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: February 2, 2009 01:53 PM Monday; Rod Welch

Krshna called to schedule Millie's hyperthermia treatment on Feb 19th
needed for 6th relapse of IBC in time to be effective.

1...Summary/Objective


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SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 9 0000. ref SDS 6 0000.
040502 -
040503 -
040505 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Krshna called back, returning the message left earlier this morning in
040902 - the record on 090202 1138. ref SDS 9 6N5Q
040904 -  ..
040905 - Krshna said thanks for assisting UCSF coordinating to get
040906 - authorization from Kaiser for Millie's urgent treatment ordered by
040907 - Doctor Rugo on 090129, reported in Millie's letter to the medical team
040908 - on 090130, ref SDS 3 TZ6H
040910 -  ..
040911 - Krshna said she now has all of the documentation she requested on
040912 - 090130 to schedule Millie for urgent hyperthermia treatment.
040913 - ref SDS 2 XU6I
040915 -  ..
040916 - She commended Pam at Kaiser Outside Referrals in Walnut Creek, CA for
040917 - terrific work expediting Millie's referral, reported earlier today on
040918 - 090202 1047. ref SDS 7 9Y5I  Pam demonstrated persistance and
040919 - innovation solving difficult problems caused by initial incomplete
040920 - authorization and non-availability of Millie's doctor. ref SDS 7 0256
040921 - Krshna said referrals sometimes take weeks, even months to accomplish
040922 - complex case management, cited in Millie's letter to the medical team
040923 - earlier today on 090202 1139. ref SDS 10 M88H
040925 -  ..
040926 - Krshna said UCSF can schedule Millie to meet with Doctor Hsu on any
040927 - of the following dates...
040928 -
040929 -               090219 1000
040930 -               090220 1400
040931 -               090224 0900
040933 -  ..
040934 - Krshna asked if any of these dates are okay for Millie?  She advised
040935 - that Millie will not get actual treatment for another 3 - 5 weeks,
040936 - because the doctor needs to layout treatment zones, and carefully
040937 - design a work plan.
040938 -
040939 -        [On 090202 1550 called VCI and asked about Millie getting
040940 -        hyperthermia treatment immediately, rather than wait to 090219
040941 -        offered by UCSF. ref SDS 12 SP6H
040943 -         ..
040944 -        [On 090203 talked to Doctor Al-Bussam; he said VCI can start
040945 -        Millie's treatment on 090204, Wednesday, and will take about 2
040946 -        weeks, cost OA $40K. ref SDS 14 8488
040948 -         ..
040949 -        [On 090203 called UCSF Radiation Oncology and asked Jennette to
040950 -        advance Millie's treatment with hyperthermia to recover from
040951 -        6th relapse of IBC from 090219 to this week. ref SDS 15 UT7I
040953 -         ..
040954 -        [On 090203 1417 Millie notifies medical team alternate vendor
040955 -        for hyperthermia medical services can start tomorrow on 090204,
040956 -        ref SDS 16 IS3P, in time to be effective recovering from
040957 -        Millie's 6th relapse of IBC, and asks for medical opinion on
040958 -        VCI offer compared to waiting 3 weeks for treatment at UCSF.
040959 -        ref SDS 16 IS3Y
040961 -         ..
040962 -        [On 090202 1438 Jennette with UCSF Radiation Oncology
040963 -        Department called back and advised that Doctor Hsu will begin
040964 -        hypertermia treatment on 090205 so that Millie can recover from
040965 -        6th relapse of IBC, rather than risk waiting until 090219, as
040966 -        proposed yesterday. ref SDS 17 XX5I
040968 -  ..
040969 - Reviewed the record on 090129 (reported on 090130) showing Doctor Rugo
040970 - in the Breast Care Clinic prescribed treatment for Millie right away
040971 - to recover from 7th relapse of cancer, ref SDS 3 4S8O, because urgent
040972 - treatment was already delayed a week by communication and coordination
040973 - issues. ref SDS 3 AY8Q  Cited Doctor Rugo's letter this moring saying
040974 - that Doctor Hsu is aware of Millie's situation requires urgent
040975 - treatment. ref SDS 8 V47L
040977 -  ..
040978 - Krshna asvised that she was not aware Millie needs urgent treatment.
040979 -
040980 -        [On 090202 1932 letter from Doctor Rugo with copy to Krshna
040981 -        says Millie needs urgent treatment quickly in time to be
040982 -        effective recovering from 6th relapse of IBC. ref SDS 13 Y15J
040984 -  ..
040985 - Krshna advised that she talked to Doctor Hsu this morning about his
040986 - schedule.  The doctor did not mention anything about Millie.  Krshna
040987 - said there is nothing in the UCSF computer that says Millie needs
040988 - priority schedule for urgent treatment.  Krshna indicated other
040989 - patients were scheduled last week and this morning, so unless she is
040990 - told the patient needs urgent treatment, she can only go by what the
040991 - computer says.  Krshna noted that seeing the doctor in 3 weeks is very
040992 - fast for Radiation Oncology practice.  She does not feel comfortable
040993 - asking the doctor to advance Millie's treatment.
040995 -         ..
040996 -        [in another record today on 090202 1437 reported to medical
040997 -        team that Kashna in Radiation Oncology scheduled Millie for
040998 -        hyperthermia treatment on 090219, and advised that Doctor Hsu
040999 -        is not aware that Millie requires urgent treatment. ref SDS 11
041000 -        R23P
041002 -  ..
041003 - Krshna asked if Millie should be booked for treatment in 3 weeks on...
041004 -
041005 -               090219 1000
041007 -  ..
041008 - Decided to get something entered on the books, so requested that
041009 - Krshna enter the meeting, and try to coordinate with Doctor Hsu for a
041010 - determination that treatment for Millie on 090219 will be in time to
041011 - be effective.
041012 -
041013 -        [On 090202 1550 called VCI and asked about Millie getting
041014 -        hyperthermia treatment immediately, rather than wait to 090219
041015 -        offered by UCSF. ref SDS 12 SP6H
041017 -         ..
041018 -        [On 090203 talked to Doctor Al-Bussam; he said VCI can start
041019 -        Millie's treatment on 090204, Wednesday, and will take about 2
041020 -        weeks, cost OA $40K. ref SDS 14 8488
041022 -  ..
041023 - Krshna suggested that Doctor Rugo coordinate with Doctor Hsu if she
041024 - feels Millie needs urgent treatment before 090219 scheduled today.
041025 -
041026 -        [...in another record today on 090202 Millie reports IBC
041027 -        disease has increased significantly since meeting at UCSF on
041028 -        090129, ref SDS 11 R23S, further notes that UCSF proposal to
041029 -        delay treatment seems shocking compared to progression of IBC
041030 -        shown by cancer marker CA 15-3 303 on Kaiser lab on 090116,
041031 -        ref SDS 11 R23Y; asks medical team if delaying treatment to
041032 -        090219 does not risk losing local control. ref SDS 11 R23V
041034 -         ..
041035 -        [On 090202 1932 letter from Doctor Rugo says Millie needs
041036 -        urgent treatment quickly in time to be effective recovering
041037 -        from 6th relapse of IBC. ref SDS 13 Y15J
041039 -         ..
041040 -        [On 090203 talked to Doctor Al-Bussam; he said VCI can start
041041 -        Millie's treatment on 090204, Wednesday, and will take about 2
041042 -        weeks, cost OA $40K. ref SDS 14 8488
041044 -         ..
041045 -        [On 090203 called UCSF Radiation Oncology and asked Jennette to
041046 -        advance Millie's treatment with hyperthermia to recover from
041047 -        6th relapse of IBC from 090219 to this week. ref SDS 15 UT7I
041049 -  ..
041050 - Krshna gave an email address to expedite coordination for timely
041054 -  ..
041055 - Thanked Krshna for assistance.
041056 -
041057 -
041058 -
041059 -
041060 -
041061 -
0411 -