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 24, 2008 07:00 AM Wednesday; Rod Welch

Millie sunitinib #36 paused until Dec 26th so blood counts can recover

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 F9 0000. ref SDS F8 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 F9 505G, ref SDS F8 505G.
040904 -
040905 - Background on starting treatment is reported in the record on 081214.
040906 - ref SDS E5 505G
040908 -  ..
040909 - Background on good response after 35 treatments, and severe side
040910 - effects summarized in the record on 081219. ref SDS F3 FS5N
040912 -  ..
040913 - Background pausing sunitinib and cyclophosphamide treatments from
040914 - 081218 until 081226, ref SDS F9 716I, and after 4 days Millie
040915 - experienced reduced side effects, was reported on 081223. ref SDS F9
040916 - 6E7G
040918 -  ..
040919 - Today side effects are further reduced.  Millie is more energetic
040920 - moving around with strength and purpose. ref SDS 0 6E7G  She planned
040921 - to go hiking at Lafayette reservoir today.  Bad weather changed
040922 - activities today, ref SDS 0 3E4K, and so she will go to the Wellness
040923 - Community Support group meeting.
040925 -  ..
040926 - IBC seems to be recurring suddenly today with increased intensity,
040927 - most notably in the breasbone area.  The entire left chest wrapping
040928 - toward the back now has definite color which had subsided the past few
040929 - weeks, reported on 081218. ref SDS F2 WS8N
040930 -
040931 -        [On 081225 IBC seems to rise further while Millie is not
040932 -        getting treatment. ref SDS G0 1Y4I
040934 -         ..
040935 -        [On 081226 IBC rash seems to subsided after rising today and
040936 -        tomorrow, and resumes treatment with sunitinib and
040937 -        cyclophyosphamide. ref SDS G1 124N
040939 -         ..
040940 -        [On 081230 0109 Millie's letter to medical team reports IBC
040941 -        seemed to significantly increase on 081224 and 081225, then
040942 -        seemed to improve somewhat. ref SDS G2 JV5M
040944 -         ..
040945 -        [On 090106 1136 Millie's letter to medical team submits
040946 -        agenda for meeting on 090108 to evaluate progress and
040947 -        reported again IBC increased then seemed to get better
040948 -        after resuming treatment on 081226. ref SDS G3 YO4V
040950 -         ..
040951 -        [On 090130 1722 Millie's letter to medical team confirms
040952 -        examination at UCSF finding IBC recurrence 6th relapse; plans
040953 -        treatment with hypertermia and Doxil chemotherapy. ref SDS G4
040954 -        4S8O
040956 -  ..
040957 - NEUTS patient history of neutropenia from chemotherapy everyday with
040958 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
040960 -  ..
040961 - Neupogen treatments on 081219 and 081220 at Kaiser, ref SDS F6 UZ7K,
040962 - help maintain blood counts to strengthen Millie's immunity system,
040963 - shown in the schedule for Neupogen treatments updated on 081220.
040964 - ref SDS F6 HS5M
040965 -
040967 -  ..
040968 - Sunitinib Cyclophosmaide Methotrexate Patient History
040969 -
040970 - Follow up ref SDS F9 OE6K, ref SDS F8 OE6K.
040971 -
040973 -        Cycle 1  begin 081128 after 14 treatmenst sunitinib alone
040974 -        Cohort: 3
040976 -        ..
040977 -                                          Cyclophos  Metho
040978 -                               Sunitinib   phamide   trexate
040979 -       Days  Date  Time  Cycle    37.5       50        5
040980 -       =======================================================
040981 -       Follow up ref SDS F9 PA8Y, ref SDS F8 PA8Y.
040982 -
040983 -        1.  081114 0700  Load    37.5         0         0 ... ref SDS 94 OE6K
040984 -        2.  081115 0700  Load    75.0         0         0 ... ref SDS 95 OE6K
040985 -        3.  081116 0700  Load   112.5         0         0 ... ref SDS 96 OE6K
040986 -        4.  081117 0700  Load   150.0         0         0 ... ref SDS 97 OE6K
040987 -        5.  081118 0700  Load   187.5         0         0 ... ref SDS A0 OE6K
040988 -        6.  081119 0700  Load   225.0         0         0 ... ref SDS A2 OE6K
040989 -        7.  081120 0700  Load   263.5         0         0 ... ref SDS A3 OE6K
040990 -        8.  081121 0700  Load   301.0         0         0 ... ref SDS A4 OE6K
040991 -        9.  081122 0700  Load   338.5         0         0 ... ref SDS A5 OE6K
040992 -       10.  081123 0700  Load   376.0         0         0 ... ref SDS A6 OE6K
040993 -       11.  081124 0700  Load   413.5         0         0 ... ref SDS A7 OE6K
040994 -       12.  081125 0700  Load   451.0         0         0 ... ref SDS A8 OE6K
040995 -             ..
040996 -       13.  081126 0700  Load   488.5         0         0 ... ref SDS A9 OE6K
040997 -             ..
040998 -            081126 0820  NEUTS........1.50................... ref SDS B0 PU6K
041000 -             ..
041001 -       14.  081127 0700  Load   526.0         0         0 ... ref SDS B1 OE6K
041002 -       15.  081128 0700  1  1   563.5   1    50    1    5 ... ref SDS B4 OE6K
041003 -       16.  081129 0700  1  2   601.0   2   100    2   10 ... ref SDS B7 OE6K
041004 -       17.  081130 0700  1  3   638.5   3   150    2   10 ... ref SDS B8 OE6K
041005 -       18.  081201 0700  1  4   676.0   4   200    2   10 ... ref SDS B9 OE6K
041006 -       19.  081202 0700  1  5   713.5   5   250    2   10 ... ref SDS C1 OE6K
041007 -             ..
041008 -       20.  081203 0700  1  6   751.0   6   300    2   10 ... ref SDS C3 OE6K
041009 -
041010 -            081203 0735. NEUTS....... 0.624 ...... .......... ref SDS C2 RN5G
041011 -
041012 -                Rate of change per day = 1500 - 624 = 876 / 7
041013 -
041014 -                                       = 120+ per day
041016 -             ..
041017 -       21.  081204 0700  1  7   788.5   7   350    2   10 ... ref SDS C4 OE6K
041018 -             ..
041019 -       22.  081205 0700  1  8   826.0   8   400    3   15 ... ref SDS C5 OE6K
041020 -
041021 -            081205 1300  Neupogen...... 480 mcg  480......... ref SDS C6 KV84
041023 -             ..
041024 -       23.  081206 0700  1  9   863.5   9   450    4   20 ... ref SDS C9 OE6K
041025 -
041026 -            081206 0930  Neupogen...... 480 mcg  960......... ref SDS D0 BI4J
041028 -             ..
041029 -       24.  081207 0700  1 10   901.0  10   500    4   20 ... ref SDS D1 OE6K
041030 -       25.  081208 0700  1 11   938.5  11   550    4   20 ... ref SDS D2 OE6K
041031 -       26.  081209 0700  1 12   976.0  12   600    4   20 ... ref SDS D3 OE6K
041032 -             ..
041033 -       27.  081210 0700  1 13  1013.5  13   650    4   20 ... ref SDS D5 OE6K
041034 -
041035 -            081210 1301. NEUTS....... 1.085 ................. ref SDS D6 QY6H
041037 -             ..
041038 -       28.  081211 0700  1 14  1050.0  14   700    4   20 ... ref SDS D9 OE6K
041039 -             ..
041040 -       29.  081212 0700  1 15  1087.5  15   750    5   25 ... ref SDS E1 OE6K
041041 -
041042 -            081212 1115. NEUTS....... 1.054 ................. ref SDS E2 QY6H
041044 -             ..
041045 -       30.  081213 0700  1 16  1125.0  16   800    6   30 ... ref SDS E4 OE6K
041046 -       31.  081214 0700  1 17  1162.5  17   850    6   30 ... ref SDS E5 OE6K
041047 -       32.  081215 0700  1 18  1200.0  18   900    6   30 ... ref SDS E6 OE6K
041048 -       33.  081216 0700  1 19  1237.5  19   950    6   30 ... ref SDS E7 OE6K
041049 -             ..
041050 -       34.  081217 0700  1 20  1275.0  20  1000    6   30 ... ref SDS E8 OE6K
041051 -       35.  081218 0700  1 21  1312.5  21  1050    6   30 ... ref SDS F0 OE6K
041052 -
041053 -            081218 0830. NEUTS....... 0.740 ................. ref SDS F1 QY6H
041055 -             ..
041056 -       36.  081219 0700  2  1  paused until 081226........... ref SDS F3 OE6K
041057 -
041058 -            081219 1130  Neupogen...... 480 mcg 1440 ........ ref SDS F4 UZ7K
041059 -            081220 0900  Neupogen...... 480 mcg 1920 ........ ref SDS F6 UZ7K
041061 -  ..
041062 - Background on recent blood tests is reported yesterday on 081218.
041063 - ref SDS F0 S18L
041064 -
041065 -
041066 -
041067 -
041068 -
0411 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Side Effects Sunitinib Study with Cyclophosphamide Methotrexate
050403 -
050404 - Follow up ref SDS F9 LF8M, ref SDS F8 LF8M.
050405 -
050406 - Fatigue is a likely side effect of sunitinib with cyclophosphamide,
050407 - listed in the Consent document reviewed on 081017. ref SDS 76 4G7G
050409 -  ..
050410 - Low blood counts NEUTS 0.740 reported for the lab at UCSF on 081218,
050411 - ref SDS F1 QY6H, causing rising fatigue, reported by the medical team
050412 - during meeting at UCSF on 081218. ref SDS F2 WS4J
050414 -  ..
050415 - Background on Neupogen treatments and UCSF comments are reported on
050416 - 081207. ref SDS D1 673J
050418 -  ..
050419 - NEUTS blood tests show patient history of treatments with Nuepogen to
050420 - recover from neutropenia caused by getting chemotherapy everyday with
050421 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
050423 -  ..
050424 - Neupogen treatment on 081219 and 081220 at Kaiser, ref SDS F6 UZ7K,
050425 - helps maintain blood counts to strengthen Millie's immunity system.
050427 -  ..
050428 - Schedule for Neupogen treatments is listed on 081220. ref SDS F6 WJ4O
050430 -  ..
050431 - Sunitinib treatments were paused on 081219 until 081226, reported
050432 - 081218, ref SDS F2 QW48, so that Millie can recover from severe side
050433 - effects, including fatigue, due to very low blood counts, as discussed
050434 - with the medical team at UCSF on 081218. ref SDS F2 QW49
050436 -  ..
050437 - Millie more energetic today, continuing recovery from severe side
050438 - effects that began yesterday on 081223. ref SDS F9 6E7G  Millie
050439 - planned to go hiking today, but the weather is bad.  She went to the
050440 - group meeting at the Wellness Community and found the facility was
050441 - closed for the holidays.  She went to the store and did some shopping
050442 - for Christmas eve dinner.  Millie had a long day of Christmas eve
050443 - activity.  She went to her daughter, Pam's home and did the cooking
050444 - for prime rib.  Millie left for home about 0900, and had trouble
050445 - falling asleep.  She took an atavin.
050447 -  ..
050448 - Feet and toes better today, less sensitive to walking, reported during
050449 - the meeting at UCSF on 081218. ref SDS F2 HM4M  Subsiding side effects
050450 - restoring normal use of feet enabled exercise in the gym, following
050451 - reports yesterday on 081222 of possible less pain from walking.
050452 - ref SDS F8 UO8I
050454 -  ..
050455 - Joint pain, discomfort, and total ill feeling, and weakness much less
050456 - severe today, commonly associated with chemotherapy, reported on
050457 - 081218, ref SDS F0 E38H, and discussed with the medical team at UCSF
050458 - also on 081218, ref SDS F2 QW7H, leading to the doctor stopping all
050459 - treatment for 1 week, ref SDS F2 QW48, as shown in patient history
050460 - below. ref SDS F7 053F
050462 -  ..
050463 - Interstitional lung disease discussed in the record on 081218,
050464 - ref SDS F0 KM5F, shows no evident symptoms.
050466 -  ..
050467 - Vitals were reported today at the meeting at Kaiser with the primary
050468 - care physician...
050469 -
050470 -                   BP *** ** pulse **
050472 -  ..
050473 - Millie reports continued relief from heartburn with daily treatments
050474 - using Prilosce started on 081208. ref SDS D2 7J6K
050476 -  ..
050477 - Sore throat problem, reported initially on 081218, as having begun
050478 - days earlier, ref SDS F0 2B8M, seems better today today continuing
050479 - relief reported yesterday on 081222. ref SDS F8 TT4O  This increases
050480 - interest in eating food.  Millie had eggs and a baggel for a late
050481 - lunch after returning from the gym.  Swallowing seems much more normal
050482 - now.
050484 -  ..
050485 - Millie reports improved taste from some foods today (e.g., soup),
050486 - cited in study consent documents, reviewed on 081017. ref SDS 76 6T5H
050488 -     ..
050489 -                                   Date
050490 -    Description Adverse Event   Start  Stop     Medication
050491 -    ---------------------------------------------------------
050492 -    Follow up ref SDS F9 MV5H, ref SDS F8 MV5H.
050493 -
050494 -    Diarrhea                    081114 081114   Imodium........ ref SDS 94 LF8M
050495 -    Low pulse                   081120 081120   None........... ref SDS A3 LF8M
050496 -    Low pulse                   081121 081121   None........... ref SDS A4 7G8M
050497 -    BP 144 84 Pulse 48          081121 081121   Hiking......... ref SDS A4 LF8M
050498 -    Joint pain minor            081121 081121   Hiking......... ref SDS A4 LF8M
050499 -    Fatigue minor               081121 081121   Hiking......... ref SDS A4 LF8M
050500 -    Low pulse                   081122 081122   None........... ref SDS A5 7G8M
050501 -    Fatigue minor               081122 081122   Hiking......... ref SDS A5 LF8M
050502 -    Low pulse                   081123 081122   None........... ref SDS A6 7G8M
050503 -    BP 121 74 Pulse 53          081123 081123   Hiking......... ref SDS A6 LF8M
050504 -    Fatigue minor               081123 081122   Hiking......... ref SDS A6 LF8M
050505 -    Joint pain minor            081124 081124   Hiking......... ref SDS A7 LF8M
050506 -    Fatigue minor               081124 081124   Hiking......... ref SDS A7 LF8M
050507 -    Heartburn                   081124 081124   None........... ref SDS A7 HS9K
050508 -    BP 144 78 Pulse 52          081125 081125   Hiking......... ref SDS A8 LF8M
050509 -    Joint pain minor            081125 081125   Hiking......... ref SDS A8 LF8M
050510 -    Fatigue minor               081125 081125   Hiking......... ref SDS A8 LF8M
050511 -    Heartburn                   081125 081125   None........... ref SDS A8 HS9K
050512 -    Heartburn                   081126 081126   None........... ref SDS A9 HS9K
050513 -    Heartburn                   081127 081127   None........... ref SDS B3 HS9K
050514 -    BP 135 73 Pulse 48          081128 081128   Hiking......... ref SDS B4 5X6K
050515 -    Upset stomach               081128 081128   Hiking......... ref SDS B4 T76O
050516 -    BP 140 75 Pulse 50          081129 081129   Hiking......... ref SDS B7 5X6K
050517 -    Heartburn                   081129 081129   None........... ref SDS B7 HS9K
050518 -     ..
050519 -    Fatigue                     081129 081129   Rest........... ref SDS B7 LF8M
050520 -    Fatigue                     081130 081130   Rest........... ref SDS B8 LF8M
050521 -    BP 136 79 Pulse 46          081201 081201   Hiking......... ref SDS B9 5X6K
050522 -    Fatigue                     081201 081201   Rest........... ref SDS B9 LF8M
050523 -    Taste altered               081201 081201   Rest........... ref SDS B9 VP4G
050524 -    BP 141 77 Pulse 46          081202 081202   Aerobics gym... ref SDS C1 5X6K
050525 -    Fatigue                     081202 081202   Rest........... ref SDS C1 LF8M
050526 -    Taste altered               081202 081202   Rest........... ref SDS C1 VP4G
050527 -    BP 138 77 Pulse 48          081203 081203   Hiking......... ref SDS C3 5X6K
050528 -    Fatigue                     081203 081203   Rest........... ref SDS C3 LF8M
050529 -    Taste altered               081203 081203   Rest........... ref SDS C3 VP4G
050530 -    NEUTS (ANC)     0.624       081203 081203   Neupogen.......
050531 -    BP 133 72 Pulse 45          081204 081204   Rest........... ref SDS C4 5X6K
050532 -    Fatigue                     081204 081204   Rest........... ref SDS C4 LF8M
050533 -    Taste altered               081204 081204   Rest........... ref SDS C4 VP4G
050534 -    BP 138 76 Pulse 49          081205 081205   Rest........... ref SDS C5 5X6K
050535 -    Diarrhea                    081205 081114   Imodium........ ref SDS C5 Q67F
050536 -    Fatigue                     081205 081205   Rest........... ref SDS C5 LF8M
050537 -    Taste altered               081205 081205   Rest........... ref SDS C5 VP4G
050538 -    BP *** ** Pulse **          081206 081206   Rest........... ref SDS C9 5X6K
050539 -    Fatigue                     081206 081206   Rest........... ref SDS C9 LF8M
050540 -    BP 128 70 Pulse 53          081207 081207   Hiking......... ref SDS D1 5X6K
050541 -    Fatigue                     081207 081207   Rest........... ref SDS D1 LF8M
050542 -    BP 137 68 Pulse 53          081208 081208   Rest........... ref SDS D2 5X6K
050543 -    Fatigue                     081208 081208   Rest........... ref SDS D2 LF8M
050544 -    BP *** ** Pulse **          081209 081209   Rest........... ref SDS D2 5X6K
050545 -    Fatigue                     081209 081209   Rest........... ref SDS D2 LF8M
050546 -    Heartburn                   081209 081209   Prilosec....... ref SDS D3 7J6K
050547 -    BP 136 70 Pulse 53          081210 081210   Rest........... ref SDS D5 5X6K
050548 -    Fatigue                     081210 081210   Rest........... ref SDS D5 LF8M
050549 -    Heartburn                   081210 081210   Prilosec....... ref SDS D5 7J6K
050550 -    BP *** ** Pulse **          081211 081211   Rest........... ref SDS D9 5X6K
050551 -    Fatigue                     081211 081211   Exercise gym... ref SDS D9 LF8M
050552 -    Heartburn                   081211 081211   Prilosec....... ref SDS D9 7J6K
050553 -    BP 137 76 Pulse 53          081212 081212   Rest........... ref SDS E1 5X6K
050554 -    Fatigue                     081212 081212   Exercise gym... ref SDS E1 LF8M
050555 -    Heartburn                   081212 081212   Prilosec....... ref SDS E1 7J6K
050556 -    BP 147 80 Pulse 51          081213 081213   Rest........... ref SDS E4 5X6K
050557 -    Fatigue                     081213 081213   Exercise gym... ref SDS E4 LF8M
050558 -    BP *** ** Pulse **          081214 081214   Rest........... ref SDS E5 5X6K
050559 -    Fatigue                     081214 081214   Rest........... ref SDS E5 LF8M
050560 -    BP *** ** Pulse **          081215 081215   Rest........... ref SDS E6 5X6K
050561 -    Fatigue                     081215 081215   Rest........... ref SDS E6 LF8M
050562 -    BP 144 79 Pulse 54          081216 081216   Rest........... ref SDS E7 5X6K
050563 -    Fatigue                     081216 081216   Exercise gym... ref SDS E7 LF8M
050564 -     ..
050565 -    Joint pain minor            081216 081216   Rest........... ref SDS E7 E38H
050566 -    BP 137 69 Pulse 63          081217 081217   Rest........... ref SDS E8 5X6K
050567 -    Fatigue                     081217 081217   Rest........... ref SDS E8 LF8M
050568 -    Joint pain minor            081217 081217   Rest........... ref SDS E8 E38H
050569 -    Nosebleed minor             081217 081217   Rest........... ref SDS E8 ZF5F
050570 -     ..
050571 -    BP *** ** Pulse **          081218 081218   Rest........... ref SDS F0 5X6K
050572 -    Fatigue                     081218 081218   Rest........... ref SDS F0 LF8M
050573 -    Joint pain minor            081218 081218   Rest........... ref SDS F0 E38H
050574 -    Nosebleed moderate          081218 081218   Rest........... ref SDS F0 ZF5F
050575 -    Throat pain eating          081218 081218   Eating less.... ref SDS F0 2B8M
050576 -    BP 155 84 Pulse 53          081219 081219   Rest........... ref SDS F3 5X6K
050577 -    Fatigue                     081121 081219   Rest........... ref SDS F3 LF8M
050578 -    Feet toes lesions           081219 081219   Rest........... ref SDS F3 UO8I
050579 -    Joint pain ill feeling      081121 081219   Rest........... ref SDS F3 E38H
050580 -    Throat sore eating          081218 081219   Eating less.... ref SDS F3 TT4O
050581 -    BP 123 69 pulse 53          081220 081220   Rest........... ref SDS F5 5X6K
050582 -    Fatigue                     081121 081220   Rest........... ref SDS F5 LF8M
050583 -    Feet toes lesions           081219 081220   Rest........... ref SDS F5 UO8I
050584 -    Joint pain ill feeling      081121 081220   Rest........... ref SDS F5 E38H
050585 -    Throat sore eating          081218 081220   Eating less.... ref SDS F5 TT4O
050586 -    BP 117 71 pulse 65          081221 081221   Rest........... ref SDS F7 5X6K
050587 -    Fatigue                     081121 081221   Rest........... ref SDS F7 LF8M
050588 -    Feet toes lesions           081219 081221   Rest........... ref SDS F7 UO8I
050589 -    Joint pain ill feeling      081121 081221   Rest........... ref SDS F7 E38H
050590 -    Throat sore eating          081218 081221   Eating less.... ref SDS F7 TT4O
050591 -    BP 117 71 pulse 65          081222 081222   Rest........... ref SDS F8 5X6K
050592 -    Fatigue                     081121 081222   Rest........... ref SDS F8 LF8M
050593 -    Feet toes lesions           081219 081222   Rest........... ref SDS F8 UO8I
050594 -    Joint pain ill feeling      081121 081222   Rest........... ref SDS F8 E38H
050595 -    Throat sore eating          081218 081222   Eating less.... ref SDS F8 TT4O
050596 -    BP 143 68 pulse 65          081223 081223   Rest........... ref SDS F8 5X6K
050597 -    Fatigue more energy         081121 081223   Exercise gym... ref SDS F9 LF8M
050598 -    Feet feel better            081219 081223   Exercise gym... ref SDS F9 UO8I
050599 -    Joint pain subsides         081121 081223   Exercise gym... ref SDS F9 E38H
050600 -    Throat sore improved        081218 081223   Eating normal.. ref SDS F9 TT4O
050601 -    BP *** ** pulse **          081224 081224   Rest........... ref SDS 0 5X6K
050602 -    Fatigue more energy         081121 081224   Activity....... ref SDS 0 LF8M
050603 -    Feet feel better            081219 081224   Activity....... ref SDS 0 UO8I
050604 -    Joint pain subsides         081121 081224   Activity....... ref SDS 0 E38H
050605 -    Throat sore improved        081218 081224   Eating normal.. ref SDS 0 TT4O
050606 -
050607 -
050608 -
0507 -

SUBJECTS
Default Null Subject Account for Blank Record

0603 -
060401 -  ..
060402 - Exercise Hiking Maintain Fitness Strengthen Immune System
060403 -
060404 - Follow up ref SDS F9 3E4K, ref SDS F8 3E4K.
060406 -  ..
060407 - Millie feels energetic again today.  She planned to go hiking at
060408 - Lafayette tomorrow, perhaps part of a lap, but the weather is bad for
060409 - outside activities.
060411 -  ..
060412 - Increased exercise today reflects rising energy from subsiding side
060413 - effects, per above, ref SDS 0 6E7G, after pausing daily treatments
060414 - with cyclophosphamide and sunitinib, also reported yesterday on
060415 - 081223. ref SDS F9 716I
060417 -  ..
060418 - NEUTS blood tests show patient history treatments with Nuepogen for
060419 - neutropenia from chemotherapy everyday with cyclophosphamide reported
060420 - in case study on 081205. ref SDS C5 EC5N
060422 -  ..
060423 - Millie had her 35th treatment with sunitinib on 081218. ref SDS F0
060424 - PA8Y
060426 -  ..
060427 - Sunitinib treatments were paused on 081218 until 081226, reported
060428 - 081218, ref SDS F2 QW48, so that Millie can recover from severe side
060429 - effects, including fatigue, due to very low blood counts. ref SDS F2
060430 - QW49
060432 -  ..
060433 - On 081110, Millie complained about difficulty lifting herself from a
060434 - full squatting position. ref SDS 90 HX67  For several weeks, she was
060435 - exercising to strengthen legs, and arms, shown by going to the gym on
060436 - 081211. ref SDS D9 3E4K  Rising fatigue now prevents continuing
060437 - exercise.
060438 -
060440 -  ..
060441 - Case Study on Pateint History Exercising
060442 -
060443 - Follow up ref SDS F9 X64F, ref SDS F8 X64F.
060444 -
060445 -                                              +- scm = Sunitinib Cyclophosphmaide Methotrexate
060446 -                                              +- sc  = Sunitinib Cyclophosphmaide
060447 -                           Time     Pulse     |
060448 -    Location        Miles Minutes  Avg Max  Chem  Neupo  Date
060449 -    ----------------------------------------------------------------
060450 -    Concord home                                        081224, ref SDS 0 3E4K
060451 -    Concord home (gym)                                  081223, ref SDS F9 3E4K
060452 -    Concord home                                        081222, ref SDS F8 3E4K
060453 -    Concord home                                        081221, ref SDS F7 3E4K
060454 -    Concord home                                        081220, ref SDS F5 3E4K
060455 -    Concord home                                        081219, ref SDS F3 3E4K
060456 -    Concord home                              sc        081218, ref SDS F0 3E4K
060457 -    Concord home                              sc        081217, ref SDS E8 3E4K
060458 -    Concord home (gym)                        sc        081216, ref SDS E7 3E4K
060459 -    Concord home                              sc        081215, ref SDS E6 3E4K
060460 -    Concord home                              sc        081214, ref SDS E5 3E4K
060461 -    Concord home (gym)                        scm       081213, ref SDS E4 3E4K
060462 -    Concord home                              scm       081212, ref SDS E1 3E4K
060463 -    Concord home (gym)                        sc        081211, ref SDS D9 3E4K
060464 -    Concord home                              sc        081210, ref SDS D5 3E4K
060465 -    Concord home                              sc        081209, ref SDS D3 3E4K
060466 -    Concord home                              sc        081208, ref SDS D2 3E4K
060467 -    Lafayette        4.75   78.6    95 110    sc        081207, ref SDS D1 3E4K
060468 -    Concord home                              scm       081206, ref SDS C9 3E4K
060469 -    Concord home                              scm       081205, ref SDS C5 3E4K
060470 -    Concord home                              sc        081204, ref SDS C4 3E4K
060471 -    Lafayette        2.75   62.7    90 117    sc        081203, ref SDS C3 3E4K
060472 -    Concord home (gym)                        sc        081202, ref SDS C1 3E4K
060473 -    Lafayette        5.50  102.3    95 122    sc        081201, ref SDS B9 3E4K
060474 -    Concord home                              sc        081130, ref SDS B8 3E4K
060475 -    Lafayette        2.75   56.7    90 115    scm       081129, ref SDS B7 3E4K
060476 -    Lafayette        2.75   46.5   100 128    scm       081128, ref SDS B4 3E4K
060477 -    Lafayette        5.50   93.3   100 122    s         081127, ref SDS B3 3E4K
060478 -    Concord home                              s         081126, ref SDS A9 3E4K
060479 -    Lafayette        4.00   73.7   105 127    s         081125, ref SDS A8 3E4K
060480 -    Lafayette        5.50   91.4   100 129    s         081124, ref SDS A7 3E4K
060481 -    Concord home                              s         081123, ref SDS A6 3E4K
060482 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS A5 3E4K
060483 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS A4 3E4K
060484 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS A3 3E4K
060485 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS A2 3E4K
060486 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS A1 3E4K
060487 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 98 3E4K
060488 -    Concord home                              s         081116, ref SDS 96 Y68J
060489 -    Concord home                              s         081115, ref SDS 95 EK7I
060490 -    Concord home                              s         081114, ref SDS 94 XW6H
060491 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 90 3E4K
060492 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 89 3E4K
060493 -    Kaiser                                         x    081108, ref SDS 88 UZ7K
060494 -    Kaiser                                         x    081107, ref SDS 87 UZ7K
060495 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 83 3E4K
060496 -    Kaiser                                         x    081025, ref SDS 83 UZ7K
060497 -    Kaiser                                         x    081024, ref SDS 82 UZ7K
060498 -    UCSF                                      c         081023, ref SDS 81 V94O
060499 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 80 3E4K
060500 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 79 3E4K
060501 -    Kaiser                                         x    081018, ref SDS 78 UZ7K
060502 -    Kaiser                                         x    081017, ref SDS 77 UZ7K
060503 -    UCSF                                      e         081016, ref SDS 75 V94O
060504 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 74 3E4K
060505 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 73 3E4K
060506 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 72 3E4K
060507 -    Kaiser                                         x    081011, ref SDS 71 UZ7K
060508 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 70 3E4K
060509 -    Kaiser                                         x    081010, ref SDS 70 UZ7K
060510 -    UCSF                                      e         081009, ref SDS 69 V94O
060511 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 68 3E4K
060512 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 67 3E4K
060513 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 66 3E4K
060514 -    UCSF                                      c         081002, ref SDS 65 V94O
060515 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 64 3E4K
060516 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 64 3E4K
060517 -    Kaiser                                         x    080927, ref SDS 63 UZ7K
060518 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 62 3E4K
060519 -    UCSF                                      c         080925, ref SDS 61 V94O
060520 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 60 3E4K
060521 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 60 3E4K
060522 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 60 3E4K
060523 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 59 3E4K
060524 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 58 3E4K
060525 -    UCSF                                      c         080918, ref SDS 57 V94O
060526 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 58 3E4K
060527 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 56 3E4K
060528 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 55 3E4K
060529 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 54 3E4K
060530 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 53 3E4K
060531 -    UCSF                                      c         080911, ref SDS 52 V94O
060532 -    Lafayette        2.75   46.8   113 140              080909
060533 -    Lafayette        5.50   89.2   117 143              080908
060534 -    Lafayette        5.50   92.1   115 138              080907
060535 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 51 3E4K
060536 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 50 3E4K
060537 -    UCSF                                      c         080904, ref SDS 49 V94O
060538 -    Lafayette        8.25  140.4   116 131              080903
060539 -    Lafayette        5.50   94.9   115 134              080902
060540 -    Kaiser                                         x    080830
060541 -    Kaiser                                         x    080829
060542 -    UCSF                                      c         080828, ref SDS 48 V94O
060543 -    Lafayette        5.50   93.6   120 137              080826
060544 -    Lafayette        5.50   93.2   117 138              080825
060545 -    Lafayette        5.50   93.2   123 136         x    080823
060546 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 47 3E4K
060547 -    UCSF                                      e         080821, ref SDS 46 V94O
060548 -    Lafayette        5.50   94.7   115 137              080820
060549 -    Lafayette        5.50   94.3   115 135              080819
060550 -    Lafayette        8.25  141.7   118 134              080815
060551 -    UCSF                                      e         080814, ref SDS 45 V94O
060552 -    Lafayette        5.50   93.8   120 136              080813
060553 -    Lafayette        5.50   94.4   116 139              080812
060554 -    Lafayette        5.50   94.2   119 133              080810
060555 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 43 3E4K
060556 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 42 3E4K
060557 -    UCSF                                      c         080807, ref SDS 41 V94O
060558 -    Lafayette        8.25  143.7   115 132              080805
060559 -    Concord          7.00  127.6   105 118              080804
060560 -    Lafayette        8.25  143.2   112 134              080802
060561 -    Lafayette        5.50   93.4   115 138              080801
060562 -    Lafayette        5.50   92.2   118 140              080729
060563 -    Lafayette        5.50   92.6   116 137              080728
060564 -    Lafayette        8.25  142.6   114 134              080727
060565 -    Lafayette        5.50   91.5   120 143              080726
060566 -    Lafayette        8.25  140.8   117 135              080725
060567 -    Lafayette        5.50   91.8   122 141              080723
060568 -    Lafayette        5.50   91.3   120 139              080722
060569 -    Lafayette        8.25  143.3   115 133              080720
060570 -    Lafayette        5.50   90.7   125 144              080719
060571 -    Lafayette        5.50   92.4   123 142              080716
060572 -    Lafayette        2.25   46.8   116 137              080715
060573 -    Lafayette        8.25  141.8   116 136              080712
060574 -    Lafayette        5.50   92.9   116 139              080711
060575 -    Lafayette        8.25  143.3   113 137              080704
060576 -    Lafayette        5.50   90.2   121 147              080630
060577 -    Lafayette        8.25  142.4   116 138              080628
060578 -    Lafayette        5.50   91.4   118 138              080625
060579 -    Lafayette        2.25   47.9   116 136              080623
060580 -    Lafayette        5.50   94.2   112 138              080622
060581 -    Lafayette        5.50   94.7   115 133              080621
060582 -    Lafayette        2.25   48.3   110 129              080620
060583 -    Mt Diablo        7.00  129.4   130 153              080616
060584 -    Lafayette        5.50   90.8   120 146              080615
060585 -    Lafayette        5.50   91.3   124 144              080614
060586 -    Lafayette        5.50   89.7   122 143              080613
060587 -    Lafayette        2.76   45.8   120 147              080611
060588 -    Lafayette        5.50   90.5   123 145              080609
060589 -    Lafayette        5.50   92.7   115 138              080607
060590 -    Lafayette        5.50   94.2   118 139              080602
060591 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 19 WO8M
060592 -
060593 -
060594 -
060595 -
060596 -
060597 -
0606 -