CONTACTS 

SUBJECTS
2nd Opinion Retainer $300 Scope of Work  Rceived Support Medical Tea

1803 -
1803 -    ..
1804 - Summary/Objective
1805 -
180501 - Follow up ref SDS 76 0000. ref SDS 70 0000.
180502 -
180503 -
180504 -
180505 -
180507 -  ..
1806 -
1807 -
1808 - Background
1809 -
180901 - Prior work with Doctor Stritter is reported on 090106. ref SDS 48 KI5I
180902 - This record focuses on 2nd opinion for strategy to treat cancer as a
180903 - chronic disease after recovering from 6th relapse of IBC by achieving
180904 - local control with hyperthermia treatments at UCSF...
180905 -
180906 -    1.  Millie met Doctor Stritter during
180907 -        seminar presentation at Wellness
180908 -        Community cancer support
180909 -        group.............................. 081018, ref SDS 28 PQ6X
180911 -         ..
180912 -    2.  Doctor Stritter asked for copies of
180913 -        correspondence with the medical team
180914 -        on Millie's response to sunitinib
180915 -        treatment for cancer that supports
180916 -        Doctor Stritter's research on
180917 -        advanced cancer
180918 -        treatments......................... 081018, ref SDS 28 1Y4G
180920 -         ..
180921 -    3.  Doctor Stritter was helpful finding
180922 -        referral for resolving payment issues
180923 -        with Kaiser for Millie's treatment
180924 -        on referral to UCSF................ 081114, ref SDS 32 638G
180926 -         ..
180927 -    4.  Millie was confused, worried, and
180928 -        emotional about plans to maintain
180929 -        strong recovery from cancer and reduce
180930 -        side effects by adjusting treatments
180931 -        to tolerable levels on 081226,
180932 -        presented during meeting at
180933 -        UCSF............................... 081218, ref SDS 40 QW48
180934 -        as set out in the letter confirming
180935 -        understandings to the medical
180936 -        team............................... 081218, ref SDS 41 GF4V
180937 -        Millie submitted a copy to Doctor
180938 -        Stritter of the letter on 081218 to
180939 -        the medical team reporting results of
180940 -        examination at
180941 -        UCSF............................... 081218. ref SDS 41 4P7F
180943 -         ..
180944 -    5.  Millie sent a copy to Doctor Stritter
180945 -        of another letter to the primary care
180946 -        physician at Kaiser on 081219, requesting
180947 -        assistance managing the work plan at
180948 -        UCSF for Millie's treatment with
180949 -        sunitinib.......................... 081219, ref SDS 43 KY8Q
180950 -        noting that case management is
180951 -        difficult due to limited time and emotional
180952 -        feelings that prevent thorough analysis
180953 -        during meetings with
180954 -        doctors............................ 081219, ref SDS 43 SU8X
180956 -         ..
180957 -    6.  Millie's letter to Doctor Stritter
180958 -        requested second opinion on Millie's
180959 -        treatment with sunitinib staying at
180960 -        full strength and reducing or ending
180961 -        treatment with cyclophosphamide
180962 -        to reduce side
180963 -        effects............................ 081220, ref SDS 44 I69Q
180965 -         ..
180966 -    7.  Millie received a letter from Doctor
180967 -        Stritter with terms and conditions for
180968 -        2nd opinion, and transmitting a pdf file
180969 -        requesting patient history in a
180970 -        questionnaire...................... 081223, ref SDS 45 8N9M
180972 -         ..
180973 -    8.  Questionnaire could not be filled out
180974 -        in pdf file because Adobe Acrobat
180975 -        could not be configured; information
180976 -        requested in the form was
180977 -        entered in the
180978 -        record............................. 081223, ref SDS 45 DQ6J
180980 -         ..
180981 -    9.  Patient history for Doctor Stritter's
180982 -        2nd opinion support was developed
180983 -        in the SDS record.................. 090106, ref SDS 48 IP6H
180985 -         ..
180986 -   10.  Millie sent letter to Doctor Stritter
180987 -        with payment of $300 for 2nd
180988 -        opinion services................... 090106, ref SDS 48 S34O
180989 -        and listing objectives for
180990 -        conslutation....................... 090106, ref SDS 48 6H3Q
180992 -         ..
180993 -   11.  Doctor Stritter notified Millie that
180994 -        she was attending a professional conference
180995 -        on integrative oncology conference in
180996 -        Florida, and would respond to
180997 -        Millie's letter on
180998 -        090114............................. 090107, ref SDS 50 PJ3I ,
181000 -         ..
181001 -   12.  Doctor Stritter called and advised she
181002 -        needs another $300 to provide a 2nd
181003 -        opinion on treatments for
181004 -        Millie............................. 090114, ref SDS 51 U290
181005 -        doctor requested support reviewing
181006 -        Millie's complex patient history
181007 -        for 2nd opinion
181008 -        work............................... 090114, ref SDS 51 U271
181010 -         ..
181011 -   13.  Millie sent a letter to Doctor Stritter,
181012 -        ref SDS 54 3C5O, following up the letter
181013 -        on 090106 setting out scope of assignment,
181014 -        ref SDS 48 S34O, confirming understandings
181015 -        from the call on 090114, and submitting
181016 -        additional information on pathology
181017 -        reports and CT tests requested
181018 -        by the doctor...................... 090119, ref SDS 51 U271
181020 -         ..
181021 -   14.  Called Doctor Stritter who asked for
181022 -        information in a questionaire she
181023 -        submitted with a letter to Millie on
181024 -        091223, ref SDS 45 DQ6J, the doctor
181025 -        wants another $300 to provide a list
181026 -        of treatments that can
181027 -        help Millie........................ 090120, ref SDS 55 CM66
181029 -         ..
181030 -   15.  Millie sent a letter to Stritter Medical
181031 -        Consulting transmitting information
181032 -        requested in the Questionnaire
181033 -        received in the record on
181034 -        081223............................. 090121, ref SDS 56 C57O
181036 -         ..
181037 -   16.  Regrettably, time has become a factor
181038 -        because the cancer marker jumped to
181039 -        CA 15-3 303 for the lab on 090116.
181040 -        ref SDS 52 PQTQ; Millie needs
181041 -        input as soon as
181042 -        possible........................... 090121, ref SDS 56 SC5T
181044 -         ..
181045 -   17.  Dislocated shoulder from fall treatment
181046 -        in Emergency Department on 090122, and
181047 -        notice that UCSF ended Millie's
181048 -        treatment with sunitinib due to 6th
181049 -        relapse of IBC, and rising side
181050 -        effects; copy of letter to
181051 -        medical team sent to Doctor
181052 -        Stritter........................... 090123, ref SDS 58 KR4P
181054 -         ..
181055 -   18.  Millie letter notified Doctor Stritter
181056 -        that UCSF ended treatment with sunitinib
181057 -        due progression of
181058 -        disease............................ 090126, ref SDS 61 Q59G
181059 -        Millie meeting with UCSF on 090129
181060 -        asks Doctor Stritter for
181061 -        treatment options.................. 090126, ref SDS 61 066T
181063 -         ..
181064 -   19.  Doctor Stritter letter proposes teleon
181065 -        2nd opinion on 090203 or on 090205 at
181066 -        1600, and needs payment of another
181067 -        $300 paymnet in advance of
181068 -        consultation....................... 090127, ref SDS 62 L24J
181070 -         ..
181071 -   20.  Millie submitted payment of $300 and
181072 -        requests consultation on 090203,
181073 -        requests receipt................... 090127, ref SDS 62 HO5W
181075 -         ..
181076 -   21.  Doctor Stritter receives payment;
181077 -        says cannot have telecon on 090203;
181078 -        asks about having consultation
181079 -        on 090205 1600..................... 090130, ref SDS 65 4W6L
181081 -         ..
181082 -   22.  Millie responds to Gwen's letter on
181083 -        090130, ref SDS 65 4W6L, reports cancer
181084 -        is progressing [see Millie's letter to
181085 -        medical team on 090130, ref SDS 66 AY7X,
181086 -        and lining up treatment
181087 -        options has been
181088 -        difficult.......................... 090131, ref SDS 67 4W6L
181089 -        and shown in the letter to the
181090 -        medical team on 090130, with a copy
181091 -        to Gwen. ref SDS 66 W858
181093 -         ..
181094 -   23.  Primary objective for Stritter Medical
181095 -        is to submit research and written opinion
181096 -        listing treatments for IBC, and sources
181097 -        for Millie's complex patient profile,
181098 -        shown in Millie's letter to
181099 -        Gwen............................... 090131, ref SDS 67 H95S
181100 -        Obvious question is are there
181101 -        other treatments that can
181102 -        help me............................ 090131, ref SDS 67 H96U
181104 -         ..
181105 -   24.  Agenda requested a day or so before
181106 -        telecon consultation with a partial
181107 -        list of possible treatments, so
181108 -        people can be prepared with
181109 -        focused questions.................. 090131, ref SDS 67 H96X
181111 -         ..
181112 -   25.  Millie receives letter from Gwen
181113 -        reporting plans to submit preliminary
181114 -        research on 090203 in time to be
181115 -        prepared for telephone conference
181116 -        on 090205 1600; recommends start
181117 -        Doxil and hyperthermia
181118 -        at UCSF............................ 090202, ref SDS 70 EF9M
181120 -         ..
181121 -   26.  Millie received letter from Gwen
181122 -        transmitting preliminary research
181123 -        for cancer treatments that fit Millie's
181124 -        complex patient profile that requires
181125 -        continuing treatment for cancer as a
181126 -        chronic disease after hyperthermia and
181127 -        lower dose radiation at UCSF to achieve
181128 -        local control, and implements planning
181129 -        presented in Gwen's letter on 090202,
181130 -        ref SDS 71 EF9M, which responded to
181131 -        Millie's request in a letter to
181132 -        Stritter Medical Consulting on
181133 -        090131, ref SDS 68 H96X, for
181134 -        an agenda to guide telecon
181135 -        consultation scheduled
181136 -        for 090205......................... 090203, ref SDS 76 CF7J
181137 -
181139 -  ..
1812 -
1813 -
1814 - Progress
1815 -
181501 - Millie responds to Gwen's letter on 090203 2347 transmitting
181502 - preliminary report on treatments for Millie, ref SDS 76 CF7J, which
181503 - will be needed after hyperthermia treatment at UCSF achieves local
181504 - control of IBC, and Millie will require a strategy for continuing
181505 - treatment of cancer as a chronic disease, shown in Millie's letter to
181506 - UCSF earlier this morning on 090204 0219 calling for teamwork between
181507 - Kaiser and UCSF, and between UCSF Breast Care Clinic, and Radiation
181508 - Oncology, supervised by Doctor Rugo, ref SDS 78 278Q, and further
181509 - requesting medical opinion on teatments after hyperthermia.
181510 - ref SDS 78 278T
181511 -
181512 -    1.  Subject: Oncology Strategy Case Management
181513 -        Date: Wed, 04 Feb 2009 03:03:12 -0800
181520 -         ..
181521 -    3.  Your [preliminary] report is excellent; exactly what I was
181522 -        hoping to see, a list of possibilities [shown in Gwen's letter
181523 -        on 090203 2257, ref SDS 76 CF7J].  Looking forward to
181524 -        discussion on Thursday about how to investigate so we have a
181525 -        strategy to transition, when needed in a few weeks, or
181526 -        hopefully many months.
181528 -         ..
181529 -    4.  I think you were notified that UCSF came through yesterday, and
181530 -        moved my treatment from 090219 to 090205, Thursday [reported on
181531 -        090203 1438, ref SDS 74 XX5I, and shown in Millie's letter to
181532 -        the medical team on 090203 1444, ref SDS 75 YQ5W].  I am very
181533 -        pleased to have this opportunity.  I see the doctor at 0900,
181534 -        and expect to be home in time for your call at 4p.  I don't
181535 -        know how long the meeting at UCSF will take.  Initial review
181536 -        indicates that treatment occurs over days up to several weeks
181537 -        or more.
181539 -         ..
181540 -    5.  As you can see [from attached copy of Millie's letter to UCSF
181541 -        on 090203 0217, ref SDS 78 135F, I am striving to keep Doctor
181542 -        Rugo in the loop, ref SDS 78 278Q, but cost may be prohibitive.
181544 -         ..
181545 -    6.  As you request, I do not share your work product with Doctor
181546 -        Rugo.  This, however, is the type of thing I would like to get
181547 -        her input on with your permission.  I can anticipate she may
181548 -        resist commenting on trials at other facilities.  She said in a
181549 -        separate letter that she would not get hyperthermia treatment
181550 -        at VCI [letter from UCSF on 090203 2341, ref SDS 77 DY4K],
181551 -        which was proposed early yesterday [in Millie's letter to the
181552 -        medical team on 090203 1417, ref SDS 73 IS3P, when UCSF was
181553 -        saying I could not get treatment for 3 weeks (nearly had a
181554 -        heart attack) [see record on 090202 1353, ref SDS 69 XO7G].
181556 -         ..
181557 -    7.  In your report, hoping for some narrative to identify the most
181558 -        promising treatments, which should be tried first.  Perhaps the
181559 -        list is already set up that way?
181561 -         ..
181562 -    8.  Quick question - came across some research on evaluating blood
181563 -        or tissue, in my case IBC infected skin, for testing in a
181564 -        laboratory to discover the most effective cancer treatment
181565 -        [shown in the record on 090129, ref SDS 64 YL7G].
181567 -         ..
181568 -    9.  Looking forward to our talk tomorrow.
181569 -
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1816 -