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: January 10, 2009 09:30 AM Saturday; Rod Welch

Millie 2nd Neupgogen at Kaiser recover from sunitinib treatment.

1...Summary/Objective
2...Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
3...Schedule Neupogen Treatments Extended through August
4...Side Effects Neupogen Treatments Increase May Be Chemotherapy


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CONTACTS 

SUBJECTS
Neupogen Side Effects Bone Pain Fatigue No Headache Suffered Today A

1503 -
1503 -    ..
1504 - Summary/Objective
1505 -
150501 - Follow up ref SDS E3 0000. ref SDS E0 0000.
150502 -
150503 -
150504 -
150505 -
150506 -
150507 -
150508 -
150510 -  ..
1506 -
1507 -
1508 - Progress
1509 -
150901 - Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
150902 -
150903 - Follow up ref SDS E3 9W9I, ref SDS E0 9W9I.
150904 -
150905 - Patient history of low blood counts shown by NEUTS (ANC at Kaiser)
150906 - from laboratory blood tests, including background on missing treatment
150907 - at UCSF due to low blood counts, are reported in the record today of
150908 - Millie's current treatments for the 5th relapse of IBC. ref SDS D0
150909 - EC5N
150911 -  ..
150912 - Case study on 060809 shows Millie has often received chemotherapy when
150913 - blood counts are below the standard for safe treatments, and on some
150914 - occassions has received Neupogen to increase blood counts. ref SDS 9
150915 - HV45
150917 -  ..
150918 - Research on neutropenia was reported on 070301, ref SDS 10 O59H, when
150919 - Doctor Rugo was concerned about holding blood counts with weekly
150920 - Carboplatin treatments. ref SDS 10 VF6O
150922 -  ..
150923 - Background on Neupogen treatment is reported on 081107. ref SDS B9
150924 - 1M9O  Tara gave instructions at UCSF on 081126 to defer Neupogen with
150925 - NEUTS 1.50 until labs at UCSF on 081218. ref SDS C5 AT8U  On 081205,
150926 - Doctor Rugo clarified that Neupogen should not be self-medicated, and
150927 - is not needed until neutrophils are low. ref SDS C9 JE5I  On 081210
150928 - the primary care physician ordered Neupogen treatments according to
150929 - Kaiser standards and practices when NEUTS drop below 1.00 (ANC 1000).
150930 - ref SDS D4 J43V
150932 -  ..
150933 - On 090108 Doctor Rugo ordered Neupogen for yesterday 090109 and today
150934 - 090110. ref SDS D7 R65H,
150936 -  ..
150937 - Bella was Millie's nurse today.
150939 -  ..
150940 - Bella gave Millie 2 injections in the right abdomen for the 2nd
150941 - Neupogen treatment using the UCSF protocol...
150942 -
150943 -            Neupogen 480 mcg SQ
150944 -
150945 - ...as shown in UCSF Chemotherapy Order on 080918, ref SDS 83 PWSY, and
150946 - ordered by primary care physician at Kaiser on 080609. ref SDS 38 L16I
150948 -  ..
150949 - Neupogen today makes a total of 6 treatments and 2880 mcg of Neupogen
150950 - Millie has received since starting the sunitinib protocol on 081114.
150951 - ref SDS E0 HS5M
150953 -  ..
150954 - Instructions on Kaiser protocol for 480 mcg be given with 2 injections
150955 - in the arm discussed on 080801 ref SDS 58 9W9I, and originally
150956 - presented by Laura on 080628. ref SDS 43 Q74G
150957 -
150958 -
150959 -
150960 -
1510 -

SUBJECTS
Default Null Subject Account for Blank Record

1603 -
160401 -  ..
160402 - Schedule Neupogen Treatments Extended through August
160403 -
160404 - Follow up ref SDS E3 WJ4O, ref SDS E0 WJ4O.
160405 -
160406 - Bella updated Millie's schedule for Neupogen.
160408 -  ..
160409 - Neupogen schedule....
160410 -
160411 -                                    UCSF Treatment Prescription
160412 -                                              Cyclophos  Metho
160413 -                         Neupogen  Sunitinib   phamide   trexate
160414 -    #   Date    Time NEUTS   MCG    #    MG    #   MG     #   MG    Neupogen            IBC Treatment
160415 -   =================================================================================================
160416 -    1.  081205  1300 0.624   480   22  826.0   8   400    3   15 .. ref SDS C8 KV84 and ref SDS C6 PY5I
160417 -    2.  081206  0900         960   23  863.5   9   450    4   20 .. ref SDS D1 BI4 and ref SDS D0 PY5I
160418 -        081210  1302 1.085         27 1013.5  13   650    4   20 .. ref SDS D3 QY6H and ref SDS D2 X59G
160419 -        081212  1300       canceled
160420 -        081213  0900       canceled
160421 -        081218  0700               35 1312.5  21  1050    6   30 .. ref SDS D5 MF5H
160422 -        081218  0830 0.740.........paused.....paused.....canceled.. ref SDS D6 QY6H
160423 -    3.  081219  1130        1440................................... ref SDS D8 UZ7K
160424 -    4.  081220  0900        1920................................... ref SDS E0 UZ7K
160425 -        081226  1030 1.710......................................... ref SDS E1 QY6H
160426 -        081226  0930       canceled
160427 -        081227  0930       canceled
160428 -        090102  0800       canceled
160429 -        090103  0930       canceled
160430 -        090108  0820 0.87.....................paused............... ref SDS E2 QY6H
160431 -    5.  090109  0830        2400................................... ref SDS E3 UZ7K
160432 -    6.  090110  0930        2880................................... ref SDS 0 UZ7K
160433 -    7.  090116  1030
160434 -    8.  090117  0930
160435 -    9.  090123  0830
160436 -   10.  090124  0930
160437 -   11.  090130  0830
160438 -   12.  090131  0930
160439 -
160440 -
160441 -
1605 -

SUBJECTS
Default Null Subject Account for Blank Record

1703 -
170401 -  ..
170402 - Side Effects Neupogen Treatments Increase May Be Chemotherapy
170403 -
170404 - Follow up ref SDS E3 SB8I, ref SDS E0 SB8I.
170405 -
170406 - Research on Neupogen side effects was reported on 080629. ref SDS 43
170407 - RQ9I
170409 -  ..
170410 - Millie last reported side effects on 081018 experiencing bone pain,
170411 - headache, and fatigue associated with Neupogen and chemotherapy.
170412 - ref SDS A3 Y17L  Prior to yesterday on 081219, ref SDS D8 UZ7K, Millie
170413 - had Neupogen treatments previously on 081205 and 081206. ref SDS D1
170414 - BI4J  The record today shows side effects of fatigue began OA 081130
170415 - about 4 days after starting treatment for cancer that added
170416 - chemotherapy to sunitinib. ref SDS D9 EV6J  Joint pain side effects
170417 - can occurs with Neupogen and commonly occur with cancer treatments.
170418 - Side effects of Neupogen last 2 - 3 days.  Millie began reporting
170419 - joint pain on 081216, ref SDS D9 V15F, about 10 days after her last
170420 - Neupogen treatment on 081206.  This patient history suggests daily
170421 - cancer treatments are causing continual joint pain side effects,
170422 - possibly compounded when Millie gets Neupogen treatments.
170424 -  ..
170425 - Bella took vitals today...
170426 -
170427 -                BP 173 83 48  Temp 97.3
170429 -  ..
170430 - Side effects of Neupogen reported on...
170431 -
170432 -               081018................, ref SDS A3 Y17L
170433 -               081011................, ref SDS 96 FL4H
170434 -               081010................, ref SDS 95 SB8I
170435 -               081006................, ref SDS 93 3E4K
170436 -               081004................, ref SDS 92 Y17L
170437 -               081002................, ref SDS 90 Y17L
170438 -               080930................, ref SDS 89 Y17L
170439 -               080923................, ref SDS 85 K16F
170440 -               080915................, ref SDS 81 9W9I
170441 -               080810................, ref SDS 63 9W9I
170442 -               080803................, ref SDS 59 9W9I
170443 -               080726................, ref SDS 56 9W9I
170444 -               080721................, ref SDS 54 9W9I
170445 -               080713................, ref SDS 48 RM94
170446 -               080629................, ref SDS 43 6Q5J
170447 -               080628................, ref SDS 41 6Q5J
170448 -
170449 -
170450 -
170451 -
170452 -
170453 -
170454 -
170455 -
170456 -
170457 -
1705 -