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 23, 2008 11:48 PM Tuesday; Rod Welch

Millie notifies Kaiser that UCSF approves Neupogen when ANC below 1000.

1...Summary/Objective
........Commend Glenna UCSF Coordination Patient Case Management


..............
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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 10 0000. ref SDS 8 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 081218 UCSF set work plan to pause treatment until 081226, and then
040902 - to do a blood that evaluates whether to reduce sunitinib dosage, and
040903 - to continue the doce of cyclophosphamide, and end Methotrexate.
040904 - ref SDS 5 QW48
040906 -  ..
040907 - Platelets were a consideration on maintaining the high dose of
040908 - sunitinib.
040910 -  ..
040911 - Guidance in UCSF documentation instructed Millie to call for
040912 - additional instructions in the case that platelets are below 75.
040913 - ref SDS 5 TY8O
040915 -  ..
040916 - In the evening, on 081218, Millie sent a letter to the medical team
040917 - confirming these understandings. ref SDS 6 GF4V
040919 -  ..
040920 - There was no discussion on 081218 about Millie getting Neupogen
040921 - treatments scheduled for this Friday and Saturday, 081226 and 081227.
040923 -  ..
040924 - Glenna called yesterday, while Millie was at the gym. ref SDS 9 3E4K
040925 - She asked about Millie, and was pleased to hear that Millie may be
040926 - feeling better with side effects finally beginning to subside after 4
040927 - days without cancer treatment, reported in the record of patient
040928 - history today. ref SDS 9 6E7G
040930 -  ..
040931 - Glenna advised that the medical team wants Millie to get Neupogen
040932 - treatments at Kaiser, when blood counts fall below NEUTS 1.000 (ANC
040933 - 1000).  Millie has a blood test on Friday, 081226, ordered by Doctor
040934 - Rugo at UCSF on 081218. ref SDS 5 BQ8F
040935 -
040936 -        [On 090109 UCSF letter orders Neupogen treatment because blood
040937 -        counts NEUTS 0.87 are below 1.00. ref SDS 12 UX4V
040939 -  ..
040940 - Earlier this evening, Millie sent a letter wishing happy holidays to
040941 - the medical team, and congratulating Doctor Rugo for engineering
040942 - recovery from the 5th relapse of IBC. ref SDS 10 2I8H
040944 -  ..
040945 - Millie sent another letter to UCSF with a copy to the primary care
040946 - physician at Kaiser confirming guidance for Millie to get Neupogen
040947 - when blood counts for ANC are below 1000 (NEUTS 1.00 at UCSF), per
040948 - Glenna's call this afternoon. ref SDS 0 BJ97
040950 -  ..
040951 - Millie's letter says...
040952 -
040953 -    1.  Subject: Blood Test 081226 Neupogen ANC below 1000
040954 -        Date: Tue, 23 Dec 2008 23:51:13 -0800
040962 -         ..
040963 -    2.  Confirming your call yesterday, saying that Doctor Rugo concurs
040964 -        with Kaiser's practice to prescribe Neupogen in my case when
040965 -        ANC falls below 1000, which was applied previously by Doctor
040966 -        Johnson at Kaiser, reported on 081210. ref SDS 4 J43V
040967 -
040968 -            [On 090109 UCSF letter orders Neupogen treatment because
040969 -            blood counts NEUTS 0.87 are below 1.00. ref SDS 12 UX4V
040971 -         ..
040972 -    3.  As noted in the letter to the medical team earlier today,
040973 -        Doctor Johnson ordered a blood test for 081226 to evaluate the
040974 -        treatment plan, as requested by UCSF [during the meeting on
040975 -        081218, ref SDS 5 BQ8F].  I am scheduled to get Neupogen on
040976 -        081226 and 081227.  This will be canceled if ANC is greater
040977 -        than 1000.  I expect it will be, after a week without
040978 -        treatments, and 2 Neupogen treatments last week.
040979 -
040981 -         ..
040982 -        Commend Glenna UCSF Coordination Patient Case Management
040983 -
040984 -    4.  Thanks very much for calling to ask how I am doing [earlier
040985 -        today on 081223 - reported in the record the next day on
040986 -        081224. ref SDS 11 BJ97].  It means a lot to know I am not
040987 -        sailing alone out here in the "deep water." I adored Jackie,
040988 -        and worried when she left UCSF.  You have been a terrific
040989 -        coordinator in every respect.  I have been blessed to get two
040990 -        great people in a row.
040991 -
040992 -            [On 081224 report Glenna's call today asking about Millie's
040993 -            response to treatment. ref SDS 11 BJ97
040995 -             ..
040996 -            [On 081224 Millie received a letter from Glenna apoligizing
040997 -            for not calling back with planning guidance for Millie's
040998 -            care, and due to a hectic schedule. ref SDS 11 0E6G
041000 -             ..
041001 -            [On 090116 Glenna called again to ask about response to
041002 -            treatment. ref SDS 13 JY6L
041003 -
041010 -
041011 -
041012 -
041013 -
041014 -
041015 -
041016 -
041017 -
0411 -