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 3, 2009 12:03 PM Tuesday; Rod Welch

Called VCI to expedite hyphermia treatment for Millie recover from IBC.

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 16 0000. ref SDS 14 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -
040902 -    1.  On 090122 Doctor Rugo diagnosed progression of disease; Millie
040903 -        suffered 6th relapse of IBC.  The doctor ended treatment with
040904 -        sunitinib, and scheduled new treatment to begin on 090129.
040905 -        ref SDS 7 K96F
040907 -         ..
040908 -    2.  On 090129 Doctor Rugo indicated there was a communication mixup
040909 -        that delayed for a week authorization from Kaiser for Millie to
040910 -        get hyperthermia treatment at UCSF, shown in Millie's letter on
040911 -        090130. ref SDS 9 AY8Q
040913 -         ..
040914 -    3.  On 090202 1353 UCSF finally got authorization from Kaiser, and
040915 -        proposed giving Millie hyperthermia treatment on 090219.
040916 -        ref SDS 12 SP6H
040918 -         ..
040919 -    4.  On 090202 1437 Millie sent a letter to the medical team,
040920 -        ref SDS 13 JR4J, advising that IBC has significantly advanced
040921 -        since the meeting at UCSF on 090129, and asking if delaying
040922 -        treatment 3 weeks to 090219 would not place Millie at risk of
040923 -        losing control of cancer, because IBC is an aggressive disease.
040924 -        ref SDS 13 R23S
040926 -         ..
040927 -    5.  On 090202 1550 called VCI and talked to Nash about Millie
040928 -        getting hyperthermia treatment this week, ref SDS 14 YU8H, and
040929 -        prior to 090219 proposed by UCSF.  Nash indicated the cost
040930 -        would be about $40K. ref SDS 14 546H
040932 -         ..
040933 -    6.  On 090202 1550 VCI planned to call back about scheduling Millie
040934 -        for treatment.ref SDS 14 ML6F
040936 -         ..
040937 -    7.  On 090202 1932 letter from Doctor Rugo says Millie needs urgent
040938 -        treatment quickly in time to be effective recovering from 6th
040939 -        relapse of IBC. ref SDS 15 Y15J
040941 -         ..
040942 -    8.  On 090203 0939 called VCI and explained urgency of getting
040943 -        Millie hyperthermia treatment quickly in time to be effective,
040944 -        ref SDS 16 9Y5I, noted in Doctor Rugo's letter on 090202.
040945 -        ref SDS 15 Y15J
040947 -         ..
040948 -    9.  On 090203 1009 Millie submitted letter to VCI with background
040949 -        on patient history listed on 090121, ref SDS 4 NU5H, to
040950 -        facilitate medical review to evaluate providing hyperthermia
040951 -        treatment in time to be effective recovering from 6th relapse
040952 -        of IBC. ref SDS 16 IN94
040954 -         ..
040955 -   10.  On 090203 1024 called UCSF asked about changing date for
040956 -        Millie's hyperthermia treatment from 090219 to this week.
040957 -        ref SDS 17 NM6O, based on Doctor Rugo's letter on 090202
040958 -        advising medical team that Millie's urgent treatment done
040959 -        quickly. ref SDS 15 Y15J  Jennette plans to ask doctor
040960 -        advancing the date for Millie's treatment at UCSF in time to be
040961 -        effective. ref SDS 17 IX8S
040962 -
040963 -
040964 -
040965 -
040967 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Called VCI and talked to Nash.
041302 -
041303 - She has submitted Millie's patient background to the doctor's
041304 - assistant, but the doctor is still in a meeting with another patient.
041306 -  ..
041307 - Asked about talking to the assistant to facilitate effective
041308 - communication for the doctor.
041310 -  ..
041311 - Nash said that actually, she gave the information to the doctor.
041313 -  ..
041314 - She said that as soon as the doctor is finished talking to the
041315 - current patient (the door is closed), she will remind him to call
041316 - about Millie.
041317 -
041318 -            [...in another latter later today on 090203 1206 Doctor
041319 -            Al-Bussam with VCI called and offered to start hyperthermia
041320 -            treatment for Millie tomorrow in time to recover from 6th
041321 -            relapse of IBC. ref SDS 18 8488
041322 -
041323 -
041324 -
041325 -
041326 -
041327 -
041328 -
041329 -
041330 -
041331 -
0414 -






























or Al-Bussam said Millie's paitient history is very complicated, 041716 - and so took more time than for most patients. The doctor said the 041717 - record on 090121, ref SDS 4 NU5H, submitted with Millie's letter this 041718 - morning, per above. ref SDS 16 IN94 was well organized and this helped 041719 - his review. 041720 - 041721 - [On 090206 Doctor Stritter cited patient longevity 041722 - surprising for IBC credits case management. ref SDS 19 7Q7J 041724 - .. 041725 - Doctor Al-Bussam said that without seeing Millie he cannot say for 041726 - certain that delaying treatment will risk losing control. He feels 041727 - Doctor's Rugo's letter yesterday on 090202 saying Millie needs urgent 041728 - treatment that should be done quickly means right away, rather than 041729 - waiting to Feb 19th, proposed by UCSF yesterday on 090202 1353. 041730 - ref SDS 12 XO7G Doctor Al-Bussam noted the trend in the cancer 041731 - marker in Doctor Johnson's letter on 090122 showing CA 15-3 303 on 041732 - 090116 supports immediate treatment. ref SDS 6 FJ8W 041734 - .. 041735 - The doctor said that VCI can do the work tomorrow, and will take 1 - 2 041736 - weeks for the full treatment. Cost would run about $40K. 041738 - .. 041739 - They will do hyperthermia with radiation, and can add Doxil per Doctor 041740 - Rugo prescription in the letter on 090129. 041742 - .. 041743 - We need a PET/CT to identify IBC fields for treatment. We can get 041744 - this at Kaiser or they can do it at VCI, Kaiser cannot fit the work 041745 - in. 041746 - 041747 - [On 090203 medical team at Kaiser and UCSF asked for 041748 - opinion on accepting VCI offer to provide hyperthermia 041749 - treatment tomorrow on 090204 in time to be effective for 041750 - Millie to recover from IBC compared to UCSF offer to 041751 - delay treatment 3 weeks; and notes preference to work 041752 - with UCSF if schedule can be advanced to current week in 041753 - order to benefit from practice synergy. ref SDS 18 IS4R 041754 - 041755 - 041756 - 041757 - 041758 - 041759 - 041760 - 041761 - 0418 -