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 13, 2009 07:00 AM Tuesday; Rod Welch

Millie sunitinib 54 treatments IBC 5th relapse cycle 3 and 5th treatment.

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 J1 0000. ref SDS J0 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 J1 505G, ref SDS J0 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 and nodules in the breastbone area seems about the same as on
040918 - 090110, ref SDS I8 124N, and after 5 days of treatment with only
040919 - sunitinib, and 19 total treatments with sunitinib since the pause on
040920 - 081218 and resuming on 081226, shown below. ref SDS 0 6C4J
040922 -  ..
040923 - Today, Millie went to the gym for an hour of aerobic exercise; she did
040924 - not go hiking, per below, ref SDS 0 X64F, because of rising side
040925 - effects that cause fagitue, ref SDS 0 LF8M, muscle weakness,
040926 - ref SDS 0 KL4J, and perpherial neuropathy, ref SDS 0 HY8M,
040928 -  ..
040929 - NEUTS patient history of neutropenia from chemotherapy everyday with
040930 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
040932 -  ..
040933 - Neupogen treatments prescribed on 090108 by the medical team at UCSF
040934 - for 090109 and 090110, help maintain blood counts to strengthen the
040935 - immunity system, shown in Millie's letter to the medical team on
040936 - 090109. ref SDS I6 UF3Q  On 090110, Millie had the 2nd Neupogen
040937 - treatment at Kaiser. ref SDS I9 P73J
040938 -
040940 -  ..
040941 - Sunitinib Cyclophosmaide Methotrexate Patient History
040942 -
040943 - Follow up ref SDS J1 OE6K, ref SDS J0 OE6K.
040944 -
040946 -        Cycle 1  begin 081128 after 14 treatmenst sunitinib alone
040947 -        Cohort: 3
040949 -         ..
040950 -        Cycle 2 begin 081218 was paused a week and
040951 -        so began on 081226 and without
040952 -        methotrexate............................... ref SDS 0 9I6T
040954 -         ..
040955 -        Cycle 3 began 090109 with only
040956 -        sunitinib.................................. ref SDS 0 6C4J
040958 -        ..
040959 -                                          Cyclophos  Metho
040960 -                               Sunitinib   phamide   trexate
040961 -       Days  Date  Time  Cycle    37.5       50        5
040962 -       =======================================================
040963 -       Follow up ref SDS J1 PA8Y, ref SDS J0 PA8Y.
040964 -
040965 -        1.  081114 0700  Load    37.5         0         0 ... ref SDS 94 OE6K
040966 -        2.  081115 0700  Load    75.0         0         0 ... ref SDS 95 OE6K
040967 -        3.  081116 0700  Load   112.5         0         0 ... ref SDS 96 OE6K
040968 -        4.  081117 0700  Load   150.0         0         0 ... ref SDS 97 OE6K
040969 -        5.  081118 0700  Load   187.5         0         0 ... ref SDS A0 OE6K
040970 -        6.  081119 0700  Load   225.0         0         0 ... ref SDS A2 OE6K
040971 -        7.  081120 0700  Load   263.5         0         0 ... ref SDS A3 OE6K
040972 -        8.  081121 0700  Load   301.0         0         0 ... ref SDS A4 OE6K
040973 -        9.  081122 0700  Load   338.5         0         0 ... ref SDS A5 OE6K
040974 -       10.  081123 0700  Load   376.0         0         0 ... ref SDS A6 OE6K
040975 -       11.  081124 0700  Load   413.5         0         0 ... ref SDS A7 OE6K
040976 -       12.  081125 0700  Load   451.0         0         0 ... ref SDS A8 OE6K
040977 -             ..
040978 -       13.  081126 0700  Load   488.5         0         0 ... ref SDS A9 OE6K
040979 -             ..
040980 -            081126 0820  NEUTS........1.50................... ref SDS B0 PU6K
040982 -             ..
040983 -       14.  081127 0700  Load   526.0         0         0 ... ref SDS B1 OE6K
040984 -       15.  081128 0700  1  1   563.5   1    50    1    5 ... ref SDS B4 OE6K
040985 -       16.  081129 0700  1  2   601.0   2   100    2   10 ... ref SDS B7 OE6K
040986 -       17.  081130 0700  1  3   638.5   3   150    2   10 ... ref SDS B8 OE6K
040987 -       18.  081201 0700  1  4   676.0   4   200    2   10 ... ref SDS B9 OE6K
040988 -       19.  081202 0700  1  5   713.5   5   250    2   10 ... ref SDS C1 OE6K
040989 -             ..
040990 -       20.  081203 0700  1  6   751.0   6   300    2   10 ... ref SDS C3 OE6K
040991 -
040992 -            081203 0735. NEUTS....... 0.624 ...... .......... ref SDS C2 RN5G
040993 -
040994 -                Rate of change per day = 1500 - 624 = 876 / 7
040995 -
040996 -                                       = 120+ per day
040998 -             ..
040999 -       21.  081204 0700  1  7   788.5   7   350    2   10 ... ref SDS C4 OE6K
041000 -             ..
041001 -       22.  081205 0700  1  8   826.0   8   400    3   15 ... ref SDS C5 OE6K
041002 -
041003 -            081205 1300  Neupogen...... 480 mcg  480......... ref SDS C6 KV84
041005 -             ..
041006 -       23.  081206 0700  1  9   863.5   9   450    4   20 ... ref SDS C9 OE6K
041007 -
041008 -            081206 0930  Neupogen...... 480 mcg  960......... ref SDS D0 BI4J
041010 -             ..
041011 -       24.  081207 0700  1 10   901.0  10   500    4   20 ... ref SDS D1 OE6K
041012 -       25.  081208 0700  1 11   938.5  11   550    4   20 ... ref SDS D2 OE6K
041013 -       26.  081209 0700  1 12   976.0  12   600    4   20 ... ref SDS D3 OE6K
041014 -             ..
041015 -       27.  081210 0700  1 13  1013.5  13   650    4   20 ... ref SDS D5 OE6K
041016 -
041017 -            081210 1301. NEUTS....... 1.085 ................. ref SDS D6 QY6H
041019 -             ..
041020 -       28.  081211 0700  1 14  1050.0  14   700    4   20 ... ref SDS D9 OE6K
041021 -             ..
041022 -       29.  081212 0700  1 15  1087.5  15   750    5   25 ... ref SDS E1 OE6K
041023 -
041024 -            081212 1115. NEUTS....... 1.054 ................. ref SDS E2 QY6H
041026 -             ..
041027 -       30.  081213 0700  1 16  1125.0  16   800    6   30 ... ref SDS E4 OE6K
041028 -       31.  081214 0700  1 17  1162.5  17   850    6   30 ... ref SDS E5 OE6K
041029 -       32.  081215 0700  1 18  1200.0  18   900    6   30 ... ref SDS E6 OE6K
041030 -       33.  081216 0700  1 19  1237.5  19   950    6   30 ... ref SDS E7 OE6K
041031 -             ..
041032 -       34.  081217 0700  1 20  1275.0  20  1000    6   30 ... ref SDS E8 OE6K
041033 -       35.  081218 0700  1 21  1312.5  21  1050    canceled.. ref SDS F0 OE6K
041034 -
041035 -            081218 0830. NEUTS....... 0.740 ................. ref SDS F1 QY6H
041037 -             ..
041038 -            081219 0700  2  1  paused until 081226........... ref SDS F3 OE6K
041040 -             ..
041041 -            081219 1130  Neupogen...... 480 mcg 1440 ........ ref SDS F4 UZ7K
041042 -            081220 0900  Neupogen...... 480 mcg 1920 ........ ref SDS F6 UZ7K
041044 -             ..
041045 -       36.  081226 0700  2  1  1350.0  22  1100.............. ref SDS G3 OE6K
041046 -       37.  081227 0700  2  2  1387.5  23  1150.............. ref SDS G5 OE6K
041047 -       38.  081228 0700  2  3  1425.0  24  1200.............. ref SDS G6 OE6K
041048 -       39.  081229 0700  2  4  1462.5  25  1250.............. ref SDS G7 OE6K
041049 -       40.  081230 0700  2  5  1500.0  26  1300.............. ref SDS G9 OE6K
041050 -       41.  081231 0700  2  6  1537.5  27  1350.............. ref SDS H1 OE6K
041051 -       42.  090101 0700  2  7  1575.0  28  1400.............. ref SDS H2 OE6K
041052 -       43.  090102 0700  2  8  1612.5  29  1450.............. ref SDS H3 OE6K
041053 -       44.  090103 0700  2  9  1650.0  30  1500.............. ref SDS H4 OE6K
041054 -       45.  090104 0700  2 10  1687.5  31  1550.............. ref SDS H5 OE6K
041055 -       46.  090105 0700  2 11  1725.0  32  1600.............. ref SDS H6 OE6K
041056 -       47.  090106 0700  2 12  1762.5  33  1650.............. ref SDS H8 OE6K
041057 -       48.  090107 0700  2 13  1800.0  34  1700.............. ref SDS I1 OE6K
041058 -             ..
041059 -       49.  090108 0700  2 14  1837.5  35  1750.............. ref SDS I2 OE6K
041060 -             ..
041061 -       50.  090109 0700  3  1  1875.0..paused................ ref SDS I7 OE6K
041062 -             ..
041063 -       51.  090110 0700  3  2  1910.5..paused................ ref SDS I8 OE6K
041064 -       52.  090111 0700  3  3  1948.0..paused................ ref SDS J0 OE6K
041065 -       53.  090112 0700  3  4  1985.5..paused................ ref SDS J1 OE6K
041066 -       54.  090113 0700  3  5  2023.0..paused................ ref SDS 0 OE6K
041067 -
041068 -
041069 -
041070 -
041071 -
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 J1 LF8M, ref SDS J0 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, as a result of getting 19 daily
050413 - cancer treatments starting on 081226, shown by patient history above.
050414 - ref SDS 0 9I6T  Low blood counts are side affects for some patients of
050415 - sunitinib, listed on 081017, ref SDS 76 ZP5L, that contribute to
050416 - fatigue, also listed as the primary side effect of sunitinib.
050417 - ref SDS 76 4G7G  Chemotherapy also causes low blood counts, which
050418 - compounds the problem of fatigue that prevents exercise, causing
050419 - fitness to decline, shown by case study below. ref SDS J1 X64F  This
050420 - weakens the immune system enabling cancer and other disease to rise.
050421 - Since the doctor paused cyclophosphamide chemotherapy for a week on
050422 - 090108, ref SDS I2 9V4I, this may reduce the problem of lower blood
050423 - counts and so help relieve fatigue.  Additionally, Neupogen treatments
050424 - on 090109 and 090110 ref SDS J0 RG7J, prescribed by medical team at
050425 - UCSF on 090108, ref SDS I2 9V4I, further enable blood counts to rise
050426 - so that treatment with sunitinib can continue at full strength,
050427 - explained in Millie's letter to the medical team on 090109.
050428 - ref SDS I6 UF3T  A blood test will be performed at Kaiser next Friday
050429 - on 090116; if NEUTS > 1.00 cyclophsphamide will be continued at
050430 - reduced dose of 5 days per week, instead 7. ref SDS I6 UF3W  This
050431 - aligns with letter from UCSF on 090108 summarizing instructions from
050432 - medical team. ref SDS I5 UX5S
050434 -  ..
050435 - Millie went to the gym for aerobics today; she did not go hiking at
050436 - Lafayette reservoir.  On 090111, and the day before on 090110 Millie
050437 - had severe pain in her feet, discussed below, ref SDS 0 HY8M, and
050438 - muscle weakness in the legs, while hiking at Lafayette, ref SDS J0
050439 - 3E4K, which are listed as a separate side effect of sunitinib on
050440 - 081017. ref SDS 76 4G7G  Millie's legs tire quickly, reported below,
050441 - ref SDS 0 3E4K, cited previously on 090102. ref SDS H3 6E7G
050442 - Increased exercise the past few days increased fatigue from 19 cancer
050443 - treatments beginning on 081226, shown above, ref SDS 0 9I6T, even
050444 - with blood counts rising from 2 Neupogen treatments, and from pausing
050445 - treatment with cyclophosphamide on 090109, per above. ref SDS 0 6M7G
050447 -  ..
050448 - Background on Neupogen treatments and UCSF comments are reported on
050449 - 081207. ref SDS D1 673J
050451 -  ..
050452 - NEUTS blood tests show patient history of treatments with Nuepogen to
050453 - recover from neutropenia caused by getting chemotherapy everyday with
050454 - cyclophosphamide reported in case study on 081205. ref SDS C5 EC5N
050456 -  ..
050457 - Schedule for Neupogen treatments is listed in the record on 090110.
050458 - ref SDS I9 HS5M
050460 -  ..
050461 - Neupogen treatments prescribed on 090108 by the medical team at UCSF
050462 - for 090109 and 090110, help maintain blood counts to strengthen the
050463 - immune system, shown in Millie's letter to the medical team on 090109.
050464 - ref SDS I6 UF3Q  On 090110, Millie had the 2nd Neupogen treatment at
050465 - Kaiser. ref SDS I9 P73J
050467 -  ..
050468 - Feet and toes very sensitive from peripheral neuropathy caused by side
050469 - effects of sunitinib, reported yesterday on 090112, ref SDS J1 HY8M,
050470 - and citing possible dilemma about treatment with cyclophosphamide.
050471 - ref SDS J1 OG9G  Millie went to the gym this morning for aerobic
050472 - exercise.  She complained of great difficulty doing this activity due
050473 - to pain in her feet and toes.
050474 -
050475 -        [On 090115 Millie went to the gym and did aerobic exercise
050476 -        again; did not experience severe pain in feet and toes during
050477 -        exercise; discomfort set in an hour or so later. ref SDS J4
050478 -        3E4K
050480 -  ..
050481 - Tearing eyes reported during examination on 090108; Tara, ref SDS I4
050482 - XB3M, prescribed over-the-counter eye drops.
050484 -  ..
050485 - Joint pain, discomfort, and total ill feeling, commonly associated
050486 - with chemotherapy, reported on 081218, ref SDS F0 E38H, and discussed
050487 - with the medical team at UCSF also on 081218, ref SDS F2 QW7H, has now
050488 - mostly disipated, as a result of the doctor stopping all treatment for
050489 - 1 week, ref SDS F2 QW48, as shown in patient history above.
050490 - ref SDS G6 053F
050492 -  ..
050493 - Interstitional lung disease discussed in the record on 081218,
050494 - ref SDS F0 KM5F, shows no evident symptoms.
050496 -  ..
050497 - Vitals were taken today at home after minimal activity sitting up in
050498 - bed reading, and walking about the house.
050499 -
050500 -                   BP 153 74 pulse 49
050502 -  ..
050503 - Millie reports continued relief from heartburn with daily treatments
050504 - using Prilosce started on 081208. ref SDS D2 7J6K
050506 -  ..
050507 - Sore throat problem, reported initially on 081218, as having begun
050508 - days earlier, ref SDS F0 2B8M, seems better today today continuing
050509 - relief reported yesterday on 081222. ref SDS F8 TT4O  This increases
050510 - interest in eating food.  Millie had eggs and a baggel for a late
050511 - lunch after returning from the gym.  Swallowing seems much more normal
050512 - now.
050514 -  ..
050515 - Severe diarrhea occurred in the late evening.  This may be related to
050516 - diet from having cabbage along with corned beef for dinner.  The
050517 - previous incident on 081230 at Kaiser when Millie was getting a CT
050518 - test was similarly correlated with barrium sulfate suspension for
050519 - contrast medium, ref SDS H0 I84N, and cited in the record of sunitinib
050520 - treatments on 081230. ref SDS G9 KZ9N
050522 -  ..
050523 - Millie reports improved taste from some foods today (e.g., soup),
050524 - cited in study consent documents, reviewed on 081017. ref SDS 76 6T5H
050526 -     ..
050527 -                                   Date
050528 -    Description Adverse Event   Start  Stop     Medication
050529 -    ---------------------------------------------------------
050530 -    Follow up ref SDS J1 MV5H, ref SDS J0 MV5H.
050531 -
050532 -    Diarrhea                    081114 081114   Imodium........ ref SDS 94 LF8M
050533 -    Low pulse                   081120 081120   None........... ref SDS A3 LF8M
050534 -    Low pulse                   081121 081121   None........... ref SDS A4 7G8M
050535 -    BP 144 84 Pulse 48          081121 081121   Hiking......... ref SDS A4 LF8M
050536 -    Joint pain minor            081121 081121   Hiking......... ref SDS A4 LF8M
050537 -    Fatigue minor               081121 081121   Hiking......... ref SDS A4 LF8M
050538 -    Low pulse                   081122 081122   None........... ref SDS A5 7G8M
050539 -    Fatigue minor               081122 081122   Hiking......... ref SDS A5 LF8M
050540 -    Low pulse                   081123 081122   None........... ref SDS A6 7G8M
050541 -    BP 121 74 Pulse 53          081123 081123   Hiking......... ref SDS A6 LF8M
050542 -    Fatigue minor               081123 081122   Hiking......... ref SDS A6 LF8M
050543 -    Joint pain minor            081124 081124   Hiking......... ref SDS A7 LF8M
050544 -    Fatigue minor               081124 081124   Hiking......... ref SDS A7 LF8M
050545 -    Heartburn                   081124 081124   None........... ref SDS A7 HS9K
050546 -    BP 144 78 Pulse 52          081125 081125   Hiking......... ref SDS A8 LF8M
050547 -    Joint pain minor            081125 081125   Hiking......... ref SDS A8 LF8M
050548 -    Fatigue minor               081125 081125   Hiking......... ref SDS A8 LF8M
050549 -    Heartburn                   081125 081125   None........... ref SDS A8 HS9K
050550 -    Heartburn                   081126 081126   None........... ref SDS A9 HS9K
050551 -    Heartburn                   081127 081127   None........... ref SDS B3 HS9K
050552 -    BP 135 73 Pulse 48          081128 081128   Hiking......... ref SDS B4 5X6K
050553 -    Upset stomach               081128 081128   Hiking......... ref SDS B4 T76O
050554 -    BP 140 75 Pulse 50          081129 081129   Hiking......... ref SDS B7 5X6K
050555 -    Heartburn                   081129 081129   None........... ref SDS B7 HS9K
050556 -     ..
050557 -    Fatigue                     081129 081129   Rest........... ref SDS B7 LF8M
050558 -    Fatigue                     081130 081130   Rest........... ref SDS B8 LF8M
050559 -    BP 136 79 Pulse 46          081201 081201   Hiking......... ref SDS B9 5X6K
050560 -    Fatigue                     081201 081201   Rest........... ref SDS B9 LF8M
050561 -    Taste altered               081201 081201   Rest........... ref SDS B9 VP4G
050562 -    BP 141 77 Pulse 46          081202 081202   Aerobics gym... ref SDS C1 5X6K
050563 -    Fatigue                     081202 081202   Rest........... ref SDS C1 LF8M
050564 -    Taste altered               081202 081202   Rest........... ref SDS C1 VP4G
050565 -    BP 138 77 Pulse 48          081203 081203   Hiking......... ref SDS C3 5X6K
050566 -    Fatigue                     081203 081203   Rest........... ref SDS C3 LF8M
050567 -    Taste altered               081203 081203   Rest........... ref SDS C3 VP4G
050568 -    NEUTS (ANC)     0.624       081203 081203   Neupogen.......
050569 -    BP 133 72 Pulse 45          081204 081204   Rest........... ref SDS C4 5X6K
050570 -    Fatigue                     081204 081204   Rest........... ref SDS C4 LF8M
050571 -    Taste altered               081204 081204   Rest........... ref SDS C4 VP4G
050572 -    BP 138 76 Pulse 49          081205 081205   Rest........... ref SDS C5 5X6K
050573 -    Diarrhea                    081205 081114   Imodium........ ref SDS C5 Q67F
050574 -    Fatigue                     081205 081205   Rest........... ref SDS C5 LF8M
050575 -    Taste altered               081205 081205   Rest........... ref SDS C5 VP4G
050576 -    BP *** ** Pulse **          081206 081206   Rest........... ref SDS C9 5X6K
050577 -    Fatigue                     081206 081206   Rest........... ref SDS C9 LF8M
050578 -    BP 128 70 Pulse 53          081207 081207   Hiking......... ref SDS D1 5X6K
050579 -    Fatigue                     081207 081207   Rest........... ref SDS D1 LF8M
050580 -    BP 137 68 Pulse 53          081208 081208   Rest........... ref SDS D2 5X6K
050581 -    Fatigue                     081208 081208   Rest........... ref SDS D2 LF8M
050582 -    BP *** ** Pulse **          081209 081209   Rest........... ref SDS D2 5X6K
050583 -    Fatigue                     081209 081209   Rest........... ref SDS D2 LF8M
050584 -    Heartburn                   081209 081209   Prilosec....... ref SDS D3 7J6K
050585 -    BP 136 70 Pulse 53          081210 081210   Rest........... ref SDS D5 5X6K
050586 -    Fatigue                     081210 081210   Rest........... ref SDS D5 LF8M
050587 -    Heartburn                   081210 081210   Prilosec....... ref SDS D5 7J6K
050588 -    BP *** ** Pulse **          081211 081211   Rest........... ref SDS D9 5X6K
050589 -    Fatigue                     081211 081211   Exercise gym... ref SDS D9 LF8M
050590 -    Heartburn                   081211 081211   Prilosec....... ref SDS D9 7J6K
050591 -    BP 137 76 Pulse 53          081212 081212   Rest........... ref SDS E1 5X6K
050592 -    Fatigue                     081212 081212   Exercise gym... ref SDS E1 LF8M
050593 -    Heartburn                   081212 081212   Prilosec....... ref SDS E1 7J6K
050594 -    BP 147 80 Pulse 51          081213 081213   Rest........... ref SDS E4 5X6K
050595 -    Fatigue                     081213 081213   Exercise gym... ref SDS E4 LF8M
050596 -    BP *** ** Pulse **          081214 081214   Rest........... ref SDS E5 5X6K
050597 -    Fatigue                     081214 081214   Rest........... ref SDS E5 LF8M
050598 -    BP *** ** Pulse **          081215 081215   Rest........... ref SDS E6 5X6K
050599 -    Fatigue                     081215 081215   Rest........... ref SDS E6 LF8M
050600 -    BP 144 79 Pulse 54          081216 081216   Rest........... ref SDS E7 5X6K
050601 -    Fatigue                     081216 081216   Exercise gym... ref SDS E7 LF8M
050602 -     ..
050603 -    Joint pain minor            081216 081216   Rest........... ref SDS E7 E38H
050604 -    BP 137 69 Pulse 63          081217 081217   Rest........... ref SDS E8 5X6K
050605 -    Fatigue                     081217 081217   Rest........... ref SDS E8 LF8M
050606 -    Feet toes neuropathy        081216 081217   Rest........... ref SDS E8 HY8M
050607 -    Joint pain minor            081217 081217   Rest........... ref SDS E8 E38H
050608 -    Nosebleed minor             081217 081217   Rest........... ref SDS E8 ZF5F
050609 -     ..
050610 -    BP *** ** Pulse **          081218 081218   Rest........... ref SDS F0 5X6K
050611 -    Fatigue                     081218 081218   Rest........... ref SDS F0 LF8M
050612 -    Joint pain minor            081218 081218   Rest........... ref SDS F0 E38H
050613 -    Nosebleed moderate          081218 081218   Rest........... ref SDS F0 ZF5F
050614 -    Throat pain eating          081218 081218   Eating less.... ref SDS F0 2B8M
050615 -    Feet toes neuropathy        081216 081218   Rest........... ref SDS F0 HY8M
050616 -    BP 155 84 Pulse 53          081219 081219   Rest........... ref SDS F3 5X6K
050617 -    Fatigue                     081121 081219   Rest........... ref SDS F3 LF8M
050618 -    Feet toes neuropathy        081216 081219   Rest........... ref SDS F3 HY8M
050619 -    Joint pain ill feeling      081121 081219   Rest........... ref SDS F3 E38H
050620 -    Throat sore eating          081218 081219   Eating less.... ref SDS F3 TT4O
050621 -    BP 123 69 pulse 53          081220 081220   Rest........... ref SDS F5 5X6K
050622 -    Fatigue                     081121 081220   Rest........... ref SDS F5 LF8M
050623 -    Feet toes neuropathy        081216 081220   Rest........... ref SDS F5 HY8M
050624 -    Joint pain ill feeling      081121 081220   Rest........... ref SDS F5 E38H
050625 -    Throat sore eating          081218 081220   Eating less.... ref SDS F5 TT4O
050626 -    BP 117 71 pulse 65          081221 081221   Rest........... ref SDS F7 5X6K
050627 -    Fatigue                     081121 081221   Rest........... ref SDS F7 LF8M
050628 -    Feet toes neuropathy        081216 081221   Rest........... ref SDS F7 HY8M
050629 -    Joint pain ill feeling      081121 081221   Rest........... ref SDS F7 E38H
050630 -    Throat sore eating          081218 081221   Eating less.... ref SDS F7 TT4O
050631 -    BP 117 71 pulse 65          081222 081222   Rest........... ref SDS F8 5X6K
050632 -    Fatigue                     081121 081222   Rest........... ref SDS F8 LF8M
050633 -    Feet toes neuropathy        081216 081222   Rest........... ref SDS F8 HY8M
050634 -    Joint pain ill feeling      081121 081222   Rest........... ref SDS F8 E38H
050635 -    Throat sore eating          081218 081222   Eating less.... ref SDS F8 TT4O
050636 -    BP 143 68 pulse 65          081223 081223   Rest........... ref SDS F8 5X6K
050637 -    Fatigue more energy         081121 081223   Exercise gym... ref SDS F9 LF8M
050638 -    Feet toes neuropathy better 081219 081223   Exercise gym... ref SDS F9 HY8M
050639 -    Joint pain subsides         081121 081223   Exercise gym... ref SDS F9 E38H
050640 -    Throat sore improved        081218 081223   Eating normal.. ref SDS F9 TT4O
050641 -    BP *** ** pulse **          081224 081224   Rest........... ref SDS G1 5X6K
050642 -    Fatigue more energy         081121 081224   Exercise gym... ref SDS G1 LF8M
050643 -    Feet feel better            081219 081224   Exercise gym... ref SDS G1 UO8I
050644 -    Joint pain subsides         081121 081224   Exercise gym... ref SDS G1 E38H
050645 -    Throat sore improved        081218 081224   Eating normal.. ref SDS G1 TT4O
050646 -    BP 124 80 pulse 66          081225 081225   Rest........... ref SDS G2 5X6K
050647 -    Fatigue more energy         081121 081225   Activity....... ref SDS G2 LF8M
050648 -    Fatigue more energy         081121 081226   Activity....... ref SDS G3 LF8M
050649 -    BP *** ** pulse **          081227 081227   Rest........... ref SDS G5 5X6K
050650 -    Fatigue more energy         081121 081227   Hiking......... ref SDS G5 LF8M
050651 -    BP *** ** pulse **          081228 081228   Rest........... ref SDS G6 5X6K
050652 -    Fatigue more energy         081121 081228   Rest........... ref SDS G6 LF8M
050653 -    BP 112 76 pulse 63          081229 081229   Rest........... ref SDS G7 5X6K
050654 -    Fatigue more energy         081121 081229   Rest........... ref SDS G7 LF8M
050655 -    BP *** ** pulse **          081230 081230   Rest........... ref SDS G9 5X6K
050656 -    Diarrhea                    081230 081230   Imodium........ ref SDS G9 KZ9N
050657 -    Fatigue more energy         081121 081230   Rest........... ref SDS G9 LF8M
050658 -    BP *** ** pulse **          081231 081231   Rest........... ref SDS H1 5X6K
050659 -    Fatigue more energy         081121 081231   Rest........... ref SDS H1 LF8M
050660 -    BP *** ** pulse **          090101 090101   Rest........... ref SDS H2 5X6K
050661 -    Fatigue more energy         081121 090101   Hiking......... ref SDS H2 LF8M
050662 -    BP *** ** pulse **          090102 090102   Rest........... ref SDS H3 5X6K
050663 -    Fatigue more energy         081121 090102   Hiking......... ref SDS H3 LF8M
050664 -    BP *** ** pulse **          090103 090103   Rest........... ref SDS H4 5X6K
050665 -    Fatigue less energy         081121 090103   Exercise gym... ref SDS H4 LF8M
050666 -    BP *** ** pulse **          090104 090104   Rest........... ref SDS H5 5X6K
050667 -    Fatigue less energy         081121 090104   Rest........... ref SDS H5 LF8M
050668 -    BP *** ** pulse **          090105 090105   Rest........... ref SDS H6 5X6K
050669 -    Fatigue less energy         081121 090105   Rest........... ref SDS H6 LF8M
050670 -    BP *** ** pulse **          090106 090106   Rest........... ref SDS H8 5X6K
050671 -    Fatigue less energy         081121 090106   Exercise gym... ref SDS H8 LF8M
050672 -    BP *** ** pulse **          090107 090107   Rest........... ref SDS H8 5X6K
050673 -    Fatigue less energy         081121 090107   Rest........... ref SDS I1 LF8M
050674 -    BP *** ** pulse **          090108 090108   Rest........... ref SDS I2 5X6K
050675 -    Fatigue less energy         081121 090108   Rest........... ref SDS I2 LF8M
050676 -    Eyes tearing                090108 090108   Eye drops...... ref SDS I2 518H
050677 -    BP *** ** pulse **          090109 090109   Rest........... ref SDS I7 5X6K
050678 -    Fatigue less energy         081121 090109   Rest........... ref SDS I7 LF8M
050679 -    Eyes tearing                090108 090109   Eye drops...... ref SDS I7 518H
050680 -    BP *** ** pulse **          090110 090110   Rest........... ref SDS I8 5X6K
050681 -    Fatigue less energy         081121 090110   Hiking......... ref SDS I8 LF8M
050682 -    Eyes tearing                090108 090110   Eye drops...... ref SDS I8 518H
050683 -    BP *** ** pulse **          090111 090111   Rest........... ref SDS J0 5X6K
050684 -    Fatigue more energy         081121 090111   Hiking......... ref SDS J0 LF8M
050685 -    Eyes tearing                090108 090111   Eye drops...... ref SDS J0 518H
050686 -    Feet toes neuropathy        090111 090111   Hiking......... ref SDS J0 HY8M
050687 -    BP 144 78 pulse 54          090112 090112   Rest........... ref SDS J1 5X6K
050688 -    Fatigue more energy         081121 090112   rest........... ref SDS J1 LF8M
050689 -    Eyes tearing                090108 090112   Eye drops...... ref SDS J1 518H
050690 -    Feet toes neuropathy        090111 090112   rest........... ref SDS J1 HY8M
050691 -    BP 153 74 pulse 49          090113 090113   Rest........... ref SDS 0 5X6K
050692 -    Fatigue more energy         081121 090113   Exercise gym... ref SDS 0 LF8M
050693 -    Eyes tearing                090108 090113   Eye drops...... ref SDS 0 518H
050694 -    Feet toes neuropathy        090111 090113   Exercise gym... ref SDS 0 HY8M
050695 -    Diarrhea                    090113 090113   Imodium........ ref SDS 0 KZ9N
050696 -
050697 -
050698 -
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 J1 3E4K, ref SDS J0 3E4K.
060405 -
060406 - Today, Millie went to the gym for aerobic exercise; she did not hike
060407 - at Lafayette reservoir due to rising...
060408 -
060409 -          Fatigue............................... ref SDS 0 LF8M
060410 -          Muscle weakness....................... ref SDS 0 KL4J
060411 -          Perpherial neuropathy
060412 -          pain in feet and toes................. ref SDS 0 HY8M
060414 -  ..
060415 - Aerobic exerecise was difficult on Millie's legs and feet at the gym
060416 - this morning, reported previously on 090102, ref SDS H3 6E7G, due to
060417 - rising side effects of fatigue from 19 cancer treatments beginning on
060418 - 081226. ref SDS J1 9I6T  Neupogen treatments on 090109 and on 090110,
060419 - and pausing cyclophosphamide may enable blood counts and energy to
060420 - rise, per above. ref SDS 0 LF8M
060422 -  ..
060423 - NEUTS blood tests show patient history treatments with Nuepogen for
060424 - neutropenia from chemotherapy everyday with cyclophosphamide reported
060425 - in case study on 081205. ref SDS C5 EC5N
060427 -  ..
060428 - On 081110, Millie complained about difficulty lifting herself from a
060429 - full squatting position. ref SDS 90 HX67  For several weeks, she was
060430 - exercising to strengthen legs, and arms, shown by going to the gym on
060431 - 081211. ref SDS D9 3E4K  Rising fatigue now prevents continuing
060432 - exercise.
060433 -
060435 -  ..
060436 - Case Study on Pateint History Exercising
060437 -
060438 - Follow up ref SDS J1 X64F, ref SDS J0 X64F.
060439 -
060440 -                                              +- scm = Sunitinib Cyclophosphmaide Methotrexate
060441 -                                              +- sc  = Sunitinib Cyclophosphmaide
060442 -                           Time     Pulse     |
060443 -    Location        Miles Minutes  Avg Max  Chem  Neupo  Date
060444 -    ----------------------------------------------------------------
060445 -    Concord home (gym)                        s         090113, ref SDS 0 3E4K
060446 -    Concord home                              s         090112, ref SDS J1 3E4K
060447 -    Lafayette        4.75   90.4    95 111    s         090111, ref SDS J0 3E4K
060448 -    Lafayette        2.75   58.9    85 105    s         090110, ref SDS I8 3E4K
060449 -    Concord home                              s         090109, ref SDS I7 3E4K
060450 -    Concord home                              sc        090108, ref SDS I2 3E4K
060451 -    Concord home                              sc        090107, ref SDS I1 3E4K
060452 -    Concord home (gym)                        sc        090106, ref SDS H8 3E4K
060453 -    Concord home                              sc        090105, ref SDS H6 3E4K
060454 -    Concord home                              sc        090104, ref SDS H5 3E4K
060455 -    Concord home (gym)                        sc        090103, ref SDS H4 3E4K
060456 -    Clayton Safeway  3.00   58.7    83  94    sc        090102, ref SDS H3 3E4K
060457 -    Lafayette        2.75   58.4    87 103    sc        090101, ref SDS H2 3E4K
060458 -    Concord home                              sc        081231, ref SDS H1 3E4K
060459 -    Concord home                              sc        081230, ref SDS G9 3E4K
060460 -    Concord home                              sc        081229, ref SDS G7 3E4K
060461 -    Concord home                              sc        081228, ref SDS G6 3E4K
060462 -    Lafayette        2.75   56.2    90 112    sc        081227, ref SDS G5 3E4K
060463 -    Concord home                              sc        081226, ref SDS G3 3E4K
060464 -    Concord travel                                      081225, ref SDS G2 3E4K
060465 -    Concord home                                        081224, ref SDS G1 3E4K
060466 -    Concord home (gym)                                  081223, ref SDS F9 3E4K
060467 -    Concord home                                        081222, ref SDS F8 3E4K
060468 -    Concord home                                        081221, ref SDS F7 3E4K
060469 -    Concord home                                        081220, ref SDS F5 3E4K
060470 -    Concord home                                        081219, ref SDS F3 3E4K
060471 -    Concord home                              sc        081218, ref SDS F0 3E4K
060472 -    Concord home                              sc        081217, ref SDS E8 3E4K
060473 -    Concord home (gym)                        sc        081216, ref SDS E7 3E4K
060474 -    Concord home                              sc        081215, ref SDS E6 3E4K
060475 -    Concord home                              sc        081214, ref SDS E5 3E4K
060476 -    Concord home (gym)                        scm       081213, ref SDS E4 3E4K
060477 -    Concord home                              scm       081212, ref SDS E1 3E4K
060478 -    Concord home (gym)                        sc        081211, ref SDS D9 3E4K
060479 -    Concord home                              sc        081210, ref SDS D5 3E4K
060480 -    Concord home                              sc        081209, ref SDS D3 3E4K
060481 -    Concord home                              sc        081208, ref SDS D2 3E4K
060482 -    Lafayette        4.75   78.6    95 110    sc        081207, ref SDS D1 3E4K
060483 -    Concord home                              scm       081206, ref SDS C9 3E4K
060484 -    Concord home                              scm       081205, ref SDS C5 3E4K
060485 -    Concord home                              sc        081204, ref SDS C4 3E4K
060486 -    Lafayette        2.75   62.7    90 117    sc        081203, ref SDS C3 3E4K
060487 -    Concord home (gym)                        sc        081202, ref SDS C1 3E4K
060488 -    Lafayette        5.50  102.3    95 122    sc        081201, ref SDS B9 3E4K
060489 -    Concord home                              sc        081130, ref SDS B8 3E4K
060490 -    Lafayette        2.75   56.7    90 115    scm       081129, ref SDS B7 3E4K
060491 -    Lafayette        2.75   46.5   100 128    scm       081128, ref SDS B4 3E4K
060492 -    Lafayette        5.50   93.3   100 122    s         081127, ref SDS B3 3E4K
060493 -    Concord home                              s         081126, ref SDS A9 3E4K
060494 -    Lafayette        4.00   73.7   105 127    s         081125, ref SDS A8 3E4K
060495 -    Lafayette        5.50   91.4   100 129    s         081124, ref SDS A7 3E4K
060496 -    Concord home                              s         081123, ref SDS A6 3E4K
060497 -    Lafayette        5.50   92.8    95 122    s         081122, ref SDS A5 3E4K
060498 -    Lafayette        5.50   94.4    85 112    s         081121, ref SDS A4 3E4K
060499 -    Lafayette        5.50   94.7    90 122    s         081120, ref SDS A3 3E4K
060500 -    San Francisco    1.00   60.0    65  75    s         081119, ref SDS A2 3E4K
060501 -    Lafayette        2.75   49.2    97 130    s         081118, ref SDS A1 3E4K
060502 -    Lafayette        5.50   93.6   115 138    s         081117, ref SDS 98 3E4K
060503 -    Concord home                              s         081116, ref SDS 96 Y68J
060504 -    Concord home                              s         081115, ref SDS 95 EK7I
060505 -    Concord home                              s         081114, ref SDS 94 XW6H
060506 -    Lafayette        5.50   94.2   115 138              081110, ref SDS 90 3E4K
060507 -    Lafayette        2.75   48.4   105 128              081109, ref SDS 89 3E4K
060508 -    Kaiser                                         x    081108, ref SDS 88 UZ7K
060509 -    Kaiser                                         x    081107, ref SDS 87 UZ7K
060510 -    Lafayette        5.50   90.2   120 143              081025, ref SDS 83 3E4K
060511 -    Kaiser                                         x    081025, ref SDS 83 UZ7K
060512 -    Kaiser                                         x    081024, ref SDS 82 UZ7K
060513 -    UCSF                                      c         081023, ref SDS 81 V94O
060514 -    Lafayette        5.50   90.6   115 141              081021, ref SDS 80 3E4K
060515 -    Lafayette        5.50   90.4   110 128              081020, ref SDS 79 3E4K
060516 -    Kaiser                                         x    081018, ref SDS 78 UZ7K
060517 -    Kaiser                                         x    081017, ref SDS 77 UZ7K
060518 -    UCSF                                      e         081016, ref SDS 75 V94O
060519 -    Lafayette        5.50   90.1   115 154              081014, ref SDS 74 3E4K
060520 -    Lafayette        5.50   92.7   115 138              081013, ref SDS 73 3E4K
060521 -    Lafayette        8.25  146.4   180 224              081012, ref SDS 72 3E4K
060522 -    Kaiser                                         x    081011, ref SDS 71 UZ7K
060523 -    Lafayette        5.50   93.3   116 138              081010, ref SDS 70 3E4K
060524 -    Kaiser                                         x    081010, ref SDS 70 UZ7K
060525 -    UCSF                                      e         081009, ref SDS 69 V94O
060526 -    Lafayette        5.50   92.1   113 137              081006, ref SDS 68 3E4K
060527 -    Lafayette        2.75   48.5   110 136         x    081004, ref SDS 67 3E4K
060528 -    Lafayette        5.50   98.2   117 136         x    081003, ref SDS 66 3E4K
060529 -    UCSF                                      c         081002, ref SDS 65 V94O
060530 -    Lafayette        5.50   94.7   115 142              080929, ref SDS 64 3E4K
060531 -    Lafayette        8.25  150.4   115 135              080928, ref SDS 64 3E4K
060532 -    Kaiser                                         x    080927, ref SDS 63 UZ7K
060533 -    Lafayette        5.50   90.2   120 140         x    080926, ref SDS 62 3E4K
060534 -    UCSF                                      c         080925, ref SDS 61 V94O
060535 -    Lafayette        5.50   92.3   116 138              080923, ref SDS 60 3E4K
060536 -    Lafayette        5.50   98.4   112 134              080922, ref SDS 60 3E4K
060537 -    Lafayette        5.50   98.2   114 137              080921, ref SDS 60 3E4K
060538 -    Lafayette        5.50  101.6   110 133         x    080920, ref SDS 59 3E4K
060539 -    Lafayette        5.50   89.3   115 144         x    080919, ref SDS 58 3E4K
060540 -    UCSF                                      c         080918, ref SDS 57 V94O
060541 -    Lafayette        2.75   46.2   117 139              080916, ref SDS 58 3E4K
060542 -    Lafayette        5.50   91.8   117 142              080915, ref SDS 56 3E4K
060543 -    Clayton Safeway  3.00   62.4    98 118              080914, ref SDS 55 3E4K
060544 -    Lafayette        8.25  129.7   123 147         x    080913, ref SDS 54 3E4K
060545 -    Lafayette        5.50   88.4   118 146         x    080912, ref SDS 53 3E4K
060546 -    UCSF                                      c         080911, ref SDS 52 V94O
060547 -    Lafayette        2.75   46.8   113 140              080909
060548 -    Lafayette        5.50   89.2   117 143              080908
060549 -    Lafayette        5.50   92.1   115 138              080907
060550 -    Lafayette        2.75   45.3   120 144         x    080906, ref SDS 51 3E4K
060551 -    Lafayette        2.75   56.8    93 120         x    080905, ref SDS 50 3E4K
060552 -    UCSF                                      c         080904, ref SDS 49 V94O
060553 -    Lafayette        8.25  140.4   116 131              080903
060554 -    Lafayette        5.50   94.9   115 134              080902
060555 -    Kaiser                                         x    080830
060556 -    Kaiser                                         x    080829
060557 -    UCSF                                      c         080828, ref SDS 48 V94O
060558 -    Lafayette        5.50   93.6   120 137              080826
060559 -    Lafayette        5.50   93.2   117 138              080825
060560 -    Lafayette        5.50   93.2   123 136         x    080823
060561 -    Lafayette        8.25  142.5   110 131         x    080822, ref SDS 47 3E4K
060562 -    UCSF                                      e         080821, ref SDS 46 V94O
060563 -    Lafayette        5.50   94.7   115 137              080820
060564 -    Lafayette        5.50   94.3   115 135              080819
060565 -    Lafayette        8.25  141.7   118 134              080815
060566 -    UCSF                                      e         080814, ref SDS 45 V94O
060567 -    Lafayette        5.50   93.8   120 136              080813
060568 -    Lafayette        5.50   94.4   116 139              080812
060569 -    Lafayette        5.50   94.2   119 133              080810
060570 -    Lafayette        8.25  143.6   114 132         x    080809, ref SDS 43 3E4K
060571 -    Lafayette        8.25  141.1   117 135         x    080808, ref SDS 42 3E4K
060572 -    UCSF                                      c         080807, ref SDS 41 V94O
060573 -    Lafayette        8.25  143.7   115 132              080805
060574 -    Concord          7.00  127.6   105 118              080804
060575 -    Lafayette        8.25  143.2   112 134              080802
060576 -    Lafayette        5.50   93.4   115 138              080801
060577 -    Lafayette        5.50   92.2   118 140              080729
060578 -    Lafayette        5.50   92.6   116 137              080728
060579 -    Lafayette        8.25  142.6   114 134              080727
060580 -    Lafayette        5.50   91.5   120 143              080726
060581 -    Lafayette        8.25  140.8   117 135              080725
060582 -    Lafayette        5.50   91.8   122 141              080723
060583 -    Lafayette        5.50   91.3   120 139              080722
060584 -    Lafayette        8.25  143.3   115 133              080720
060585 -    Lafayette        5.50   90.7   125 144              080719
060586 -    Lafayette        5.50   92.4   123 142              080716
060587 -    Lafayette        2.25   46.8   116 137              080715
060588 -    Lafayette        8.25  141.8   116 136              080712
060589 -    Lafayette        5.50   92.9   116 139              080711
060590 -    Lafayette        8.25  143.3   113 137              080704
060591 -    Lafayette        5.50   90.2   121 147              080630
060592 -    Lafayette        8.25  142.4   116 138              080628
060593 -    Lafayette        5.50   91.4   118 138              080625
060594 -    Lafayette        2.25   47.9   116 136              080623
060595 -    Lafayette        5.50   94.2   112 138              080622
060596 -    Lafayette        5.50   94.7   115 133              080621
060597 -    Lafayette        2.25   48.3   110 129              080620
060598 -    Mt Diablo        7.00  129.4   130 153              080616
060599 -    Lafayette        5.50   90.8   120 146              080615
060600 -    Lafayette        5.50   91.3   124 144              080614
060601 -    Lafayette        5.50   89.7   122 143              080613
060602 -    Lafayette        2.76   45.8   120 147              080611
060603 -    Lafayette        5.50   90.5   123 145              080609
060604 -    Lafayette        5.50   92.7   115 138              080607
060605 -    Lafayette        5.50   94.2   118 139              080602
060606 -    Lafayette        5.50   96.2   110 202              080507, ref SDS 19 WO8M
060607 -
060608 -
060609 -
060610 -
060611 -
060612 -
0607 -