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 11, 2009 07:00 AM Sunday; Rod Welch

Millie sunitinib #52 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 I8 0000. ref SDS I7 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 I8 505G, ref SDS I7 505G.
040904 -
040905 - Background pausing treatment on 081219 for a week enabled Millie's
040906 - blood counts to recover, and resumed on 081226 with sunitinib and
040907 - cyclophosphamide. ref SDS G3 505G  On 081230 case study dilemma cancer
040908 - treatmnets cause low blood counts, which prevents getting treatment;
040909 - not getting treatment incerases cancer; UCSF paused treatment for a
040910 - week and prescribed Neupogen to increase blood counts. ref SDS G8 I87N
040911 - On 090108 treatment with sunitinib was continued at full strength, and
040912 - cyclophosphamide was discontinued until blood counts rise above NEUTS
040913 - 1.00, and then cyclophosphamide will be reduced from 7 to 5 days a
040914 - week. ref SDS I2 9V4I
040916 -  ..
040917 - IBC rash seems about the same as yesterday on 090110, ref SDS I8 124N,
040918 - and after 2 days of treatment with only sunitinib.
040920 -  ..
040921 - Today, Millie showed rising energy hiking Lafayette reservoir over 1.5
040922 - laps, about 4.75 miles.  This is the longest hike in several months.
040923 - ref SDS 0 X64F  Better fitness from exercise strengthens the immune
040924 - system.  Synergy between cancer treatments and stronger immunity
040925 - increases resistance to cancer, cited in Millie's letter to Stritter
040926 - Medical on 010906. ref SDS H7 SX6P  Rising energy today may signal
040927 - relief from chronic fatigue caused by cancer treatments that make
040928 - hiking difficult because Millie's legs tire quickly, reported below,
040929 - ref SDS 0 3E4K, caused by side effects of low blood counts, discussed
040930 - further below, ref SDS 0 LF8M, from 17 cancer treatments beginning on
040931 - 081226, reported below. ref SDS 0 9I6T
040933 -  ..
040934 - NEUTS patient history of neutropenia from chemotherapy everyday with
040935 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
040937 -  ..
040938 - Neupogen treatments prescribed on 090108 by the medical team at UCSF
040939 - for 090109 and 090110, help maintain blood counts to strengthen the
040940 - immunity system, shown in Millie's letter to the medical team on
040941 - 090109. ref SDS I6 UF3Q  Yesterday on 090110, Millie had the 2nd
040942 - Neupogen treatment at Kaiser. ref SDS I9 P73J
040943 -
040945 -  ..
040946 - Sunitinib Cyclophosmaide Methotrexate Patient History
040947 -
040948 - Follow up ref SDS I8 OE6K, ref SDS I7 OE6K.
040949 -
040951 -        Cycle 1  begin 081128 after 14 treatmenst sunitinib alone
040952 -        Cohort: 3
040954 -        ..
040955 -                                          Cyclophos  Metho
040956 -                               Sunitinib   phamide   trexate
040957 -       Days  Date  Time  Cycle    37.5       50        5
040958 -       =======================================================
040959 -       Follow up ref SDS I8 PA8Y, ref SDS I7 PA8Y.
040960 -
040961 -        1.  081114 0700  Load    37.5         0         0 ... ref SDS 94 OE6K
040962 -        2.  081115 0700  Load    75.0         0         0 ... ref SDS 95 OE6K
040963 -        3.  081116 0700  Load   112.5         0         0 ... ref SDS 96 OE6K
040964 -        4.  081117 0700  Load   150.0         0         0 ... ref SDS 97 OE6K
040965 -        5.  081118 0700  Load   187.5         0         0 ... ref SDS A0 OE6K
040966 -        6.  081119 0700  Load   225.0         0         0 ... ref SDS A2 OE6K
040967 -        7.  081120 0700  Load   263.5         0         0 ... ref SDS A3 OE6K
040968 -        8.  081121 0700  Load   301.0         0         0 ... ref SDS A4 OE6K
040969 -        9.  081122 0700  Load   338.5         0         0 ... ref SDS A5 OE6K
040970 -       10.  081123 0700  Load   376.0         0         0 ... ref SDS A6 OE6K
040971 -       11.  081124 0700  Load   413.5         0         0 ... ref SDS A7 OE6K
040972 -       12.  081125 0700  Load   451.0         0         0 ... ref SDS A8 OE6K
040973 -             ..
040974 -       13.  081126 0700  Load   488.5         0         0 ... ref SDS A9 OE6K
040975 -             ..
040976 -            081126 0820  NEUTS........1.50................... ref SDS B0 PU6K
040978 -             ..
040979 -       14.  081127 0700  Load   526.0         0         0 ... ref SDS B1 OE6K
040980 -       15.  081128 0700  1  1   563.5   1    50    1    5 ... ref SDS B4 OE6K
040981 -       16.  081129 0700  1  2   601.0   2   100    2   10 ... ref SDS B7 OE6K
040982 -       17.  081130 0700  1  3   638.5   3   150    2   10 ... ref SDS B8 OE6K
040983 -       18.  081201 0700  1  4   676.0   4   200    2   10 ... ref SDS B9 OE6K
040984 -       19.  081202 0700  1  5   713.5   5   250    2   10 ... ref SDS C1 OE6K
040985 -             ..
040986 -       20.  081203 0700  1  6   751.0   6   300    2   10 ... ref SDS C3 OE6K
040987 -
040988 -            081203 0735. NEUTS....... 0.624 ...... .......... ref SDS C2 RN5G
040989 -
040990 -                Rate of change per day = 1500 - 624 = 876 / 7
040991 -
040992 -                                       = 120+ per day
040994 -             ..
040995 -       21.  081204 0700  1  7   788.5   7   350    2   10 ... ref SDS C4 OE6K
040996 -             ..
040997 -       22.  081205 0700  1  8   826.0   8   400    3   15 ... ref SDS C5 OE6K
040998 -
040999 -            081205 1300  Neupogen...... 480 mcg  480......... ref SDS C6 KV84
041001 -             ..
041002 -       23.  081206 0700  1  9   863.5   9   450    4   20 ... ref SDS C9 OE6K
041003 -
041004 -            081206 0930  Neupogen...... 480 mcg  960......... ref SDS D0 BI4J
041006 -             ..
041007 -       24.  081207 0700  1 10   901.0  10   500    4   20 ... ref SDS D1 OE6K
041008 -       25.  081208 0700  1 11   938.5  11   550    4   20 ... ref SDS D2 OE6K
041009 -       26.  081209 0700  1 12   976.0  12   600    4   20 ... ref SDS D3 OE6K
041010 -             ..
041011 -       27.  081210 0700  1 13  1013.5  13   650    4   20 ... ref SDS D5 OE6K
041012 -
041013 -            081210 1301. NEUTS....... 1.085 ................. ref SDS D6 QY6H
041015 -             ..
041016 -       28.  081211 0700  1 14  1050.0  14   700    4   20 ... ref SDS D9 OE6K
041017 -             ..
041018 -       29.  081212 0700  1 15  1087.5  15   750    5   25 ... ref SDS E1 OE6K
041019 -
041020 -            081212 1115. NEUTS....... 1.054 ................. ref SDS E2 QY6H
041022 -             ..
041023 -       30.  081213 0700  1 16  1125.0  16   800    6   30 ... ref SDS E4 OE6K
041024 -       31.  081214 0700  1 17  1162.5  17   850    6   30 ... ref SDS E5 OE6K
041025 -       32.  081215 0700  1 18  1200.0  18   900    6   30 ... ref SDS E6 OE6K
041026 -       33.  081216 0700  1 19  1237.5  19   950    6   30 ... ref SDS E7 OE6K
041027 -             ..
041028 -       34.  081217 0700  1 20  1275.0  20  1000    6   30 ... ref SDS E8 OE6K
041029 -       35.  081218 0700  1 21  1312.5  21  1050    canceled.. ref SDS F0 OE6K
041030 -
041031 -            081218 0830. NEUTS....... 0.740 ................. ref SDS F1 QY6H
041033 -             ..
041034 -            081219 0700  2  1  paused until 081226........... ref SDS F3 OE6K
041036 -             ..
041037 -            081219 1130  Neupogen...... 480 mcg 1440 ........ ref SDS F4 UZ7K
041038 -            081220 0900  Neupogen...... 480 mcg 1920 ........ ref SDS F6 UZ7K
041040 -             ..
041041 -       36.  081226 0700  2  1  1350.0  22  1100.............. ref SDS G3 OE6K
041042 -       37.  081227 0700  2  2  1387.5  23  1150.............. ref SDS G5 OE6K
041043 -       38.  081228 0700  2  3  1425.0  24  1200.............. ref SDS G6 OE6K
041044 -       39.  081229 0700  2  4  1462.5  25  1250.............. ref SDS G7 OE6K
041045 -       40.  081230 0700  2  5  1500.0  26  1300.............. ref SDS G9 OE6K
041046 -       41.  081231 0700  2  6  1537.5  27  1350.............. ref SDS H1 OE6K
041047 -       42.  090101 0700  2  7  1575.0  28  1400.............. ref SDS H2 OE6K
041048 -       43.  090102 0700  2  8  1612.5  29  1450.............. ref SDS H3 OE6K
041049 -       44.  090103 0700  2  9  1650.0  30  1500.............. ref SDS H4 OE6K
041050 -       45.  090104 0700  2 10  1687.5  31  1550.............. ref SDS H5 OE6K
041051 -       46.  090105 0700  2 11  1725.0  32  1600.............. ref SDS H6 OE6K
041052 -       47.  090106 0700  2 12  1762.5  33  1650.............. ref SDS H8 OE6K
041053 -       48.  090107 0700  2 13  1800.0  34  1700.............. ref SDS I1 OE6K
041054 -             ..
041055 -       49.  090108 0700  2 14  1837.5  35  1750.............. ref SDS I2 OE6K
041056 -             ..
041057 -       50.  090109 0700  3  1  1875.0..paused................ ref SDS I7 OE6K
041058 -             ..
041059 -       51.  090110 0700  3  2  1910.5..paused................ ref SDS I8 OE6K
041060 -       52.  090111 0700  3  3  1948.0..paused................ ref SDS 0 OE6K
041061 -
041062 -
041063 -
041064 -
041065 -
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 I8 LF8M, ref SDS I7 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 - Blood counts NEUTS 0.87 reported for labs on 090108 at UCSF,
050411 - ref SDS I3 QY6H, show another significant decline from NEUTS 1.710
050412 - reported on 081226, ref SDS G4 B35J, from getting 17 daily cancer
050413 - treatments starting on 081226, shown by patient history above,
050414 - ref SDS 0 9I6T, has caused significant side effects of fatigue the
050415 - prevents exercise.  Neupogen treatments on 090109 and 090110
050416 - ref SDS 0 RG7J, and pausing cyclophosphamide, prescribed by medical
050417 - team at UCSF on 090108, ref SDS I2 9V4I, enable blood counts to rise
050418 - so that treatment with sunitinib can continue at full strength,
050419 - explained in Millie's letter to the medical team on 090109.
050420 - ref SDS I6 UF3T  A blood test will be performed at Kaiser next Friday
050421 - on 090116; if NEUTS > 1.00 cyclophsphamide will be continued at
050422 - reduced dose of 5 days per week, instead 7. ref SDS I6 UF3W  This
050423 - aligns with letter from UCSF on 090108 summarizing instructions from
050424 - medical team. ref SDS I5 UX5S
050426 -  ..
050427 - Millie went hiking at Lafayette Reservoir today and did 1.5 laps,
050428 - about 4.75 miles, ref SDS 0 X64F  Hiking is difficult because Millie's
050429 - legs tire quickly, reported below, ref SDS 0 3E4K, cited previously on
050430 - 090102. ref SDS H3 6E7G  Increased exercise today may signal reduced
050431 - side effects of fatigue from 17 cancer treatments beginning on 081226,
050432 - shown above, ref SDS 0 9I6T, because blood counts are rising from 2
050433 - Neupogen treatments, and from pausing treatment with cyclophosphamide
050434 - on 090109, per above. ref SDS 0 6M7G
050436 -  ..
050437 - Background on Neupogen treatments and UCSF comments are reported on
050438 - 081207. ref SDS D1 673J
050440 -  ..
050441 - NEUTS blood tests show patient history of treatments with Nuepogen to
050442 - recover from neutropenia caused by getting chemotherapy everyday with
050443 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
050445 -  ..
050446 - Schedule for Neupogen treatments is listed in another record today on
050447 - 090110. ref SDS I9 HS5M
050449 -  ..
050450 - Neupogen treatments prescribed on 090108 by the medical team at UCSF
050451 - for 090109 and 090110, help maintain blood counts to strengthen
050452 - Millie's immunity system, shown in Millie's letter to the medical team
050453 - on 090109. ref SDS I6 UF3Q  Yesterday on 090110, Millie had the 2nd
050454 - treatment at Kaiser. ref SDS I9 P73J
050456 -  ..
050457 - Feet and toes very sensitive to hiking today, reported during the
050458 - meeting at UCSF on 081218. ref SDS F2 HM4M  This problem was first
050459 - reported on 081216. ref SDS E7 HY8M  Feet were examined at UCSF on
050460 - 081218. ref SDS F2 HM4M  At that time, rising side effects on 081218,
050461 - most notably low blood counts, caused pausing all treatments for 1
050462 - week. ref SDS F2 QW48  Later on 081223, Millie recovered from
050463 - peripheral neruopathy that causes feet and toes to hurt. ref SDS F9
050464 - HY8M  Treatment resumed on 081226.  Millie continued to suffer side
050465 - effects of fatigue that prevented exercise.  Yesterday, she hiked 2.75
050466 - miles at Lafayette and complained her legs were very tired.  Today,
050467 - she hiked further, 4.75 miles, and reported her feet and toes hurt
050468 - badly.  Rising peripheral neuropathy side effects presents another
050469 - obstacle for hiking to maintain fitness, which reduces synergy between
050470 - treatment and exercise to increase the immune system that resists
050471 - cancer, cited
050473 -  ..
050474 - Background on peripheral neuropathy was reviewed on 081216.
050475 - ref SDS E7 3G9I  There seemed to be an indication reviewing sunitinib
050476 - consent document on 081017 that cyclophosphamide may help contain some
050477 - forms of neuropathy, and in some cases can increase peripheral
050478 - neuropathy. ref SDS 76 UF9J
050480 -  ..
050481 - Tearing eyes reported during examination on 090108; Tara, ref SDS I4
050482 - XB3M, prescribed over-the-counter eye drops.  This was evident during
050483 - the hike today.
050485 -  ..
050486 - Joint pain, discomfort, and total ill feeling, commonly associated
050487 - with chemotherapy, reported on 081218, ref SDS F0 E38H, and discussed
050488 - with the medical team at UCSF also on 081218, ref SDS F2 QW7H, has now
050489 - mostly disipated, as a result of the doctor stopping all treatment for
050490 - 1 week, ref SDS F2 QW48, as shown in patient history above.
050491 - ref SDS G6 053F
050493 -  ..
050494 - Interstitional lung disease discussed in the record on 081218,
050495 - ref SDS F0 KM5F, shows no evident symptoms.
050497 -  ..
050498 - Vitals were taken today at home after minimal activity sitting up in
050499 - bed reading, and walking about the house.
050500 -
050501 -                   BP 130 71 pulse 49
050503 -  ..
050504 - Millie reports continued relief from heartburn with daily treatments
050505 - using Prilosce started on 081208. ref SDS D2 7J6K
050507 -  ..
050508 - Sore throat problem, reported initially on 081218, as having begun
050509 - days earlier, ref SDS F0 2B8M, seems better today today continuing
050510 - relief reported yesterday on 081222. ref SDS F8 TT4O  This increases
050511 - interest in eating food.  Millie had eggs and a baggel for a late
050512 - lunch after returning from the gym.  Swallowing seems much more normal
050513 - now.
050515 -  ..
050516 - Millie reports improved taste from some foods today (e.g., soup),
050517 - cited in study consent documents, reviewed on 081017. ref SDS 76 6T5H
050519 -     ..
050520 -                                   Date
050521 -    Description Adverse Event   Start  Stop     Medication
050522 -    ---------------------------------------------------------
050523 -    Follow up ref SDS I8 MV5H, ref SDS I7 MV5H.
050524 -
050525 -    Diarrhea                    081114 081114   Imodium........ ref SDS 94 LF8M
050526 -    Low pulse                   081120 081120   None........... ref SDS A3 LF8M
050527 -    Low pulse                   081121 081121   None........... ref SDS A4 7G8M
050528 -    BP 144 84 Pulse 48          081121 081121   Hiking......... ref SDS A4 LF8M
050529 -    Joint pain minor            081121 081121   Hiking......... ref SDS A4 LF8M
050530 -    Fatigue minor               081121 081121   Hiking......... ref SDS A4 LF8M
050531 -    Low pulse                   081122 081122   None........... ref SDS A5 7G8M
050532 -    Fatigue minor               081122 081122   Hiking......... ref SDS A5 LF8M
050533 -    Low pulse                   081123 081122   None........... ref SDS A6 7G8M
050534 -    BP 121 74 Pulse 53          081123 081123   Hiking......... ref SDS A6 LF8M
050535 -    Fatigue minor               081123 081122   Hiking......... ref SDS A6 LF8M
050536 -    Joint pain minor            081124 081124   Hiking......... ref SDS A7 LF8M
050537 -    Fatigue minor               081124 081124   Hiking......... ref SDS A7 LF8M
050538 -    Heartburn                   081124 081124   None........... ref SDS A7 HS9K
050539 -    BP 144 78 Pulse 52          081125 081125   Hiking......... ref SDS A8 LF8M
050540 -    Joint pain minor            081125 081125   Hiking......... ref SDS A8 LF8M
050541 -    Fatigue minor               081125 081125   Hiking......... ref SDS A8 LF8M
050542 -    Heartburn                   081125 081125   None........... ref SDS A8 HS9K
050543 -    Heartburn                   081126 081126   None........... ref SDS A9 HS9K
050544 -    Heartburn                   081127 081127   None........... ref SDS B3 HS9K
050545 -    BP 135 73 Pulse 48          081128 081128   Hiking......... ref SDS B4 5X6K
050546 -    Upset stomach               081128 081128   Hiking......... ref SDS B4 T76O
050547 -    BP 140 75 Pulse 50          081129 081129   Hiking......... ref SDS B7 5X6K
050548 -    Heartburn                   081129 081129   None........... ref SDS B7 HS9K
050549 -     ..
050550 -    Fatigue                     081129 081129   Rest........... ref SDS B7 LF8M
050551 -    Fatigue                     081130 081130   Rest........... ref SDS B8 LF8M
050552 -    BP 136 79 Pulse 46          081201 081201   Hiking......... ref SDS B9 5X6K
050553 -    Fatigue                     081201 081201   Rest........... ref SDS B9 LF8M
050554 -    Taste altered               081201 081201   Rest........... ref SDS B9 VP4G
050555 -    BP 141 77 Pulse 46          081202 081202   Aerobics gym... ref SDS C1 5X6K
050556 -    Fatigue                     081202 081202   Rest........... ref SDS C1 LF8M
050557 -    Taste altered               081202 081202   Rest........... ref SDS C1 VP4G
050558 -    BP 138 77 Pulse 48          081203 081203   Hiking......... ref SDS C3 5X6K
050559 -    Fatigue                     081203 081203   Rest........... ref SDS C3 LF8M
050560 -    Taste altered               081203 081203   Rest........... ref SDS C3 VP4G
050561 -    NEUTS (ANC)     0.624       081203 081203   Neupogen.......
050562 -    BP 133 72 Pulse 45          081204 081204   Rest........... ref SDS C4 5X6K
050563 -    Fatigue                     081204 081204   Rest........... ref SDS C4 LF8M
050564 -    Taste altered               081204 081204   Rest........... ref SDS C4 VP4G
050565 -    BP 138 76 Pulse 49          081205 081205   Rest........... ref SDS C5 5X6K
050566 -    Diarrhea                    081205 081114   Imodium........ ref SDS C5 Q67F
050567 -    Fatigue                     081205 081205   Rest........... ref SDS C5 LF8M
050568 -    Taste altered               081205 081205   Rest........... ref SDS C5 VP4G
050569 -    BP *** ** Pulse **          081206 081206   Rest........... ref SDS C9 5X6K
050570 -    Fatigue                     081206 081206   Rest........... ref SDS C9 LF8M
050571 -    BP 128 70 Pulse 53          081207 081207   Hiking......... ref SDS D1 5X6K
050572 -    Fatigue                     081207 081207   Rest........... ref SDS D1 LF8M
050573 -    BP 137 68 Pulse 53          081208 081208   Rest........... ref SDS D2 5X6K
050574 -    Fatigue                     081208 081208   Rest........... ref SDS D2 LF8M
050575 -    BP *** ** Pulse **          081209 081209   Rest........... ref SDS D2 5X6K
050576 -    Fatigue                     081209 081209   Rest........... ref SDS D2 LF8M
050577 -    Heartburn                   081209 081209   Prilosec....... ref SDS D3 7J6K
050578 -    BP 136 70 Pulse 53          081210 081210   Rest........... ref SDS D5 5X6K
050579 -    Fatigue                     081210 081210   Rest........... ref SDS D5 LF8M
050580 -    Heartburn                   081210 081210   Prilosec....... ref SDS D5 7J6K
050581 -    BP *** ** Pulse **          081211 081211   Rest........... ref SDS D9 5X6K
050582 -    Fatigue                     081211 081211   Exercise gym... ref SDS D9 LF8M
050583 -    Heartburn                   081211 081211   Prilosec....... ref SDS D9 7J6K
050584 -    BP 137 76 Pulse 53          081212 081212   Rest........... ref SDS E1 5X6K
050585 -    Fatigue                     081212 081212   Exercise gym... ref SDS E1 LF8M
050586 -    Heartburn                   081212 081212   Prilosec....... ref SDS E1 7J6K
050587 -    BP 147 80 Pulse 51          081213 081213   Rest........... ref SDS E4 5X6K
050588 -    Fatigue                     081213 081213   Exercise gym... ref SDS E4 LF8M
050589 -    BP *** ** Pulse **          081214 081214   Rest........... ref SDS E5 5X6K
050590 -    Fatigue                     081214 081214   Rest........... ref SDS E5 LF8M
050591 -    BP *** ** Pulse **          081215 081215   Rest........... ref SDS E6 5X6K
050592 -    Fatigue                     081215 081215   Rest........... ref SDS E6 LF8M
050593 -    BP 144 79 Pulse 54          081216 081216   Rest........... ref SDS E7 5X6K
050594 -    Fatigue                     081216 081216   Exercise gym... ref SDS E7 LF8M
050595 -     ..
050596 -    Joint pain minor            081216 081216   Rest........... ref SDS E7 E38H
050597 -    BP 137 69 Pulse 63          081217 081217   Rest........... ref SDS E8 5X6K
050598 -    Fatigue                     081217 081217   Rest........... ref SDS E8 LF8M
050599 -    Feet toes neuropathy        081216 081217   Rest........... ref SDS E8 HY8M
050600 -    Joint pain minor            081217 081217   Rest........... ref SDS E8 E38H
050601 -    Nosebleed minor             081217 081217   Rest........... ref SDS E8 ZF5F
050602 -     ..
050603 -    BP *** ** Pulse **          081218 081218   Rest........... ref SDS F0 5X6K
050604 -    Fatigue                     081218 081218   Rest........... ref SDS F0 LF8M
050605 -    Joint pain minor            081218 081218   Rest........... ref SDS F0 E38H
050606 -    Nosebleed moderate          081218 081218   Rest........... ref SDS F0 ZF5F
050607 -    Throat pain eating          081218 081218   Eating less.... ref SDS F0 2B8M
050608 -    Feet toes neuropathy        081216 081218   Rest........... ref SDS F0 HY8M
050609 -    BP 155 84 Pulse 53          081219 081219   Rest........... ref SDS F3 5X6K
050610 -    Fatigue                     081121 081219   Rest........... ref SDS F3 LF8M
050611 -    Feet toes neuropathy        081216 081219   Rest........... ref SDS F3 HY8M
050612 -    Joint pain ill feeling      081121 081219   Rest........... ref SDS F3 E38H
050613 -    Throat sore eating          081218 081219   Eating less.... ref SDS F3 TT4O
050614 -    BP 123 69 pulse 53          081220 081220   Rest........... ref SDS F5 5X6K
050615 -    Fatigue                     081121 081220   Rest........... ref SDS F5 LF8M
050616 -    Feet toes neuropathy        081216 081220   Rest........... ref SDS F5 HY8M
050617 -    Joint pain ill feeling      081121 081220   Rest........... ref SDS F5 E38H
050618 -    Throat sore eating          081218 081220   Eating less.... ref SDS F5 TT4O
050619 -    BP 117 71 pulse 65          081221 081221   Rest........... ref SDS F7 5X6K
050620 -    Fatigue                     081121 081221   Rest........... ref SDS F7 LF8M
050621 -    Feet toes neuropathy        081216 081221   Rest........... ref SDS F7 HY8M
050622 -    Joint pain ill feeling      081121 081221   Rest........... ref SDS F7 E38H
050623 -    Throat sore eating          081218 081221   Eating less.... ref SDS F7 TT4O
050624 -    BP 117 71 pulse 65          081222 081222   Rest........... ref SDS F8 5X6K
050625 -    Fatigue                     081121 081222   Rest........... ref SDS F8 LF8M
050626 -    Feet toes neuropathy        081216 081222   Rest........... ref SDS F8 HY8M
050627 -    Joint pain ill feeling      081121 081222   Rest........... ref SDS F8 E38H
050628 -    Throat sore eating          081218 081222   Eating less.... ref SDS F8 TT4O
050629 -    BP 143 68 pulse 65          081223 081223   Rest........... ref SDS F8 5X6K
050630 -    Fatigue more energy         081121 081223   Exercise gym... ref SDS F9 LF8M
050631 -    Feet toes neuropathy better 081219 081223   Exercise gym... ref SDS F9 HY8M
050632 -    Joint pain subsides         081121 081223   Exercise gym... ref SDS F9 E38H
050633 -    Throat sore improved        081218 081223   Eating normal.. ref SDS F9 TT4O
050634 -    BP *** ** pulse **          081224 081224   Rest........... ref SDS G1 5X6K
050635 -    Fatigue more energy         081121 081224   Exercise gym... ref SDS G1 LF8M
050636 -    Feet feel better            081219 081224   Exercise gym... ref SDS G1 UO8I
050637 -    Joint pain subsides         081121 081224   Exercise gym... ref SDS G1 E38H
050638 -    Throat sore improved        081218 081224   Eating normal.. ref SDS G1 TT4O
050639 -    BP 124 80 pulse 66          081225 081225   Rest........... ref SDS G2 5X6K
050640 -    Fatigue more energy         081121 081225   Activity....... ref SDS G2 LF8M
050641 -    Fatigue more energy         081121 081226   Activity....... ref SDS G3 LF8M
050642 -    BP *** ** pulse **          081227 081227   Rest........... ref SDS G5 5X6K
050643 -    Fatigue more energy         081121 081227   Hiking......... ref SDS G5 LF8M
050644 -    BP *** ** pulse **          081228 081228   Rest........... ref SDS G6 5X6K
050645 -    Fatigue more energy         081121 081228   Rest........... ref SDS G6 LF8M
050646 -    BP 112 76 pulse 63          081229 081229   Rest........... ref SDS G7 5X6K
050647 -    Fatigue more energy         081121 081229   Rest........... ref SDS G7 LF8M
050648 -    BP *** ** pulse **          081230 081230   Rest........... ref SDS G9 5X6K
050649 -    Diarrhea                    081230 081230   Imodium........ ref SDS G9 KZ9N
050650 -    Fatigue more energy         081121 081230   Rest........... ref SDS G9 LF8M
050651 -    BP *** ** pulse **          081231 081231   Rest........... ref SDS H1 5X6K
050652 -    Fatigue more energy         081121 081231   Rest........... ref SDS H1 LF8M
050653 -    BP *** ** pulse **          090101 090101   Rest........... ref SDS H2 5X6K
050654 -    Fatigue more energy         081121 090101   Hiking......... ref SDS H2 LF8M
050655 -    BP *** ** pulse **          090102 090102   Rest........... ref SDS H3 5X6K
050656 -    Fatigue more energy         081121 090102   Hiking......... ref SDS H3 LF8M
050657 -    BP *** ** pulse **          090103 090103   Rest........... ref SDS H4 5X6K
050658 -    Fatigue less energy         081121 090103   Exercise gym... ref SDS H4 LF8M
050659 -    BP *** ** pulse **          090104 090104   Rest........... ref SDS H5 5X6K
050660 -    Fatigue less energy         081121 090104   Rest........... ref SDS H5 LF8M
050661 -    BP *** ** pulse **          090105 090105   Rest........... ref SDS H6 5X6K
050662 -    Fatigue less energy         081121 090105   Rest........... ref SDS H6 LF8M
050663 -    BP *** ** pulse **          090106 090106   Rest........... ref SDS H8 5X6K
050664 -    Fatigue less energy         081121 090106   Exercise gym... ref SDS H8 LF8M
050665 -    BP *** ** pulse **          090107 090107   Rest........... ref SDS H8 5X6K
050666 -    Fatigue less energy         081121 090107   Rest........... ref SDS I1 LF8M
050667 -    BP *** ** pulse **          090108 090108   Rest........... ref SDS I2 5X6K
050668 -    Fatigue less energy         081121 090108   Rest........... ref SDS I2 LF8M
050669 -    Eyes tearing                090108 090108   Eye drops...... ref SDS I2 518H
050670 -    BP *** ** pulse **          090109 090109   Rest........... ref SDS I7 5X6K
050671 -    Fatigue less energy         081121 090109   Rest........... ref SDS I7 LF8M
050672 -    Eyes tearing                090108 090109   Eye drops...... ref SDS I7 518H
050673 -    BP *** ** pulse **          090110 090110   Rest........... ref SDS I8 5X6K
050674 -    Fatigue less energy         081121 090110   Hiking......... ref SDS I8 LF8M
050675 -    Eyes tearing                090108 090110   Eye drops...... ref SDS I8 518H
050676 -    BP *** ** pulse **          090111 090111   Rest........... ref SDS 0 5X6K
050677 -    Fatigue more energy         081121 090111   Hiking......... ref SDS 0 LF8M
050678 -    Eyes tearing                090108 090111   Eye drops...... ref SDS 0 518H
050679 -    Feet toes neuropathy        090111 090111   Hiking......... ref SDS 0 HY8M
050680 -
050681 -
050682 -
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 I8 3E4K, ref SDS I7 3E4K.
060405 -
060406 - Today, Millie went hiking at Lafayette reservoir and did over 1.5 laps
060407 - about 4.75 miles in 90 minutes; the first lap was 53 minutes, which
060408 - improved hiking 1 lap in 59 minutes yesterday. ref SDS 0 X64F  Hiking
060409 - was difficult on Millie's legs, reported previously on 090102,
060410 - ref SDS H3 6E7G, due to rising side effects of fatigue from 17 cancer
060411 - treatments beginning on 081226. ref SDS 0 9I6T  During the hike
060412 - yesterday and again today, Millie reported her legs were very weak.  A
060413 - few weeks ago on 081223 Millie was assisted with light pushing her up
060414 - the steepest hills.  Today she refused assistance, and struggled a
060415 - great deal.  Neupogen treatments on 090109 and yesterday on 090110,
060416 - and pausing cyclophosphamide may enable blood counts and energy to
060417 - rise, per above. ref SDS 0 LF8M
060419 -  ..
060420 - NEUTS blood tests show patient history treatments with Nuepogen for
060421 - neutropenia from chemotherapy everyday with cyclophosphamide reported
060422 - in case study on 081205. ref SDS C5 EC5N
060424 -  ..
060425 - On 081110, Millie complained about difficulty lifting herself from a
060426 - full squatting position. ref SDS 90 HX67  For several weeks, she was
060427 - exercising to strengthen legs, and arms, shown by going to the gym on
060428 - 081211. ref SDS D9 3E4K  Rising fatigue now prevents continuing
060429 - exercise.
060430 -
060432 -  ..
060433 - Case Study on Pateint History Exercising
060434 -
060435 - Follow up ref SDS I8 X64F, ref SDS I7 X64F.
060436 -
060437 -                                              +- scm = Sunitinib Cyclophosphmaide Methotrexate
060438 -                                              +- sc  = Sunitinib Cyclophosphmaide
060439 -                           Time     Pulse     |
060440 -    Location        Miles Minutes  Avg Max  Chem  Neupo  Date
060441 -    ----------------------------------------------------------------
060442 -    Lafayette        4.75   90.4    95 111    s         090111, ref SDS 0 3E4K
060443 -    Lafayette        2.75   58.9    85 105    s         090110, ref SDS I8 3E4K
060444 -    Concord home                              s         090109, ref SDS I7 3E4K
060445 -    Concord home                              sc        090108, ref SDS I2 3E4K
060446 -    Concord home                              sc        090107, ref SDS I1 3E4K
060447 -    Concord home (gym)                        sc        090106, ref SDS H8 3E4K
060448 -    Concord home                              sc        090105, ref SDS H6 3E4K
060449 -    Concord home                              sc        090104, ref SDS H5 3E4K
060450 -    Concord home (gym)                        sc        090103, ref SDS H4 3E4K
060451 -    Clayton Safeway  3.00   58.7    83  94    sc        090102, ref SDS H3 3E4K
060452 -    Lafayette        2.75   58.4    87 103    sc        090101, ref SDS H2 3E4K
060453 -    Concord home                              sc        081231, ref SDS H1 3E4K
060454 -    Concord home                              sc        081230, ref SDS G9 3E4K
060455 -    Concord home                              sc        081229, ref SDS G7 3E4K
060456 -    Concord home                              sc        081228, ref SDS G6 3E4K
060457 -    Lafayette        2.75   56.2    90 112    sc        081227, ref SDS G5 3E4K
060458 -    Concord home                              sc        081226, ref SDS G3 3E4K
060459 -    Concord travel                                      081225, ref SDS G2 3E4K
060460 -    Concord home                                        081224, ref SDS G1 3E4K
060461 -    Concord home (gym)                                  081223, ref SDS F9 3E4K
060462 -    Concord home                                        081222, ref SDS F8 3E4K
060463 -    Concord home                                        081221, ref SDS F7 3E4K
060464 -    Concord home                                        081220, ref SDS F5 3E4K
060465 -    Concord home                                        081219, ref SDS F3 3E4K
060466 -    Concord home                              sc        081218, ref SDS F0 3E4K
060467 -    Concord home                              sc        081217, ref SDS E8 3E4K
060468 -    Concord home (gym)                        sc        081216, ref SDS E7 3E4K
060469 -    Concord home                              sc        081215, ref SDS E6 3E4K
060470 -    Concord home                              sc        081214, ref SDS E5 3E4K
060471 -    Concord home (gym)                        scm       081213, ref SDS E4 3E4K
060472 -    Concord home                              scm       081212, ref SDS E1 3E4K
060473 -    Concord home (gym)                        sc        081211, ref SDS D9 3E4K
060474 -    Concord home                              sc        081210, ref SDS D5 3E4K
060475 -    Concord home                              sc        081209, ref SDS D3 3E4K
060476 -    Concord home                              sc        081208, ref SDS D2 3E4K
060477 -    Lafayette        4.75   78.6    95 110    sc        081207, ref SDS D1 3E4K
060478 -    Concord home                              scm       081206, ref SDS C9 3E4K
060479 -    Concord home                              scm       081205, ref SDS C5 3E4K
060480 -    Concord home                              sc        081204, ref SDS C4 3E4K
060481 -    Lafayette        2.75   62.7    90 117    sc        081203, ref SDS C3 3E4K
060482 -    Concord home (gym)                        sc        081202, ref SDS C1 3E4K
060483 -    Lafayette        5.50  102.3    95 122    sc        081201, ref SDS B9 3E4K
060484 -    Concord home                              sc        081130, ref SDS B8 3E4K
060485 -    Lafayette        2.75   56.7    90 115    scm       081129, ref SDS B7 3E4K
060486 -    Lafayette        2.75   46.5   100 128    scm       081128, ref SDS B4 3E4K
060487 -    Lafayette        5.50   93.3   100 122    s         081127, ref SDS B3 3E4K
060488 -    Concord home                              s         081126, ref SDS A9 3E4K
060489 -    Lafayette        4.00   73.7   105 127    s         081125, ref SDS A8 3E4K
060490 -    Lafayette        5.50   91.4   100 129    s         081124, ref SDS A7 3E4K
060491 -    Concord home                              s         081123, ref SDS A6 3E4K
060492 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS A5 3E4K
060493 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS A4 3E4K
060494 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS A3 3E4K
060495 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS A2 3E4K
060496 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS A1 3E4K
060497 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 98 3E4K
060498 -    Concord home                              s         081116, ref SDS 96 Y68J
060499 -    Concord home                              s         081115, ref SDS 95 EK7I
060500 -    Concord home                              s         081114, ref SDS 94 XW6H
060501 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 90 3E4K
060502 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 89 3E4K
060503 -    Kaiser                                         x    081108, ref SDS 88 UZ7K
060504 -    Kaiser                                         x    081107, ref SDS 87 UZ7K
060505 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 83 3E4K
060506 -    Kaiser                                         x    081025, ref SDS 83 UZ7K
060507 -    Kaiser                                         x    081024, ref SDS 82 UZ7K
060508 -    UCSF                                      c         081023, ref SDS 81 V94O
060509 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 80 3E4K
060510 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 79 3E4K
060511 -    Kaiser                                         x    081018, ref SDS 78 UZ7K
060512 -    Kaiser                                         x    081017, ref SDS 77 UZ7K
060513 -    UCSF                                      e         081016, ref SDS 75 V94O
060514 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 74 3E4K
060515 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 73 3E4K
060516 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 72 3E4K
060517 -    Kaiser                                         x    081011, ref SDS 71 UZ7K
060518 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 70 3E4K
060519 -    Kaiser                                         x    081010, ref SDS 70 UZ7K
060520 -    UCSF                                      e         081009, ref SDS 69 V94O
060521 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 68 3E4K
060522 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 67 3E4K
060523 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 66 3E4K
060524 -    UCSF                                      c         081002, ref SDS 65 V94O
060525 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 64 3E4K
060526 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 64 3E4K
060527 -    Kaiser                                         x    080927, ref SDS 63 UZ7K
060528 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 62 3E4K
060529 -    UCSF                                      c         080925, ref SDS 61 V94O
060530 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 60 3E4K
060531 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 60 3E4K
060532 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 60 3E4K
060533 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 59 3E4K
060534 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 58 3E4K
060535 -    UCSF                                      c         080918, ref SDS 57 V94O
060536 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 58 3E4K
060537 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 56 3E4K
060538 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 55 3E4K
060539 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 54 3E4K
060540 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 53 3E4K
060541 -    UCSF                                      c         080911, ref SDS 52 V94O
060542 -    Lafayette        2.75   46.8   113 140              080909
060543 -    Lafayette        5.50   89.2   117 143              080908
060544 -    Lafayette        5.50   92.1   115 138              080907
060545 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 51 3E4K
060546 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 50 3E4K
060547 -    UCSF                                      c         080904, ref SDS 49 V94O
060548 -    Lafayette        8.25  140.4   116 131              080903
060549 -    Lafayette        5.50   94.9   115 134              080902
060550 -    Kaiser                                         x    080830
060551 -    Kaiser                                         x    080829
060552 -    UCSF                                      c         080828, ref SDS 48 V94O
060553 -    Lafayette        5.50   93.6   120 137              080826
060554 -    Lafayette        5.50   93.2   117 138              080825
060555 -    Lafayette        5.50   93.2   123 136         x    080823
060556 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 47 3E4K
060557 -    UCSF                                      e         080821, ref SDS 46 V94O
060558 -    Lafayette        5.50   94.7   115 137              080820
060559 -    Lafayette        5.50   94.3   115 135              080819
060560 -    Lafayette        8.25  141.7   118 134              080815
060561 -    UCSF                                      e         080814, ref SDS 45 V94O
060562 -    Lafayette        5.50   93.8   120 136              080813
060563 -    Lafayette        5.50   94.4   116 139              080812
060564 -    Lafayette        5.50   94.2   119 133              080810
060565 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 43 3E4K
060566 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 42 3E4K
060567 -    UCSF                                      c         080807, ref SDS 41 V94O
060568 -    Lafayette        8.25  143.7   115 132              080805
060569 -    Concord          7.00  127.6   105 118              080804
060570 -    Lafayette        8.25  143.2   112 134              080802
060571 -    Lafayette        5.50   93.4   115 138              080801
060572 -    Lafayette        5.50   92.2   118 140              080729
060573 -    Lafayette        5.50   92.6   116 137              080728
060574 -    Lafayette        8.25  142.6   114 134              080727
060575 -    Lafayette        5.50   91.5   120 143              080726
060576 -    Lafayette        8.25  140.8   117 135              080725
060577 -    Lafayette        5.50   91.8   122 141              080723
060578 -    Lafayette        5.50   91.3   120 139              080722
060579 -    Lafayette        8.25  143.3   115 133              080720
060580 -    Lafayette        5.50   90.7   125 144              080719
060581 -    Lafayette        5.50   92.4   123 142              080716
060582 -    Lafayette        2.25   46.8   116 137              080715
060583 -    Lafayette        8.25  141.8   116 136              080712
060584 -    Lafayette        5.50   92.9   116 139              080711
060585 -    Lafayette        8.25  143.3   113 137              080704
060586 -    Lafayette        5.50   90.2   121 147              080630
060587 -    Lafayette        8.25  142.4   116 138              080628
060588 -    Lafayette        5.50   91.4   118 138              080625
060589 -    Lafayette        2.25   47.9   116 136              080623
060590 -    Lafayette        5.50   94.2   112 138              080622
060591 -    Lafayette        5.50   94.7   115 133              080621
060592 -    Lafayette        2.25   48.3   110 129              080620
060593 -    Mt Diablo        7.00  129.4   130 153              080616
060594 -    Lafayette        5.50   90.8   120 146              080615
060595 -    Lafayette        5.50   91.3   124 144              080614
060596 -    Lafayette        5.50   89.7   122 143              080613
060597 -    Lafayette        2.76   45.8   120 147              080611
060598 -    Lafayette        5.50   90.5   123 145              080609
060599 -    Lafayette        5.50   92.7   115 138              080607
060600 -    Lafayette        5.50   94.2   118 139              080602
060601 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 19 WO8M
060602 -
060603 -
060604 -
060605 -
060606 -
060607 -
0607 -