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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 5 YZ5I. ref SDS 4 AT9T.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie sent a letter to the medical team on 081202 planning next CT
040902 - test, ref SDS 4 AT7T, to comply with 6 week protocol in the sunitinib
040903 - Consent document reviewed on 081017. ref SDS 2 NK5I  The letter wound
040904 - up proposing the test OA 081230 - 090102, so that the report is
040905 - available for meeting at UCSF on 090108. ref SDS 4 AT9T
040907 -  ..
040908 - Glenna called on 081203 and confirmed the test is needed for meeting
040909 - with the medical team on 090108. ref SDS 5 6F6L  Glenna confirmed
040910 - scans are needed on 090108 in a letter on 081203. ref SDS 5 ZP4Y
040912 -  ..
040913 - Therefore the test should be done at Kaiser on....
040914 -
040915 -
040916 -                081230
040917 -                081231
040918 -                090102
040920 -  ..
040921 - The best date is 081229 to give the analyst more time to prepare a
040922 - report with compressed schedule during the holiday season.
040924 -  ..
040925 - The report needs to be distributed NLT 090106.
040927 -  ..
040928 - Scope of test includes...
040929 -
040930 -      1.  Power Port
040931 -      2.  Neck, chest, abdomen, pelvis.
040932 -
040933 -
040935 -  ..
040936 - CT Test Schedule Power Port 081230 - 090102 at Kasiser Walnut Creek
040937 -
040938 - Today, Millie submitted a letter to the medical team saying...
040939 -
040940 -    1.  Subject: CT Test schedule at Kaiser Dec 30, 31 or Jan 2
040941 -        Date: Tue, 09 Dec 2008 10:25:03 -0800
040949 -         ..
040950 -    2.  Glenna, the Coordinator for my treatment at UCSF, notified me
040951 -        last week that the schedule in the letter to the medical team
040952 -        on 081202, ref SDS 4 AT9T, aligned with [UCSF] treatment
040953 -        requirements for CT tests [specified in UCSF letter on 081203.
040954 -        ref SDS 5 4P7N]
040956 -         ..
040957 -    3.  Since this is the holiday season, with folks on vacation and
040958 -        extended weekends, please schedule the next CT test at Kaiser
040959 -        in Walnut Creek preferably for 081230 to provide a few extra
040960 -        days for analysis.  Alternatively, Dec 31 or Jan 2 will be
040961 -        okay, but will compress time for review [in time for meeting
040962 -        with medical team on 090108, in accordance with UCSF letter o
040963 -        081203. ref SDS 5 4P7N]
040964 -
040965 -            [On 081210 the doctor called and scheduled the CT test on
040966 -            081230 1020. ref SDS 15 H44N
040968 -             ..
040969 -            [On 081210 Millie received a letter from the doctor
040970 -            confirming the CT test at Kaiser on 081230 1020.
040971 -            ref SDS 16 H48N
040973 -         ..
040974 -    4.  Scope includes neck to evaluate the new lump you palpated back
040975 -        on 080829, ref SDS 1 RP8T, and which was diagnosed positive
040976 -        with the biopsy on 081022 [reported on 081023, ref SDS 3 4Q9Q],
040977 -        and of course the chest, abdomen, and pelvis (essentially the
040978 -        same as the test on 081107), and should specify using the power
040979 -        port, that requires coordination with IS and the Infusion
040980 -        Clinic to access the port.
040981 -
040982 -            [On 081210 the doctor called and discussed scope of CT test
040983 -            for referral to CT department scheduled on 081230 1020.
040984 -            ref SDS 15 H44N
040986 -         ..
040987 -    5.  The blood work you ordered on 081203 was reported by Bonnie in
040988 -        the Infusion Clinic on 081205 to show ANC 624, which is NEUTS
040989 -        0.624 at UCSF. ref SDS 7 CH40  This is 60% below the target
040990 -        range of 1500.  Doctor Rugo wrote a letter saying Neupogen
040991 -        treatments should be correlated with UCSF, and are not needed
040992 -        until neutrophils are "low."  The test on 081203 shows
040993 -        neutrophils 26% about 40% blow the target range. ref SDS 6 QY6H
040995 -         ..
040996 -    6.  As a result Kaiser treated me with Neupogen on 081205 and the
040997 -        next day on 081206. ref SDS 10 BI4J  Bonnie further suggested
040998 -        consideration of a 3rd Neupogen treatment this week, and a
040999 -        follow up lab to check ANC, ref SDS 7 X35F, in advance of the
041000 -        next scheduled lab at UCSF on 081218.
041002 -         ..
041003 -    7.  This issue was presented to the medical team in a letter on
041004 -        081205, ref SDS 8 NN6P, and again on 081206. ref SDS 9 2K6P
041006 -         ..
041007 -    8.  By copy to Glenna, requesting coordination with Kaiser and
041008 -        notice of whether to get a blood test to evaluate [neutrophils]
041009 -        conditions after 2 treatments last week.  I am scheduled at
041010 -        Kaiser to get 2 treatments at the end of the week on Friday and
041011 -        Saturday.  I have been canceling these treatments under Doctor
041012 -        Rugo's orders with respect to evaluating neutrophils.
041014 -         ..
041015 -    9.  Please let me know if another lab is needed at Kaiser this week
041016 -        to assess neutrophils?
041017 -
041018 -           [On 081210 Arlette ordered follow up blood test. ref SDS 12
041019 -           616R
041020 -
041021 -           [On 081210 Millie went to Kaiser and got laboratory work for
041022 -           a blood test. ref SDS 13 L84V
041024 -            ..
041025 -           [On 081210 blood test results show ANC 1085, below the
041026 -           target of 1500; letter to Kaiser asks primary care physician
041027 -           about getting 3rd Neupogent treatment on 081210, and 2 more
041028 -           regularly scheduled on 081212 and 081213? ref SDS 14 0Y4V
041030 -            ..
041031 -           [On 081210 primary care physician called Millie and advised
041032 -           that ANC 1085 in blood test on 081210 does not require
041033 -           Neupogen until ANC falls below 1000, ref SDS 15 J43V; doctor
041034 -           ordered follow up blood test to evaluate ANC below 1000
041035 -           based on patient history indicating ANC falling 120+ points
041036 -           per day on sunitinib treatment protocol. ref SDS 15 H44M
041038 -         ..
041039 -   10.  Looking forward to the meetings next week on 081228 at UCSF and
041040 -        the next day with you on 081219.
041041 -
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0411 -