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 10, 2008 07:59 AM Wednesday; Rod Welch

Called Glenna about Millie getting 3rd Neupogen treatment.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 0000, ref SDS 5 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on Millie getting Neupogen treatment last week are reported
040902 - on 081207, ref SDS 7 673J, and citing Kaiser's recommendation for
040903 - Millie to get a 3rd Neupogen treatment this week, reported on 081205.
040904 - ref SDS 2 X35F  This was confirmed in Millie's letter to the medical
040905 - team on 081205. ref SDS 4 NN6P  Millie sent a follow up letter on
040906 - 081206 asking about a 3rd Neupogen treatment, and another blood test
040907 - this week. ref SDS 5 2K6P
040909 -  ..
040910 - Called Glenna.
040912 -  ..
040913 - Glenna cannot comment on what Doctor Rugo means by "neutrophils are
040914 - low" in her letter on 081205, ref SDS 3 JE5I, and in relation to
040915 - Millie's letter to the medical team on 081209. ref SDS 8 RL6W
040917 -  ..
040918 - She will call Arlette about doing a blood test this week.
040919 -
040921 -  ..
0410 -
0411 -
0412 - 1142
0413 -
041301 - Called Glenna.
041302 -
041303 - Glenna related having called Arlette in Oncology at Kaiser in Walnut
041304 - Creek, CA.
041306 -  ..
041307 - Arlette was very helpful talking to UCSF, but mistakes occurred
041308 - because Arlette had not received correspondence the past few days on
041309 - Millie's situation, including the letter yesterday on 081209.
041310 - ref SDS 8 RL6Q  Glenna was unable to relate correlations,
041311 - implications, and nuance for Arlette to understand objectives and
041312 - requirements.  Glenna did not take time to submit missing
041313 - correspondence to Arlette, and Arletted did not have time to review
041314 - correspondence for background and context that enables effective
041315 - communication in the telephone call.
041317 -  ..
041318 - As a result of miscommunication and confusion, Arlette told Glenna to
041319 - call the Kaiser pharmacy.  This started Glenna on a series of deadend
041320 - calls, which concluded by someone telling Glenna that Doctor Johnson
041321 - approved Millie for Neupogen treatment this past Saturday on 081206,
041322 - which has nothing to do with the current issue.
041323 -
041324 -            [On 081211 more delays correcting mistakes caused by
041325 -            confusion and ambiguity from verbal communications when
041326 -            people do not invest time to read the record. ref SDS 14
041327 -            V156
041329 -  ..
041330 - We reviewed patient history showing Millie already received Neupogen
041331 - treatment on 081206. ref SDS 6 BI4J
041333 -  ..
041334 - Millie sent a letter to the medical team on 081205 asking about
041335 - Bonnie's recommendation to get a follow up blood test this week to
041336 - evaluate requirements for a 3rd Neupogen treatment this week, and or
041337 - to get Neupogen treatmenst already scheduled for 081212 and 081213.
041338 - ref SDS 4 NN6Y  This was followed up with another letter on Saturday,
041339 - 081206, asking about getting a follow up blood test. ref SDS 5 2K5U
041341 -  ..
041342 - A 3rd follow up was sent yesterday on 081209 asking about doing a
041343 - follow up blood test. ref SDS 8 RM3R
041345 -  ..
041346 - Glenna seemed to indicate during this call today having talked to
041347 - Doctor Rugo about Millie's letter to the medical team sent yesterday
041348 - on 081209, ref SDS 8 RL6W, and that the doctor approved Millie for
041349 - Neupogen treatments when "neutrophils are low" based on Kaiser's
041350 - standards and practices, and that Kaiser's determination will satisfy
041351 - control which Doctor Rugo requested in UCSF letter to Millie on
041352 - 081205. ref SDS 3 JE5I
041354 -  ..
041355 - Glenna feels the next step is for Millie to get a blood test to
041356 - evaluate effects of Neupogen treatments last week on 081205 and
041357 - 081206, and as set out Millie's letter to the medical team yesterday
041358 - on 081209. ref SDS 8 RL6W
041360 -  ..
041361 - Glenna was frustrated after makin 6 calls to Kaiser, she was unable to
041362 - schedule Millie for another blood test today.
041364 -  ..
041365 - Glenna asked that Millie follow up to coordinate with Kaiser, because
041366 - experience today, ref SDS 0 6S9M, aligns with Doctor Rugo's concerns
041367 - on 080403 about difficulty coordinating on inter-hospital referrals.
041368 - ref SDS 1 SG7I
041369 -
041370 -        [...in another record today on 081210 called Arlette to
041371 -        coordinate scheduling blood test, ref SDS 10 6F40; Arlette
041372 -        ordered the blood test today. ref SDS 10 DK6J
041374 -         ..
041375 -        [...in another record today on 081210 Millie went to Kaiser and
041376 -        got the blood draw; partial results posted later in the day
041377 -        show ANC improved to 1085, showing neutrophils are still low.
041378 -        ref SDS 11 QY6H
041380 -         ..
041381 -        [...in another record today on 081210 Millie sent a letter
041382 -        notifying the medical team of partial results on the blood
041383 -        test, ref SDS 12 BT55; and asking about Neupogen treatments
041384 -        today and/or on Friday and Saturday, which are already
041385 -        scheduled. ref SDS 12 0Y4Q
041387 -         ..
041388 -        [On 081210 Arlette ordered follow up blood test. ref SDS 10
041389 -        616R
041391 -         ..
041392 -        [On 081210 Kaiser follow up lab, ref SDS 11 S65I, shows
041393 -        NEUTS 1.085. ref SDS 11 QY6H
041395 -         ..
041396 -        [On 081210 primary care physician called Millie and
041397 -        advised that ANC 1085 in blood test on 081210 does not
041398 -        require Neupogen until ANC falls below 1000, ref SDS 13
041399 -        J43V; doctor ordered follow up blood test to evaluate
041400 -        ANC below 1000 based on patient history indicating ANC
041401 -        falling 120+ points per day on sunitinib treatment
041402 -        protocol. ref SDS 13 H44M
041403 -
041404 -
041405 -
041406 -
041407 -
041408 -
041409 -
0415 -