - Lafayette 5.50 90.2 120 143 081025, ref SDS 82 3E4K
060488 - Kaiser x 081025, ref SDS 82 UZ7K
060489 - Kaiser x 081024, ref SDS 81 UZ7K
060490 - UCSF c 081023, ref SDS 80 V94O
060491 - Lafayette 5.50 90.6 115 141 081021, ref SDS 79 3E4K
060492 - Lafayette 5.50 90.4 110 128 081020, ref SDS 78 3E4K
060493 - Kaiser x 081018, ref SDS 77 UZ7K
060494 - Kaiser x 081017, ref SDS 76 UZ7K
060495 - UCSF e 081016, ref SDS 74 V94O
060496 - Lafayette 5.50 90.1 115 154 081014, ref SDS 73 3E4K
060497 - Lafayette 5.50 92.7 115 138 081013, ref SDS 72 3E4K
060498 - Lafayette 8.25 146.4 180 224 081012, ref SDS 71 3E4K
060499 - Kaiser x 081011, ref SDS 70 UZ7K
060500 - Lafayette 5.50 93.3 116 138 081010, ref SDS 69 3E4K
060501 - Kaiser x 081010, ref SDS 69 UZ7K
060502 - UCSF e 081009, ref SDS 68 V94O
060503 - Lafayette 5.50 92.1 113 137 081006, ref SDS 67 3E4K
060504 - Lafayette 2.75 48.5 110 136 x 081004, ref SDS 66 3E4K
060505 - Lafayette 5.50 98.2 117 136 x 081003, ref SDS 65 3E4K
060506 - UCSF c 081002, ref SDS 64 V94O
060507 - Lafayette 5.50 94.7 115 142 080929, ref SDS 63 3E4K
060508 - Lafayette 8.25 150.4 115 135 080928, ref SDS 63 3E4K
060509 - Kaiser x 080927, ref SDS 62 UZ7K
060510 - Lafayette 5.50 90.2 120 140 x 080926, ref SDS 61 3E4K
060511 - UCSF c 080925, ref SDS 60 V94O
060512 - Lafayette 5.50 92.3 116 138 080923, ref SDS 59 3E4K
060513 - Lafayette 5.50 98.4 112 134 080922, ref SDS 59 3E4K
060514 - Lafayette 5.50 98.2 114 137 080921, ref SDS 59 3E4K
060515 - Lafayette 5.50 101.6 110 133 x 080920, ref SDS 58 3E4K
060516 - Lafayette 5.50 89.3 115 144 x 080919, ref SDS 57 3E4K
060517 - UCSF c 080918, ref SDS 56 V94O
060518 - Lafayette 2.75 46.2 117 139 080916, ref SDS 57 3E4K
060519 - Lafayette 5.50 91.8 117 142 080915, ref SDS 55 3E4K
060520 - Clayton Safeway 3.00 62.4 98 118 080914, ref SDS 54 3E4K
060521 - Lafayette 8.25 129.7 123 147 x 080913, ref SDS 53 3E4K
060522 - Lafayette 5.50 88.4 118 146 x 080912, ref SDS 52 3E4K
060523 - UCSF c 080911, ref SDS 51 V94O
060524 - Lafayette 2.75 46.8 113 140 080909
060525 - Lafayette 5.50 89.2 117 143 080908
060526 - Lafayette 5.50 92.1 115 138 080907
060527 - Lafayette 2.75 45.3 120 144 x 080906, ref SDS 50 3E4K
060528 - Lafayette 2.75 56.8 93 120 x 080905, ref SDS 49 3E4K
060529 - UCSF c 080904, ref SDS 48 V94O
060530 - Lafayette 8.25 140.4 116 131 080903
060531 - Lafayette 5.50 94.9 115 134 080902
060532 - Kaiser x 080830
060533 - Kaiser x 080829
060534 - UCSF c 080828, ref SDS 47 V94O
060535 - Lafayette 5.50 93.6 120 137 080826
060536 - Lafayette 5.50 93.2 117 138 080825
060537 - Lafayette 5.50 93.2 123 136 x 080823
060538 - Lafayette 8.25 142.5 110 131 x 080822, ref SDS 46 3E4K
060539 - UCSF e 080821, ref SDS 45 V94O
060540 - Lafayette 5.50 94.7 115 137 080820
060541 - Lafayette 5.50 94.3 115 135 080819
060542 - Lafayette 8.25 141.7 118 134 080815
060543 - UCSF e 080814, ref SDS 44 V94O
060544 - Lafayette 5.50 93.8 120 136 080813
060545 - Lafayette 5.50 94.4 116 139 080812
060546 - Lafayette 5.50 94.2 119 133 080810
060547 - Lafayette 8.25 143.6 114 132 x 080809, ref SDS 42 3E4K
060548 - Lafayette 8.25 141.1 117 135 x 080808, ref SDS 41 3E4K
060549 - UCSF c 080807, ref SDS 40 V94O
060550 - Lafayette 8.25 143.7 115 132 080805
060551 - Concord 7.00 127.6 105 118 080804
060552 - Lafayette 8.25 143.2 112 134 080802
060553 - Lafayette 5.50 93.4 115 138 080801
060554 - Lafayette 5.50 92.2 118 140 080729
060555 - Lafayette 5.50 92.6 116 137 080728
060556 - Lafayette 8.25 142.6 114 134 080727
060557 - Lafayette 5.50 91.5 120 143 080726
060558 - Lafayette 8.25 140.8 117 135 080725
060559 - Lafayette 5.50 91.8 122 141 080723
060560 - Lafayette 5.50 91.3 120 139 080722
060561 - Lafayette 8.25 143.3 115 133 080720
060562 - Lafayette 5.50 90.7 125 144 080719
060563 - Lafayette 5.50 92.4 123 142 080716
060564 - Lafayette 2.25 46.8 116 137 080715
060565 - Lafayette 8.25 141.8 116 136 080712
060566 - Lafayette 5.50 92.9 116 139 080711
060567 - Lafayette 8.25 143.3 113 137 080704
060568 - Lafayette 5.50 90.2 121 147 080630
060569 - Lafayette 8.25 142.4 116 138 080628
060570 - Lafayette 5.50 91.4 118 138 080625
060571 - Lafayette 2.25 47.9 116 136 080623
060572 - Lafayette 5.50 94.2 112 138 080622
060573 - Lafayette 5.50 94.7 115 133 080621
060574 - Lafayette 2.25 48.3 110 129 080620
060575 - Mt Diablo 7.00 129.4 130 153 080616
060576 - Lafayette 5.50 90.8 120 146 080615
060577 - Lafayette 5.50 91.3 124 144 080614
060578 - Lafayette 5.50 89.7 122 143 080613
060579 - Lafayette 2.76 45.8 120 147 080611
060580 - Lafayette 5.50 90.5 123 145 080609
060581 - Lafayette 5.50 92.7 115 138 080607
060582 - Lafayette 5.50 94.2 118 139 080602
060583 - Lafayette 5.50 96.2 110 202 080507, ref SDS 18 WO8M
060584 -
060585 -
060586 -
060587 -
060588 -
060589 -
0606 -