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 26, 2008 07:00 AM Friday; Rod Welch

Millie sunitinib #36 treatment IBC 5th relapse.

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 G1 0000. ref SDS G0 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 G1 505G, ref SDS G0 505G.
040904 -
040905 - Background on...
040906 -
040907 -    1.  Starting treatment with Sunitinib protocol, including 14 days
040908 -        with only Sunitinib to evaluate effectiveness, and tolerance of
040909 -        side effects, reported in the record on 081214. ref SDS E5 505G
040911 -         ..
040912 -    2.  Good response after 35 treatments with Sunitinib, and 21
040913 -        treatments with cyclophosphamide and Methotrexate; Millie
040914 -        experienced severe side effects summarized in the record on
040915 -        081219. ref SDS F3 FS5N
040917 -         ..
040918 -    3.  Sunitinib and cyclophosphamide treatments were paused on 081218
040919 -        until 081226, ref SDS F9 716I, and after 4 days Millie
040920 -        experienced reduced side effects, was reported on 081223.
040921 -        ref SDS F9 6E7G
040923 -         ..
040924 -    4.  IBC recurring with increased intensity, reported beginning on
040925 -        081224. ref SDS G0 1Y4I  Millie wanted to start taking
040926 -        treatment yesterday on Thursday, ref SDS G1 1Y4I, but waited
040927 -        until yesterday, and by that time,
040929 -  ..
040930 - Today, IBC nodules and rash seem to have subsided; nodules in
040931 - breastbone area seem less intense, after rising the past 2 days,
040932 - reported yesterday on 081225, ref SDS G1 1Y4I, and even before
040933 - starting treatment today.
040934 -
040935 -            [On 081230 0109 Millie's letter to medical team reports IBC
040936 -            seemed to significantly increase on 081224 and 081225, then
040937 -            seemed to improve somewhat. ref SDS G3 JV5M
040939 -  ..
040940 - Treatment resumed today on 081226 with sunitinib and cyclophosphamide
040941 - and Methotrexate was terminated.
040943 -  ..
040944 - Today side effects are further reduced.  Millie is more energetic
040945 - moving around with strength and purpose. ref SDS G1 6E7G  Bad weather
040946 - continues to curtail hiking.  Millie drove to Grass Valley for
040947 - Christmas day with the family all gathering at Steve and Lilly's.
040949 -  ..
040950 - NEUTS patient history of neutropenia from chemotherapy everyday with
040951 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
040953 -  ..
040954 - Neupogen treatments on 081219 and 081220 at Kaiser, ref SDS F6 UZ7K,
040955 - help maintain blood counts to strengthen Millie's immunity system,
040956 - shown in the schedule for Neupogen treatments updated on 081220.
040957 - ref SDS F6 HS5M
040958 -
040960 -  ..
040961 - Sunitinib Cyclophosmaide Methotrexate Patient History
040962 -
040963 - Follow up ref SDS G1 OE6K, ref SDS G0 OE6K.
040964 -
040966 -        Cycle 1  begin 081128 after 14 treatmenst sunitinib alone
040967 -        Cohort: 3
040969 -        ..
040970 -                                          Cyclophos  Metho
040971 -                               Sunitinib   phamide   trexate
040972 -       Days  Date  Time  Cycle    37.5       50        5
040973 -       =======================================================
040974 -       Follow up ref SDS G1 PA8Y, ref SDS G0 PA8Y.
040975 -
040976 -        1.  081114 0700  Load    37.5         0         0 ... ref SDS 94 OE6K
040977 -        2.  081115 0700  Load    75.0         0         0 ... ref SDS 95 OE6K
040978 -        3.  081116 0700  Load   112.5         0         0 ... ref SDS 96 OE6K
040979 -        4.  081117 0700  Load   150.0         0         0 ... ref SDS 97 OE6K
040980 -        5.  081118 0700  Load   187.5         0         0 ... ref SDS A0 OE6K
040981 -        6.  081119 0700  Load   225.0         0         0 ... ref SDS A2 OE6K
040982 -        7.  081120 0700  Load   263.5         0         0 ... ref SDS A3 OE6K
040983 -        8.  081121 0700  Load   301.0         0         0 ... ref SDS A4 OE6K
040984 -        9.  081122 0700  Load   338.5         0         0 ... ref SDS A5 OE6K
040985 -       10.  081123 0700  Load   376.0         0         0 ... ref SDS A6 OE6K
040986 -       11.  081124 0700  Load   413.5         0         0 ... ref SDS A7 OE6K
040987 -       12.  081125 0700  Load   451.0         0         0 ... ref SDS A8 OE6K
040988 -             ..
040989 -       13.  081126 0700  Load   488.5         0         0 ... ref SDS A9 OE6K
040990 -             ..
040991 -            081126 0820  NEUTS........1.50................... ref SDS B0 PU6K
040993 -             ..
040994 -       14.  081127 0700  Load   526.0         0         0 ... ref SDS B1 OE6K
040995 -       15.  081128 0700  1  1   563.5   1    50    1    5 ... ref SDS B4 OE6K
040996 -       16.  081129 0700  1  2   601.0   2   100    2   10 ... ref SDS B7 OE6K
040997 -       17.  081130 0700  1  3   638.5   3   150    2   10 ... ref SDS B8 OE6K
040998 -       18.  081201 0700  1  4   676.0   4   200    2   10 ... ref SDS B9 OE6K
040999 -       19.  081202 0700  1  5   713.5   5   250    2   10 ... ref SDS C1 OE6K
041000 -             ..
041001 -       20.  081203 0700  1  6   751.0   6   300    2   10 ... ref SDS C3 OE6K
041002 -
041003 -            081203 0735. NEUTS....... 0.624 ...... .......... ref SDS C2 RN5G
041004 -
041005 -                Rate of change per day = 1500 - 624 = 876 / 7
041006 -
041007 -                                       = 120+ per day
041009 -             ..
041010 -       21.  081204 0700  1  7   788.5   7   350    2   10 ... ref SDS C4 OE6K
041011 -             ..
041012 -       22.  081205 0700  1  8   826.0   8   400    3   15 ... ref SDS C5 OE6K
041013 -
041014 -            081205 1300  Neupogen...... 480 mcg  480......... ref SDS C6 KV84
041016 -             ..
041017 -       23.  081206 0700  1  9   863.5   9   450    4   20 ... ref SDS C9 OE6K
041018 -
041019 -            081206 0930  Neupogen...... 480 mcg  960......... ref SDS D0 BI4J
041021 -             ..
041022 -       24.  081207 0700  1 10   901.0  10   500    4   20 ... ref SDS D1 OE6K
041023 -       25.  081208 0700  1 11   938.5  11   550    4   20 ... ref SDS D2 OE6K
041024 -       26.  081209 0700  1 12   976.0  12   600    4   20 ... ref SDS D3 OE6K
041025 -             ..
041026 -       27.  081210 0700  1 13  1013.5  13   650    4   20 ... ref SDS D5 OE6K
041027 -
041028 -            081210 1301. NEUTS....... 1.085 ................. ref SDS D6 QY6H
041030 -             ..
041031 -       28.  081211 0700  1 14  1050.0  14   700    4   20 ... ref SDS D9 OE6K
041032 -             ..
041033 -       29.  081212 0700  1 15  1087.5  15   750    5   25 ... ref SDS E1 OE6K
041034 -
041035 -            081212 1115. NEUTS....... 1.054 ................. ref SDS E2 QY6H
041037 -             ..
041038 -       30.  081213 0700  1 16  1125.0  16   800    6   30 ... ref SDS E4 OE6K
041039 -       31.  081214 0700  1 17  1162.5  17   850    6   30 ... ref SDS E5 OE6K
041040 -       32.  081215 0700  1 18  1200.0  18   900    6   30 ... ref SDS E6 OE6K
041041 -       33.  081216 0700  1 19  1237.5  19   950    6   30 ... ref SDS E7 OE6K
041042 -             ..
041043 -       34.  081217 0700  1 20  1275.0  20  1000    6   30 ... ref SDS E8 OE6K
041044 -       35.  081218 0700  1 21  1312.5  21  1050    canceled.. ref SDS F0 OE6K
041045 -
041046 -            081218 0830. NEUTS....... 0.740 ................. ref SDS F1 QY6H
041048 -             ..
041049 -            081219 0700  2  1  paused until 081226........... ref SDS F3 OE6K
041051 -             ..
041052 -            081219 1130  Neupogen...... 480 mcg 1440 ........ ref SDS F4 UZ7K
041053 -            081220 0900  Neupogen...... 480 mcg 1920 ........ ref SDS F6 UZ7K
041055 -             ..
041056 -       36.  081226 0700  2  1  1350.0  22  1100.............. ref SDS 0 OE6K
041058 -  ..
041059 - Background on recent blood tests is reported on 081218. ref SDS F0
041060 - S18L
041061 -
041062 -        [On 081230 case study dilemma cancer treatmnets cause low blood
041063 -        counts, which prevents getting treatment; not getting treatment
041064 -        incerases cancer; UCSF paused treatment for a week and
041065 -        prescribed Neupogen to increase blood counts. ref SDS G3 I87N
041066 -
041067 -
041068 -
041069 -
041070 -
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 G1 LF8M, ref SDS G0 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 - Today, after pausing cancer treatment for a week, and getting 2
050416 - Neupogen treatments, reported on 081220, ref SDS F6 P73J, NEUTS 1.71
050417 - (ANC 1710) increased substantially in the blood test at Kaiser today.
050418 - ref SDS G2 B35J  Substantial increase in blood counts accomplishes
050419 - Doctor Rugo's work plan on 081218. ref SDS F2 BQ8F
050420 -
050421 -        [On 081230 case study dilemma cancer treatmnets cause low blood
050422 -        counts, which prevents getting treatment; not getting treatment
050423 -        incerases cancer; UCSF paused treatment for a week and
050424 -        prescribed Neupogen to increase blood counts. ref SDS G3 I87N
050426 -  ..
050427 - Background on Neupogen treatments and UCSF comments are reported on
050428 - 081207. ref SDS D1 673J
050430 -  ..
050431 - NEUTS blood tests show patient history of treatments with Nuepogen to
050432 - recover from neutropenia caused by getting chemotherapy everyday with
050433 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
050435 -  ..
050436 - Neupogen treatment on 081219 and 081220 at Kaiser, ref SDS F6 UZ7K,
050437 - helps maintain blood counts to strengthen Millie's immunity system.
050439 -  ..
050440 - Schedule for Neupogen treatments is listed on 081220. ref SDS F6 WJ4O
050442 -  ..
050443 - Sunitinib treatments were paused on 081219 until 081226, reported
050444 - 081218, ref SDS F2 QW48, so that Millie can recover from severe side
050445 - effects, including fatigue, due to very low blood counts, as discussed
050446 - with the medical team at UCSF on 081218. ref SDS F2 QW49
050448 -  ..
050449 - Millie more energetic today, continuing recovery from severe side
050450 - effects that began on 081223. ref SDS F9 6E7G  Millie wanted to go
050451 - hiking today, but the weather is bad.  Millie feels strong enough
050452 - today for the drive of 3 hours or so to Grass Valley to visit her son
050453 - and daughter-in-law in Grass Valley for Christmas Day.  Last night at
050454 - Christmas eve, they talked about going bowling today, and this
050455 - morning Millie feels strong enough to give this a try.
050457 -  ..
050458 - Feet and toes better today, less sensitive to walking, reported during
050459 - the meeting at UCSF on 081218. ref SDS F2 HM4M  Subsiding side effects
050460 - restoring normal use of feet enabled exercise in the gym, following
050461 - reports yesterday on 081222 of possible less pain from walking.
050462 - ref SDS F8 UO8I
050464 -  ..
050465 - Joint pain, discomfort, and total ill feeling, and weakness much less
050466 - severe today, commonly associated with chemotherapy, reported on
050467 - 081218, ref SDS F0 E38H, and discussed with the medical team at UCSF
050468 - also on 081218, ref SDS F2 QW7H, leading to the doctor stopping all
050469 - treatment for 1 week, ref SDS F2 QW48, as shown in patient history
050470 - below. ref SDS F7 053F
050472 -  ..
050473 - Interstitional lung disease discussed in the record on 081218,
050474 - ref SDS F0 KM5F, shows no evident symptoms.
050476 -  ..
050477 - Vitals were reported today at the meeting at Kaiser with the primary
050478 - care physician...
050479 -
050480 -                   BP 124 80 pulse 66
050482 -  ..
050483 - Millie reports continued relief from heartburn with daily treatments
050484 - using Prilosce started on 081208. ref SDS D2 7J6K
050486 -  ..
050487 - Sore throat problem, reported initially on 081218, as having begun
050488 - days earlier, ref SDS F0 2B8M, seems better today today continuing
050489 - relief reported yesterday on 081222. ref SDS F8 TT4O  This increases
050490 - interest in eating food.  Millie had eggs and a baggel for a late
050491 - lunch after returning from the gym.  Swallowing seems much more normal
050492 - now.
050494 -  ..
050495 - Millie reports improved taste from some foods today (e.g., soup),
050496 - cited in study consent documents, reviewed on 081017. ref SDS 76 6T5H
050498 -     ..
050499 -                                   Date
050500 -    Description Adverse Event   Start  Stop     Medication
050501 -    ---------------------------------------------------------
050502 -    Follow up ref SDS G1 MV5H, ref SDS G0 MV5H.
050503 -
050504 -    Diarrhea                    081114 081114   Imodium........ ref SDS 94 LF8M
050505 -    Low pulse                   081120 081120   None........... ref SDS A3 LF8M
050506 -    Low pulse                   081121 081121   None........... ref SDS A4 7G8M
050507 -    BP 144 84 Pulse 48          081121 081121   Hiking......... ref SDS A4 LF8M
050508 -    Joint pain minor            081121 081121   Hiking......... ref SDS A4 LF8M
050509 -    Fatigue minor               081121 081121   Hiking......... ref SDS A4 LF8M
050510 -    Low pulse                   081122 081122   None........... ref SDS A5 7G8M
050511 -    Fatigue minor               081122 081122   Hiking......... ref SDS A5 LF8M
050512 -    Low pulse                   081123 081122   None........... ref SDS A6 7G8M
050513 -    BP 121 74 Pulse 53          081123 081123   Hiking......... ref SDS A6 LF8M
050514 -    Fatigue minor               081123 081122   Hiking......... ref SDS A6 LF8M
050515 -    Joint pain minor            081124 081124   Hiking......... ref SDS A7 LF8M
050516 -    Fatigue minor               081124 081124   Hiking......... ref SDS A7 LF8M
050517 -    Heartburn                   081124 081124   None........... ref SDS A7 HS9K
050518 -    BP 144 78 Pulse 52          081125 081125   Hiking......... ref SDS A8 LF8M
050519 -    Joint pain minor            081125 081125   Hiking......... ref SDS A8 LF8M
050520 -    Fatigue minor               081125 081125   Hiking......... ref SDS A8 LF8M
050521 -    Heartburn                   081125 081125   None........... ref SDS A8 HS9K
050522 -    Heartburn                   081126 081126   None........... ref SDS A9 HS9K
050523 -    Heartburn                   081127 081127   None........... ref SDS B3 HS9K
050524 -    BP 135 73 Pulse 48          081128 081128   Hiking......... ref SDS B4 5X6K
050525 -    Upset stomach               081128 081128   Hiking......... ref SDS B4 T76O
050526 -    BP 140 75 Pulse 50          081129 081129   Hiking......... ref SDS B7 5X6K
050527 -    Heartburn                   081129 081129   None........... ref SDS B7 HS9K
050528 -     ..
050529 -    Fatigue                     081129 081129   Rest........... ref SDS B7 LF8M
050530 -    Fatigue                     081130 081130   Rest........... ref SDS B8 LF8M
050531 -    BP 136 79 Pulse 46          081201 081201   Hiking......... ref SDS B9 5X6K
050532 -    Fatigue                     081201 081201   Rest........... ref SDS B9 LF8M
050533 -    Taste altered               081201 081201   Rest........... ref SDS B9 VP4G
050534 -    BP 141 77 Pulse 46          081202 081202   Aerobics gym... ref SDS C1 5X6K
050535 -    Fatigue                     081202 081202   Rest........... ref SDS C1 LF8M
050536 -    Taste altered               081202 081202   Rest........... ref SDS C1 VP4G
050537 -    BP 138 77 Pulse 48          081203 081203   Hiking......... ref SDS C3 5X6K
050538 -    Fatigue                     081203 081203   Rest........... ref SDS C3 LF8M
050539 -    Taste altered               081203 081203   Rest........... ref SDS C3 VP4G
050540 -    NEUTS (ANC)     0.624       081203 081203   Neupogen.......
050541 -    BP 133 72 Pulse 45          081204 081204   Rest........... ref SDS C4 5X6K
050542 -    Fatigue                     081204 081204   Rest........... ref SDS C4 LF8M
050543 -    Taste altered               081204 081204   Rest........... ref SDS C4 VP4G
050544 -    BP 138 76 Pulse 49          081205 081205   Rest........... ref SDS C5 5X6K
050545 -    Diarrhea                    081205 081114   Imodium........ ref SDS C5 Q67F
050546 -    Fatigue                     081205 081205   Rest........... ref SDS C5 LF8M
050547 -    Taste altered               081205 081205   Rest........... ref SDS C5 VP4G
050548 -    BP *** ** Pulse **          081206 081206   Rest........... ref SDS C9 5X6K
050549 -    Fatigue                     081206 081206   Rest........... ref SDS C9 LF8M
050550 -    BP 128 70 Pulse 53          081207 081207   Hiking......... ref SDS D1 5X6K
050551 -    Fatigue                     081207 081207   Rest........... ref SDS D1 LF8M
050552 -    BP 137 68 Pulse 53          081208 081208   Rest........... ref SDS D2 5X6K
050553 -    Fatigue                     081208 081208   Rest........... ref SDS D2 LF8M
050554 -    BP *** ** Pulse **          081209 081209   Rest........... ref SDS D2 5X6K
050555 -    Fatigue                     081209 081209   Rest........... ref SDS D2 LF8M
050556 -    Heartburn                   081209 081209   Prilosec....... ref SDS D3 7J6K
050557 -    BP 136 70 Pulse 53          081210 081210   Rest........... ref SDS D5 5X6K
050558 -    Fatigue                     081210 081210   Rest........... ref SDS D5 LF8M
050559 -    Heartburn                   081210 081210   Prilosec....... ref SDS D5 7J6K
050560 -    BP *** ** Pulse **          081211 081211   Rest........... ref SDS D9 5X6K
050561 -    Fatigue                     081211 081211   Exercise gym... ref SDS D9 LF8M
050562 -    Heartburn                   081211 081211   Prilosec....... ref SDS D9 7J6K
050563 -    BP 137 76 Pulse 53          081212 081212   Rest........... ref SDS E1 5X6K
050564 -    Fatigue                     081212 081212   Exercise gym... ref SDS E1 LF8M
050565 -    Heartburn                   081212 081212   Prilosec....... ref SDS E1 7J6K
050566 -    BP 147 80 Pulse 51          081213 081213   Rest........... ref SDS E4 5X6K
050567 -    Fatigue                     081213 081213   Exercise gym... ref SDS E4 LF8M
050568 -    BP *** ** Pulse **          081214 081214   Rest........... ref SDS E5 5X6K
050569 -    Fatigue                     081214 081214   Rest........... ref SDS E5 LF8M
050570 -    BP *** ** Pulse **          081215 081215   Rest........... ref SDS E6 5X6K
050571 -    Fatigue                     081215 081215   Rest........... ref SDS E6 LF8M
050572 -    BP 144 79 Pulse 54          081216 081216   Rest........... ref SDS E7 5X6K
050573 -    Fatigue                     081216 081216   Exercise gym... ref SDS E7 LF8M
050574 -     ..
050575 -    Joint pain minor            081216 081216   Rest........... ref SDS E7 E38H
050576 -    BP 137 69 Pulse 63          081217 081217   Rest........... ref SDS E8 5X6K
050577 -    Fatigue                     081217 081217   Rest........... ref SDS E8 LF8M
050578 -    Joint pain minor            081217 081217   Rest........... ref SDS E8 E38H
050579 -    Nosebleed minor             081217 081217   Rest........... ref SDS E8 ZF5F
050580 -     ..
050581 -    BP *** ** Pulse **          081218 081218   Rest........... ref SDS F0 5X6K
050582 -    Fatigue                     081218 081218   Rest........... ref SDS F0 LF8M
050583 -    Joint pain minor            081218 081218   Rest........... ref SDS F0 E38H
050584 -    Nosebleed moderate          081218 081218   Rest........... ref SDS F0 ZF5F
050585 -    Throat pain eating          081218 081218   Eating less.... ref SDS F0 2B8M
050586 -    BP 155 84 Pulse 53          081219 081219   Rest........... ref SDS F3 5X6K
050587 -    Fatigue                     081121 081219   Rest........... ref SDS F3 LF8M
050588 -    Feet toes lesions           081219 081219   Rest........... ref SDS F3 UO8I
050589 -    Joint pain ill feeling      081121 081219   Rest........... ref SDS F3 E38H
050590 -    Throat sore eating          081218 081219   Eating less.... ref SDS F3 TT4O
050591 -    BP 123 69 pulse 53          081220 081220   Rest........... ref SDS F5 5X6K
050592 -    Fatigue                     081121 081220   Rest........... ref SDS F5 LF8M
050593 -    Feet toes lesions           081219 081220   Rest........... ref SDS F5 UO8I
050594 -    Joint pain ill feeling      081121 081220   Rest........... ref SDS F5 E38H
050595 -    Throat sore eating          081218 081220   Eating less.... ref SDS F5 TT4O
050596 -    BP 117 71 pulse 65          081221 081221   Rest........... ref SDS F7 5X6K
050597 -    Fatigue                     081121 081221   Rest........... ref SDS F7 LF8M
050598 -    Feet toes lesions           081219 081221   Rest........... ref SDS F7 UO8I
050599 -    Joint pain ill feeling      081121 081221   Rest........... ref SDS F7 E38H
050600 -    Throat sore eating          081218 081221   Eating less.... ref SDS F7 TT4O
050601 -    BP 117 71 pulse 65          081222 081222   Rest........... ref SDS F8 5X6K
050602 -    Fatigue                     081121 081222   Rest........... ref SDS F8 LF8M
050603 -    Feet toes lesions           081219 081222   Rest........... ref SDS F8 UO8I
050604 -    Joint pain ill feeling      081121 081222   Rest........... ref SDS F8 E38H
050605 -    Throat sore eating          081218 081222   Eating less.... ref SDS F8 TT4O
050606 -    BP 143 68 pulse 65          081223 081223   Rest........... ref SDS F8 5X6K
050607 -    Fatigue more energy         081121 081223   Exercise gym... ref SDS F9 LF8M
050608 -    Feet feel better            081219 081223   Exercise gym... ref SDS F9 UO8I
050609 -    Joint pain subsides         081121 081223   Exercise gym... ref SDS F9 E38H
050610 -    Throat sore improved        081218 081223   Eating normal.. ref SDS F9 TT4O
050611 -    BP *** ** pulse **          081224 081224   Rest........... ref SDS G0 5X6K
050612 -    Fatigue more energy         081121 081224   Exercise gym... ref SDS G0 LF8M
050613 -    Feet feel better            081219 081224   Exercise gym... ref SDS G0 UO8I
050614 -    Joint pain subsides         081121 081224   Exercise gym... ref SDS G0 E38H
050615 -    Throat sore improved        081218 081224   Eating normal.. ref SDS G0 TT4O
050616 -    BP 124 80 pulse 66          081225 081225   Rest........... ref SDS G1 5X6K
050617 -    Fatigue more energy         081121 081225   Activity....... ref SDS G1 LF8M
050618 -    Fatigue more energy         081121 081226   Activity....... ref SDS 0 LF8M
050619 -
050620 -
050621 -
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 G1 3E4K, ref SDS G0 3E4K.
060406 -  ..
060407 - Millie feels energetic again today.  She planned to hiking at
060408 - Lafayette tomorrow, perhaps part of a lap, but the weather is bad
060409 - again today for outside activities.  May try bowling with the kids
060410 - while visiting in Grass Valley, a drive of 3 hours or so.
060412 -  ..
060413 - Increased exercise today reflects rising energy from subsiding side
060414 - effects, per above, ref SDS G1 6E7G, after pausing daily treatments
060415 - with cyclophosphamide and sunitinib, also reported yesterday on
060416 - 081223. ref SDS F9 716I
060418 -  ..
060419 - NEUTS blood tests show patient history treatments with Nuepogen for
060420 - neutropenia from chemotherapy everyday with cyclophosphamide reported
060421 - in case study on 081205. ref SDS C5 EC5N
060423 -  ..
060424 - Millie had her 35th treatment with sunitinib on 081218. ref SDS F0
060425 - PA8Y
060427 -  ..
060428 - Sunitinib treatments were paused on 081218 until 081226, reported
060429 - 081218, ref SDS F2 QW48, so that Millie can recover from severe side
060430 - effects, including fatigue, due to very low blood counts. ref SDS F2
060431 - QW49
060433 -  ..
060434 - On 081110, Millie complained about difficulty lifting herself from a
060435 - full squatting position. ref SDS 90 HX67  For several weeks, she was
060436 - exercising to strengthen legs, and arms, shown by going to the gym on
060437 - 081211. ref SDS D9 3E4K  Rising fatigue now prevents continuing
060438 - exercise.
060439 -
060441 -  ..
060442 - Case Study on Pateint History Exercising
060443 -
060444 - Follow up ref SDS G1 X64F, ref SDS G0 X64F.
060445 -
060446 -                                              +- scm = Sunitinib Cyclophosphmaide Methotrexate
060447 -                                              +- sc  = Sunitinib Cyclophosphmaide
060448 -                           Time     Pulse     |
060449 -    Location        Miles Minutes  Avg Max  Chem  Neupo  Date
060450 -    ----------------------------------------------------------------
060451 -    Concord home                              sc        081226, ref SDS 0 3E4K
060452 -    Concord travel                                      081225, ref SDS G1 3E4K
060453 -    Concord home                                        081224, ref SDS G0 3E4K
060454 -    Concord home (gym)                                  081223, ref SDS F9 3E4K
060455 -    Concord home                                        081222, ref SDS F8 3E4K
060456 -    Concord home                                        081221, ref SDS F7 3E4K
060457 -    Concord home                                        081220, ref SDS F5 3E4K
060458 -    Concord home                                        081219, ref SDS F3 3E4K
060459 -    Concord home                              sc        081218, ref SDS F0 3E4K
060460 -    Concord home                              sc        081217, ref SDS E8 3E4K
060461 -    Concord home (gym)                        sc        081216, ref SDS E7 3E4K
060462 -    Concord home                              sc        081215, ref SDS E6 3E4K
060463 -    Concord home                              sc        081214, ref SDS E5 3E4K
060464 -    Concord home (gym)                        scm       081213, ref SDS E4 3E4K
060465 -    Concord home                              scm       081212, ref SDS E1 3E4K
060466 -    Concord home (gym)                        sc        081211, ref SDS D9 3E4K
060467 -    Concord home                              sc        081210, ref SDS D5 3E4K
060468 -    Concord home                              sc        081209, ref SDS D3 3E4K
060469 -    Concord home                              sc        081208, ref SDS D2 3E4K
060470 -    Lafayette        4.75   78.6    95 110    sc        081207, ref SDS D1 3E4K
060471 -    Concord home                              scm       081206, ref SDS C9 3E4K
060472 -    Concord home                              scm       081205, ref SDS C5 3E4K
060473 -    Concord home                              sc        081204, ref SDS C4 3E4K
060474 -    Lafayette        2.75   62.7    90 117    sc        081203, ref SDS C3 3E4K
060475 -    Concord home (gym)                        sc        081202, ref SDS C1 3E4K
060476 -    Lafayette        5.50  102.3    95 122    sc        081201, ref SDS B9 3E4K
060477 -    Concord home                              sc        081130, ref SDS B8 3E4K
060478 -    Lafayette        2.75   56.7    90 115    scm       081129, ref SDS B7 3E4K
060479 -    Lafayette        2.75   46.5   100 128    scm       081128, ref SDS B4 3E4K
060480 -    Lafayette        5.50   93.3   100 122    s         081127, ref SDS B3 3E4K
060481 -    Concord home                              s         081126, ref SDS A9 3E4K
060482 -    Lafayette        4.00   73.7   105 127    s         081125, ref SDS A8 3E4K
060483 -    Lafayette        5.50   91.4   100 129    s         081124, ref SDS A7 3E4K
060484 -    Concord home                              s         081123, ref SDS A6 3E4K
060485 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS A5 3E4K
060486 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS A4 3E4K
060487 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS A3 3E4K
060488 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS A2 3E4K
060489 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS A1 3E4K
060490 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 98 3E4K
060491 -    Concord home                              s         081116, ref SDS 96 Y68J
060492 -    Concord home                              s         081115, ref SDS 95 EK7I
060493 -    Concord home                              s         081114, ref SDS 94 XW6H
060494 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 90 3E4K
060495 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 89 3E4K
060496 -    Kaiser                                         x    081108, ref SDS 88 UZ7K
060497 -    Kaiser                                         x    081107, ref SDS 87 UZ7K
060498 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 83 3E4K
060499 -    Kaiser                                         x    081025, ref SDS 83 UZ7K
060500 -    Kaiser                                         x    081024, ref SDS 82 UZ7K
060501 -    UCSF                                      c         081023, ref SDS 81 V94O
060502 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 80 3E4K
060503 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 79 3E4K
060504 -    Kaiser                                         x    081018, ref SDS 78 UZ7K
060505 -    Kaiser                                         x    081017, ref SDS 77 UZ7K
060506 -    UCSF                                      e         081016, ref SDS 75 V94O
060507 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 74 3E4K
060508 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 73 3E4K
060509 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 72 3E4K
060510 -    Kaiser                                         x    081011, ref SDS 71 UZ7K
060511 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 70 3E4K
060512 -    Kaiser                                         x    081010, ref SDS 70 UZ7K
060513 -    UCSF                                      e         081009, ref SDS 69 V94O
060514 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 68 3E4K
060515 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 67 3E4K
060516 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 66 3E4K
060517 -    UCSF                                      c         081002, ref SDS 65 V94O
060518 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 64 3E4K
060519 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 64 3E4K
060520 -    Kaiser                                         x    080927, ref SDS 63 UZ7K
060521 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 62 3E4K
060522 -    UCSF                                      c         080925, ref SDS 61 V94O
060523 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 60 3E4K
060524 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 60 3E4K
060525 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 60 3E4K
060526 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 59 3E4K
060527 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 58 3E4K
060528 -    UCSF                                      c         080918, ref SDS 57 V94O
060529 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 58 3E4K
060530 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 56 3E4K
060531 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 55 3E4K
060532 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 54 3E4K
060533 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 53 3E4K
060534 -    UCSF                                      c         080911, ref SDS 52 V94O
060535 -    Lafayette        2.75   46.8   113 140              080909
060536 -    Lafayette        5.50   89.2   117 143              080908
060537 -    Lafayette        5.50   92.1   115 138              080907
060538 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 51 3E4K
060539 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 50 3E4K
060540 -    UCSF                                      c         080904, ref SDS 49 V94O
060541 -    Lafayette        8.25  140.4   116 131              080903
060542 -    Lafayette        5.50   94.9   115 134              080902
060543 -    Kaiser                                         x    080830
060544 -    Kaiser                                         x    080829
060545 -    UCSF                                      c         080828, ref SDS 48 V94O
060546 -    Lafayette        5.50   93.6   120 137              080826
060547 -    Lafayette        5.50   93.2   117 138              080825
060548 -    Lafayette        5.50   93.2   123 136         x    080823
060549 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 47 3E4K
060550 -    UCSF                                      e         080821, ref SDS 46 V94O
060551 -    Lafayette        5.50   94.7   115 137              080820
060552 -    Lafayette        5.50   94.3   115 135              080819
060553 -    Lafayette        8.25  141.7   118 134              080815
060554 -    UCSF                                      e         080814, ref SDS 45 V94O
060555 -    Lafayette        5.50   93.8   120 136              080813
060556 -    Lafayette        5.50   94.4   116 139              080812
060557 -    Lafayette        5.50   94.2   119 133              080810
060558 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 43 3E4K
060559 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 42 3E4K
060560 -    UCSF                                      c         080807, ref SDS 41 V94O
060561 -    Lafayette        8.25  143.7   115 132              080805
060562 -    Concord          7.00  127.6   105 118              080804
060563 -    Lafayette        8.25  143.2   112 134              080802
060564 -    Lafayette        5.50   93.4   115 138              080801
060565 -    Lafayette        5.50   92.2   118 140              080729
060566 -    Lafayette        5.50   92.6   116 137              080728
060567 -    Lafayette        8.25  142.6   114 134              080727
060568 -    Lafayette        5.50   91.5   120 143              080726
060569 -    Lafayette        8.25  140.8   117 135              080725
060570 -    Lafayette        5.50   91.8   122 141              080723
060571 -    Lafayette        5.50   91.3   120 139              080722
060572 -    Lafayette        8.25  143.3   115 133              080720
060573 -    Lafayette        5.50   90.7   125 144              080719
060574 -    Lafayette        5.50   92.4   123 142              080716
060575 -    Lafayette        2.25   46.8   116 137              080715
060576 -    Lafayette        8.25  141.8   116 136              080712
060577 -    Lafayette        5.50   92.9   116 139              080711
060578 -    Lafayette        8.25  143.3   113 137              080704
060579 -    Lafayette        5.50   90.2   121 147              080630
060580 -    Lafayette        8.25  142.4   116 138              080628
060581 -    Lafayette        5.50   91.4   118 138              080625
060582 -    Lafayette        2.25   47.9   116 136              080623
060583 -    Lafayette        5.50   94.2   112 138              080622
060584 -    Lafayette        5.50   94.7   115 133              080621
060585 -    Lafayette        2.25   48.3   110 129              080620
060586 -    Mt Diablo        7.00  129.4   130 153              080616
060587 -    Lafayette        5.50   90.8   120 146              080615
060588 -    Lafayette        5.50   91.3   124 144              080614
060589 -    Lafayette        5.50   89.7   122 143              080613
060590 -    Lafayette        2.76   45.8   120 147              080611
060591 -    Lafayette        5.50   90.5   123 145              080609
060592 -    Lafayette        5.50   92.7   115 138              080607
060593 -    Lafayette        5.50   94.2   118 139              080602
060594 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 19 WO8M
060595 -
060596 -
060597 -
060598 -
060599 -
060600 -
0607 -