CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 8 0000. ref SDS 7 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on 081219 Millie was confused, worried, and emotional about
040902 - plans to maintain strong recovery from cancer and reduce side effects
040903 - by adjusting treatments to tolerable levels next week on 081226,
040904 - presented during the meeting at UCSF on 081218, ref SDS 6 QW48, as set
040905 - out in the letter confirming understandings to the medical team.
040906 - ref SDS 7 GF4V
040908 -  ..
040909 - Millie has been suffering with rising side effects of cancer
040910 - treatments for several weeks reported on 081218, ref SDS 5 6E7G, and
040911 - yesterday was even worse, which is why the doctor changed the
040912 - treatment on 081218, ref SDS 7 GF9X, responding to Millie's report the
040913 - day before on 081217. ref SDS 4 YJ6R
040915 -  ..
040916 - Millie sent a letter to the primary care physician at Kaiser yesterday
040917 - morning to further guide discussion, ref SDS 8 KY8Q, with agenda
040918 - issues for meeting at 1140 with the doctor to perform regularly
040919 - scheduled oversight of Millie's care on referral to UCSF, and
040920 - complementing agenda issues from the letter sent to Kaiser and the
040921 - medical team on 081218 reporting understandings meeting with UCSF.
040922 - ref SDS 7 N55I
040924 -  ..
040925 - Millie met Doctor Stritter at a seminar on 081018 presenting research
040926 - from professional events and literature on current cancer treatments
040927 - being developed and deployed. ref SDS 1 IS5L  At that time, Doctor
040928 - Stritter was familiar with the sunitinib protocol under consideration
040929 - at UCSF for Millie's next treatment. ref SDS 1 PQ6X
040931 -  ..
040932 - Doctor Stritter asked on 081018 to be notified about Millie's progress
040933 - getting treatment with sunitinib. ref SDS 1 1Y4G
040935 -  ..
040936 - Favorable reporting by Doctor Stritter for sunitinib, ref SDS 1 IT78,
040937 - as a "targeted" treatment, ref SDS 1 IT8V, were realized in Millie's
040938 - case.  Starting sunitinib on 081114, ref SDS 2 505G, two (2) weeks
040939 - later on 081126 UCSF reported substantial recovery from Millie's 5th
040940 - relapse of IBC being treated with sunitinib alone, cited in Millie's
040941 - letter to the medical team on 081126. ref SDS 3 YJ3G
040943 -  ..
040944 - This record of accurate forecasting for sunitinib supports Doctor
040945 - Stritter's strong credentials for second opinion work.
040947 -  ..
040948 - This evening, Millie sent a letter to Doctor Stritter transmitting the
040949 - report on results of meeting with the medical team at UCSF on 081218,
040950 - ref SDS 7 4P7F, and also sending a copy of Millie's letter the next
040951 - day on 081219 to the primary care physician to discuss during a
040952 - meeting at Kaiser in the late morning on 081219 complex decision on
040953 - adjusting treatments for IBC, ref SDS 8 KY8Q; and, further explaining
040954 - objectives for getting a second opinion on Millie's treatment with
040955 - sunitinib staying at full strength and reducing or ending treatment
040956 - with cyclophosphamide to reduce side effects.
040957 -
040958 -               [On 081223 Doctor Stritter responded to Millie's letter
040959 -               on 081220 submitting procedures for second opinion
040960 -               support. ref SDS 10 8N9M
040962 -  ..
040963 - Millie's letter to Doctor Stritter says...
040964 -
040965 -    1.  Subject: Meeting Agenda at Kaiser Dec 19th
040966 -        Date: Sat, 20 Dec 2008 21:06:49 -0800
040973 -         ..
040974 -    3.  Here is another letter to my primary care physician at Kaiser,
040975 -        ref SDS 8 KY8Q, that set the agenda for discussions at Kaiser
040976 -        on Friday, 081219, following up meeting the day before on
040977 -        Thursday at UCSF with Doctor Rugo and her team. ref SDS 7 4P7F
040979 -         ..
040980 -    4.  I meet with Doctor Johnson every 8 weeks for oversight of UCSF
040981 -        support for my care.
040983 -         ..
040984 -    5.  The letter presents complex challenges patients and doctors
040985 -        face sorting through conflicting choices in order to optimize
040986 -        recovery.  This is an area where your skills could be very
040987 -        helpful, because the missing ingredient is lack of time for
040988 -        deliberation.
040989 -
040990 -               [On 081223 Doctor Stritter responded to Millie's letter
040991 -               on 081220 noting Millie's case is quite complicated, and
040992 -               submitting procedures for second opinion support.
040993 -               ref SDS 10 8N9M
040995 -         ..
040996 -    6.  Doctor Johnson seemed to say that cyclophosphamide may not be
040997 -        contributing much to my recovery, since cancer cells on my 5th
040998 -        relapse may now be resistant after having 6 or so treatments
040999 -        beginning in 2002 and again in early 2005. ref SDS 9 4R49  He
041000 -        further indicated that since sunitinib is a "targeted" drug,
041001 -        cyclophosphamide chemotherapy is likely causing most of the bad
041002 -        side effects, and so nominally should be cut back before trying
041003 -        to reduce sunitinib.  He went on to indicate that the decision
041004 -        at UCSF on 081218 to initially cut back sunitinib may have
041005 -        related to the protocol for the study, such that to continue
041006 -        getting any treatment with sunitinib, UCSF is required to stick
041007 -        with cyclophosphamide, even though it may not be helping, and
041008 -        is likely causing bad side effects.  In other words, if both
041009 -        cyclophosphamide and Methotrexate are stopped, then I would be
041010 -        getting only sunitinib, which is not approved for breast
041011 -        cancer, or something like that.
041013 -         ..
041014 -    7.  The doctor further indicated that a few years ago Kaiser tried
041015 -        a treatment to increase platelets, and got good results.
041016 -        However, unlike Neupogen that lifts ANC almost immediately, the
041017 -        drug for platelets takes a long time to take effect, and so has
041018 -        fallen out of favor.
041020 -         ..
041021 -    8.  How was the conference?
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