CONTACTS 
020204 -

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 99 0000. ref SDS 97 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  Case study dilemma balancing sunitinib treatments to optimize
040902 -        recovery from 5th relapse IBC, and without increasing
040903 -        debilitating side effects that prevent exercise required to
040904 -        benefit from recovery. ref SDS 29 I87N
040906 -         ..
040907 -    2.  On 090108 examination at UCSF showed possible progression of
040908 -        IBC in breastbone area, as set out in Millie's letter to the
040909 -        medical team on 090109. ref SDS 31 UC4H  Millie reported severe
040910 -        side effects shown by wide range of blood counts falling.
040911 -        ref SDS 31 UF3Q  Medical team prescribed another cycle
040912 -        sunitinib treatment, with cyclophosphamide paused until blood
040913 -        counts increase to a safe level. ref SDS 31 UF3T
040915 -         ..
040916 -    3.  On 090109 Millie's letter reports rise of IBC with sunitinib
040917 -        seen at UCSF on 090108 occurred previously, cited in Millie's
040918 -        letter on 081125, ref SDS 24 XX4P; there was rise of IBC and
040919 -        then substantial recovery reported again on 081217, ref SDS 25
040920 -        YJ4V; on 081230 Millie's letter reported on 081224 and 081225
040921 -        rise of IBC, and then improvement on 081226, ref SDS 29 JV5M;
040922 -        most recently on 090106 Millie cited again advance of IBC on
040923 -        081224 and 081225, and now disease seems to be subsiding again.
040924 -        ref SDS 30 YO4V]
040926 -         ..
040927 -    4.  On 090115 Millie letter to Catherine and Diane in the Infusion
040928 -        Clinic at UCSF reported rising side effects of sunitinib
040929 -        protocol, ref SDS 34 5J9Y; she tried hiking a few times, but
040930 -        this hurts her feet (peripheral neuropathy) and legs are very
040931 -        weak, shown in patient history on daily treatments. ref SDS 33
040932 -        KL4J  Have been spending more time in the gym doing aerobics,
040933 -        which is a little more tolerable. ref SDS 33 3E4K
040935 -         ..
040936 -    5.  On 090116 Glenna called to ask about response to treatment and
040937 -        side effects, ref SDS 35 JY6L, and was advised that IBC in the
040938 -        breastbone area was stable to worse, and other sites are stable
040939 -        to improved with sunitinib protocol, citing the record of
040940 -        patient history the day before on 090115. ref SDS 33 124N
040942 -         ..
040943 -    6.  On 090116 during call from Glenna advised that Millie wants to
040944 -        reduce the dose of sunitinib in order to reduce debilitating
040945 -        side effects, and requested remedy to reduce side effects with
040946 -        full dose of sunitinib in order to optimize recovery.
040947 -        ref SDS 35 JY7J
040949 -         ..
040950 -    7.  On 090116 Millie received a letter from Glenna transmitting a
040951 -        copy of a letter Glenna wrote to the doctor reporting
040952 -        understandings from telecon in the morning on 090116,
040953 -        ref SDS 37 YN9H; Glenna's letter to the doctor described
040954 -        difficulty tolerating side effects of sunitinib, and IBC on
040955 -        breastbone area looks worse, ref SDS 37 4P5M, that Millie wants
040956 -        to reduce the dose to reduce side effects, but is afraid about
040957 -        losing benefits of recovering from IBC. ref SDS 37 HV3M
040959 -         ..
040960 -    8.  On 090116 Glenna's letter to the doctor asked about changing to
040961 -        another treatment. ref SDS 37 HV3O
040963 -         ..
040964 -    9.  On 090116 Glenna planned to meet with the doctor later in the
040965 -        day on 090116 to discuss changing Millie's treatment.
040966 -        ref SDS 37 HP4J
040968 -         ..
040969 -   10.  On 090116 Millie's letter to the medical team clarifies telecon
040970 -        on condition following examination at UCSF on 090108, reporting
040971 -        IBC in breastbone area looks stable to worse, and everywhere
040972 -        else looks improved to stable, indicating recovery has slowed
040973 -        ref SDS 38 IS6G, relative to findings on 081218, ref SDS 26
040974 -        VD4F, confirmed in Millie's letter later that day reporting
040975 -        significant recovery. ref SDS 27 GF8V
040977 -         ..
040978 -   11.  On 090118 Millie talks about wanting to end treatment with
040979 -        sunitinib that seems now less effective and has severe side
040980 -        effects after adding cycloposphamide. ref SDS 39 UC41
040982 -         ..
040983 -   12.  On 090121 Millie letter to primary care physician says very
040984 -        pleased to take this occasion on my birthday to say thanks for
040985 -        such great care the past 7 years.  You noted in our first
040986 -        meeting on 020321 that Oncology presents unique challenges.
040987 -        ref SDS 2 R94H  My case has been complicated by other maladies
040988 -        that strain resources of time, money, and emotion.  Having you
040989 -        at the helm with Arlette's assistance has been a blessing.
040990 -        ref SDS 42 F23Y
040992 -         ..
040993 -   13.  On 090121 Glenna calls and asks again about Millie's response
040994 -        to treatment, ref SDS 43 AJ3J, following up her call on 090116,
040995 -        ref SDS 35 JY6L, and per background above. ref SDS 43 JY5I
040997 -         ..
040998 -   14.  On 090121 during call from Glenna reported patient history,
040999 -        ref SDS 43 ZO4F, on 090120 shows IBC rash looks improved to
041000 -        stable, and nodules in the breastbone area seem worse,
041001 -        ref SDS 41 124N, relative to detailed review on 090110,
041002 -        ref SDS 32 124N, and after 11 days of treatment with only
041003 -        sunitinib, and 25 total treatments with sunitinib, since the
041004 -        pause on 081218 and resuming on 081226. ref SDS 40 6C4J
041006 -         ..
041007 -   15.  On 090121 during call from Glenna reported patient history
041008 -        reported IBC worsening in breastbone area has progressed onto
041009 -        the right breast and spread toward the left chest reflects
041010 -        rising cancer marker, ref SDS 43 N95K, Labs at Kaiser on 090116
041011 -        report CA 15-3 303. ref SDS 36 PQTQ  This record indicates
041012 -        Millie has suffered 6th relapse of IBC.
041014 -         ..
041015 -   16.  On 090121 Glenna asked for most severe side effects from
041016 -        continuing with sunitinib treatment. ref SDS 43 TW53
041018 -         ..
041019 -   17.  On 090121 Glenna asked for Millie's records on Doctor Rugo's
041020 -        plans for follow on treatments?  During the call developed
041021 -        background on UCSF planning for Millie's future treatment after
041022 -        sunitinib. ref SDS 43 Y67L
041024 -         ..
041025 -   18.  On 090121 Glenna reported during the call that she would send
041026 -        another letter to Doctor Rugo explaining Millie's slow response
041027 -        to treatment with sunitinib, and supplementing Glenna's letter
041028 -        to the doctor on 090116, ref SDS 54 SY5J; Glenna further
041029 -        advised during the call on 090121 that she would meet again
041030 -        with Doctor Rugo to discuss plans for changing Millie's
041031 -        treatment to recover from Millie's 6th IBC relapse. ref SDS 43
041032 -        N976
041033 -
041034 -           [On 090225 1752 notified Sally that we cannot attend funeral
041035 -           services for Uncle Jim on 090303, because Millie has
041036 -           treatment that day, and is in a perilous condition.
041037 -           ref SDS A8 TR4U
041039 -         ..
041040 -   19.  On 090121 patient history summarized to faciliate Glenna's
041041 -        meeting with Doctor to figure out Millie's next treatment.
041042 -        ref SDS 43 NU5H
041044 -             ..
041045 -        a.  Laboratory blood tests listed for Millie to facilitate UCSF
041046 -            considering Millie's next treatment. ref SDS 43 6Y9K
041048 -             ..
041049 -        b.  Image test history of PET, CT, Xray, MRI listed for Glenna
041050 -            to discuss with Doctor Rugo discussing Millie's next
041051 -            treatment. ref SDS 43 216F
041053 -             ..
041054 -        c.  Treatment history listed for Glenna to discuss with Doctor
041055 -            Rugo discussing Millie's next treatment. ref SDS 43 H16M
041057 -             ..
041058 -        d.  Strategy considerations for selecting Millie's next
041059 -            treatment. ref SDS 43 558O
041061 -         ..
041062 -   20.  On 090122 telephone message from Glenna reported that the
041063 -        doctor ended treament with sunitinib protocol; Glenna met with
041064 -        Doctor Rugo to develop treatment plan for Millie, and UCSF
041065 -        scheduled Millie to start new treatment on 090129. ref SDS 47
041066 -        K96F
041068 -         ..
041069 -   21.  On 090123 primary care physician at Kaiser cited sudden relapse
041070 -        of IBC with nodules spreading in the breastbone area, and
041071 -        cancer marker elevated to CA 15-3 303 in the labs at Kaiser on
041072 -        090116, ref SDS 36 PQTQ, shows Millie needs immediate change of
041073 -        treatment to prevent cancer from cascading out of control, and
041074 -        that UCSF should prescribe treatment, ref SDS 52 RK6O, because
041075 -        Millie's 6th relapse of IBC shows cancer has mutated to cells
041076 -        that are now very resistant to treatments available at Kaiser,
041077 -        as discussed previously during the meeting at Kaiser on 080829,
041078 -        and cited in Millie's letter to the medical team. ref SDS 21
041079 -        RP9R
041081 -         ..
041082 -   22.  On 090123 Millie's letter to medical team reports progress at
041083 -        UCSF scheduling Millie to start on a new treatment. ref SDS 48
041084 -        KR4P
041086 -         ..
041087 -   23.  On 090123 Glenna called and thanked her for expediting Millie's
041088 -        new treatment to start on 090129 so that cancer does not
041089 -        cascade out of control, ref SDS 49 TR80; request documentation
041090 -        on new treatment in order to be prepared starting on 090129
041091 -        0830, as presented in Glenna's telephone message on 090122,
041092 -        ref SDS 47 AT6N
041094 -         ..
041095 -   24.  On 090123 Glenna advised during her call that there was not
041096 -        enough time to meet with Doctor Rugo on 090121; she received a
041097 -        letter from the doctor to coordinate with Kaiser on getting
041098 -        timely referral to start Millie's next treatment at UCSF on
041099 -        090129. ref SDS 49 118M
041101 -         ..
041102 -   25.  On 090123 Doctor Johnson, Millie's primary care physician at
041103 -        Kaiser, called and confirmed prior advice that Doctor Rugo can
041104 -        prescribe follow on treatment for Millie because her cancer has
041105 -        become resistant to drugs available at Kaiser. ref SDS 52 8K6K
041107 -         ..
041108 -   26.  On 090127 Millie letter to medical team reporting Doctor
041109 -        Johnson called on 090123 to advise of approval for Doctor Rugo
041110 -        to prescribe Millie's follow on treatment at UCSF to start
041111 -        immediately on 090129. ref SDS 54 TY5W
041113 -         ..
041114 -   27.  On 090127 Millie's letter to the medical team submitted patient
041115 -        history to facilitate prescribing new treatment for Millie's
041116 -        6th relapse of IBC. ref SDS 54 TY6S
041118 -         ..
041119 -   28.  On 090127 Millie's letter reported side effects of sunitinib
041120 -        have begun to subside after stopping treatment on 090122 in
041121 -        order to prepare to start new treatment on 090129. ref SDS 54
041122 -        TY8T
041124 -         ..
041125 -   29.  On 090128 Millie letter to primary care physician and the
041126 -        medical team reported IBC worsening, and taking Vicodin for
041127 -        pain. ref SDS 56 2S8X
041129 -         ..
041130 -   30.  On 090129 Doctor Rugo sent a letter to primary care physician
041131 -        at Kaiser reporting rising pain from worsening IBC, ref SDS 63
041132 -        TZ6H; and, requesting referral to UCSF for treatment with
041133 -        hyperthermia and Doxil, reported in Millie's letter to medical
041134 -        team on 090130. ref SDS 63 AY9Q
041136 -         ..
041137 -   31.  On 090130 Millie letter to primary care physician, ref SDS 63
041138 -        GV4M, reports examination at UCSF on 090129 found rising vitals
041139 -        signal Millie suffering rising pain, ref SDS 63 AY7T, because
041140 -        IBC progressing rapidly, ref SDS 63 4S8O, as Doctor Johnson
041141 -        noted earlier on 090123, ref SDS 52 8K6K;
041143 -         ..
041144 -   32.  On 090130 Millie letter to primary care physician advises UCSF
041145 -        reported communication delay prevented getting referral from
041146 -        Kaiser, which then delayed starting hyperthermia treatment on
041147 -        090129 in time to be effective. ref SDS 63 AY8Q
041149 -         ..
041150 -   33.  On 090130 Millie letter to medical team reports that on 090129
041151 -        coordinating timely referral from Kaiser was delayed because
041152 -        primary care physician was not in the office. ref SDS 63 AY9T
041154 -         ..
041155 -   34.  On 090130 Krshna called Millie to schedule hyperthermia
041156 -        treatment in the Radiation Oncology Department, and said that
041157 -        UCSF has not received referral authorization from Kaiser.
041158 -        ref SDS 61 NM5H
041160 -         ..
041161 -   35.  On 090130 called Arlette, ref SDS 62 RY4G, and she contacted
041162 -        Doctor Johnson off-site in a meeting, and he advised that the
041163 -        doctor would file authorization in the evening on 090130.
041164 -        ref SDS 62 PPYY
041166 -         ..
041167 -   36.  On 090131 2318 Millie received letter from Doctor Johnson,
041168 -        primary care physician, that Kaiser authorization was issued on
041169 -        090130, ref SDS 64 GV4M, for Millie to get treatment for 6th
041170 -        relapse of IBC with hyperthermia and Doxil, prescribed by
041171 -        Doctor Rugo on 090129 (reported in Millie's letter on 090130.
041172 -        ref SDS 63 AY9Q
041174 -         ..
041175 -   37.  On 090201 Millie letter reports to medical team 6th relapse IBC
041176 -        getting worse by the hour requires immediate treatment to
041177 -        prevent cancer from getting out of control.  Rising pain from
041178 -        IBC makes sleeping difficult. ref SDS 65 KN9T
041180 -         ..
041181 -   38.  On 090201 Millie plans to go to UCSF for treatment tomorrow on
041182 -        090202 when convenient for Doctor Hsu to provide hypethermia
041183 -        treatment. ref SDS 65 KN9W
041185 -         ..
041186 -   39.  On 090201 Millie reports lymphedema recurrence caused by
041187 -        sling-immobilizer to treat dislocated shoulder on 090122;
041188 -        advises Cellulitis did not recur, as previously. ref SDS 65
041189 -        KN4S
041191 -         ..
041192 -   40.  On 090201 Millie reports good news energy recovering after side
041193 -        effects from stopping treatment on sunitinib clinical study
041194 -        ordered by Doctor Rugo on 090122. ref SDS 65 KN4Y
041196 -         ..
041197 -   41.  On 090201 UCSF letter notifies Millie that Doctor Rugo is
041198 -        communicating with Doctor Hsu using email to expedite Millie's
041199 -        treatment; recommends that Millie not come to UCSF on Monday
041200 -        090202 in order to assist the medical team start hyperthermia
041201 -        treatment in time to be effective. ref SDS 66 GV4M
041203 -         ..
041204 -   42.  On 090201 Millie letter assures medical team that the patient
041205 -        would not "camp out" in Doctor Hsu's office, but would stand-by
041206 -        in the cafeteria so that treatment can begin when convenient
041207 -        for UCSF, and without waiting for patient to travel through
041208 -        mid-day traffic, so that urgent treatment is not delayed beyond
041209 -        a point when treatment can no longer be effective. ref SDS 67
041210 -        GV4M
041212 -         ..
041213 -   43.  On 090201 Millie asks Doctor Rugo about coordinating to provide
041214 -        medical records on file in the doctor's office the past 2 years
041215 -        treating Millie at UCSF, ref SDS 67 5R4S, to use by Doctor Hsu,
041216 -        requested by Krshna in a call the day before on 090130.
041217 -        ref SDS 61 DL4J
041219 -         ..
041220 -   44.  On 090201 emotional trauma esclates from delays getting
041221 -        treatment for aggressive cancer that seems to be cascading out
041222 -        of control because of communication delays. ref SDS 67 5R4V
041224 -         ..
041225 -   45.  On 090202 Michelle at UCSF called in the morning, and said
041226 -        Kaiser has not submitted authorization for Millie's treatment
041227 -        by Doctor Hsu. ref SDS 69 9Y5I  Michelle asked the patient to
041228 -        coordinate with the primary care physician at Kaiser to file
041229 -        Authorization, ref SDS 69 9Y6Y, reported in Millie's letter to
041230 -        the medical team. ref SDS 71 GV4M
041232 -         ..
041233 -   46.  On 090202 Michelle was advised that Doctor Johnson reported in
041234 -        a letter on 090131 that Doctor Rugo at UCSF was notified on
041235 -        090130 that Kaiser issued authorization for Millie's treatment,
041236 -        ref SDS 64 GV4M, and further that Doctor Johnson would be out
041237 -        of town for several days, so he is not available on 090202 for
041238 -        coordinating requested by UCSF on 090202, ref SDS 68 Y35M, to
041239 -        file duplicate authorization, reported in Millie's letter to
041240 -        the medical team on 090202 1028. ref SDS 71 FR6P
041242 -         ..
041243 -   47.  On 090202 0940 numerous calls were made to coordinate.
041244 -        ref SDS 70 9Y5I  Florida in Kaiser Oncology Department, Walnut
041245 -        Creek CA advised that Pam in Kaiser Outside Referrals
041246 -        Department said the doctor did not enter a "code" in the
041247 -        Authorization form for hyperthermia treatment, so Pam is
041248 -        waiting to get the code when the doctor returns from traveling
041249 -        sometime in the next few days, ref SDS 70 1A5J, reported in
041250 -        Millie's letter to the medical team. ref SDS 71 FR7R
041252 -         ..
041253 -   48.  On 090202 1012 called Kaiser Outside Referrals and left a
041254 -        message that we need submission of authorization, so that
041255 -        Millie can get treatment in time to be effective. ref SDS 70
041256 -        W17K  Suggested Outside Referrals send written notice to
041257 -        Michelle Williams Jones at UCSF that authorization is on file
041258 -        at Kaiser, and will be submitted to UCSF, so that my treatment
041259 -        can be initiated concurrently. ref SDS 70 254F, reported in
041260 -        Millie's letter to the medical team. ref SDS 71 FR7U
041262 -         ..
041263 -   49.  On 090202 1047 Pam in Outside Referrals at Kaiser called and
041264 -        disclosed that the department needed to know the type of
041265 -        treatment Millie would get on referral to UCSF?  Advised
041266 -        treatment is "hyperthermia," in the Radiation Oncology
041267 -        department at UCSF.  Pam reported that Kaiser does not have a
041268 -        code for "hypethermia" nor for "Radiation Oncology."  Pam used
041269 -        a code for "Radiology."  Problem solved. ref SDS 72 QQ7N, and
041270 -        reported in Millie's letter to the medical team on 090202 1139.
041271 -        ref SDS 74 M88H
041273 -         ..
041274 -   50.  On 090202 1117 Pam called back and wanted to know if referral
041275 -        to UCSF is for in-patient or out-patient treatment?  Since
041276 -        radiation is often out-patient care, and initial discussions
041277 -        did not indicate Millie would require staying in the hospital,
041278 -        Pam coded the form for out-patient care, reported in the record
041279 -        on 090202 1047]. ref SDS 72 0256, and reported in Millie's
041280 -        letter to the medical team on 090202 1139. ref SDS 74 C94Y
041282 -         ..
041283 -   51.  On 090202 1118 Doctor Rugo notified the medical team that
041284 -        Doctor Hsu cannot see Millie on 090202; advises that Doctor Hsu
041285 -        is aware of Millie's situation. ref SDS 73 V47L
041287 -         ..
041288 -   52.  On 090202 1353 Doctor Hsu's assistant, Krshna reported that the
041289 -        doctor was not aware of urgency to treat Millie, cited in
041290 -        Doctor Rugo's letter on 090202 1118. ref SDS 73 V47L   Krshna
041291 -        proposes scheduling the work on 090219, ref SDS 75 XO7G, and
041292 -        does not feel comfortable asking Doctor Hsu to advance the date
041293 -        for treatment, because his schedule is already booked.
041294 -        ref SDS 75 SP8I, reported in Millie's letter to the medical
041295 -        team on 090202 1437. ref SDS 76 R23P
041297 -         ..
041298 -   53.  On 090202 1353 Krshna offers UCSF Radiation Oncology schedule
041299 -        hyperthermia treatment 3 weeks delay to 090219. ref SDS 75 XO7G
041301 -         ..
041302 -   54.  On 090202 1437 Millie notifies medical team that UCSF received
041303 -        Kaiser authorizations for treating the 6th relapse of IBC,
041304 -        ref SDS 76 JR4J, reported on 090202 1353. ref SDS 75 SP6H
041305 -        Millie thanks Doctor Rugo for expediting authorization with
041306 -        Doctor Johnson at Kaiser, citing Doctor Rugo's letter to Doctor
041307 -        Johnson on 090129, reported on 090130, ref SDS 63 TZ6H, Doctor
041308 -        Rugo's letter to medical team on 090202 1118, indicating Doctor
041309 -        Hsu is aware of Millie's situation. ref SDS 73 V47L
041311 -         ..
041312 -   55.  On 090202 1437 IBC disease has advanced significantly since
041313 -        examination at UCSF on 090129, and pain on chest is rising.
041314 -        Since Doctor Rugo has much more experience with IBC, if this
041315 -        just "looks bad," but delaying treatment to 090219 presents no
041316 -        risk of losing control, then I am fine with waiting until the
041317 -        19th. ref SDS 76 R23S
041319 -         ..
041320 -   56.  On 090202 1437 Millie notifies UCSF that Krshna indicated if
041321 -        Doctor Rugo feels earlier treatment is needed, she can notify
041322 -        Doctor Hsu directly. ref SDS 75 F65G, cited in Millie's letter
041323 -        to medical team on 090202 1437, ref SDS 76 R23V
041325 -         ..
041326 -   57.  On 090202 1437 Millie apologizes for adding to Doctor Rugo's
041327 -        work load.  Waiting to the 19th is a shock compared to what
041328 -        Millie sees on her chest.  Results for CA 15-3 from the lab
041329 -        last week on 090129 have not been published, but expect it will
041330 -        be 200+, since it was 303 at Kaiser on 090116. ref SDS 36 PQTQ
041331 -        Those are scary numbers in Millie's patient history.  Millie
041332 -        avers being a "sissy."  Doctor Rugo and others at UCSF and
041333 -        Kaiser are working hard to help Millie and many other patients,
041334 -        cited in Millie's letter to medical team on 090202 1437.
041335 -        ref SDS 76 R23Y
041337 -         ..
041338 -   58.  On 090202 1550 called VCI and asked about Millie getting
041339 -        hyperthermia treatment immediately, rather than wait to 090219
041340 -        offered by UCSF. ref SDS 77 YU8H
041342 -         ..
041343 -   59.  On 090202 1732 Doctor Rugo letter notifies medical team that
041344 -        Millie needs urgent treatment quickly to be effective.
041345 -        ref SDS 78 Y15J
041347 -         ..
041348 -   60.  On 090203 0939 call VCI and schedule call to discuss alternate
041349 -        source for Millie to get hyperthermia treatment in time to be
041350 -        effective recovering from 6th relapse of IBC. ref SDS 79 9Y5I
041352 -         ..
041353 -   61.  On 090203 1009 letter to VCI submits patient history for review
041354 -        to support telephone conference, ref SDS 79 IN94, on arranging
041355 -        for VCI to provide hyperthermia treatment in time for Millie to
041356 -        recover from 6th relapse of IBC. ref SDS 79 EP3S
041358 -         ..
041359 -   62.  On 090203 1024 called UCSF talked to Jennette in Radiation
041360 -        Oncology; she will discuss with Doctor Hsu advancing Millie
041361 -        getting hyperthermia treatment from 090219 to this week.
041362 -        ref SDS 80 XX5I
041364 -         ..
041365 -   63.  On 090203 1206 Doctor Al-Bussam called and reported well
041366 -        ordered record for Millie's patient history enabled expedited
041367 -        review of complex medical problems. ref SDS 81 8488  VCI
041368 -        offered to start work the next day on 090204 giving Millie
041369 -        hyperthermia treatment in time to be effective recoverying from
041370 -        6th relapse IBC. ref SDS 81 OE4F
041372 -         ..
041373 -   64.  On 090203 1417 Millie's letter to medical team reports VCI
041374 -        proposal to provide hyperthermia treatment in time to be
041375 -        effective starting tomorrow on 090204. ref SDS 82 IS3P
041377 -         ..
041378 -   65.  On 090203 1417 Millie advises medical team that if UCSF can
041379 -        juggle the schedule to start treatment in the next few days,
041380 -        Millie prefers working with Doctor Hsu locally, based on
041381 -        excellent results working with Doctor Rugo.  There is a lot of
041382 -        benefit to close practice collaboration at UCSF. ref SDS 82
041383 -        IS3Y
041385 -         ..
041386 -   66.  On 090203 1417 alternatively, Millie requests a medical opinion
041387 -        on risks of waiting to Feb 19th against advantages of doing the
041388 -        work tomorrow at VCI. ref SDS 82 IS4R
041390 -         ..
041391 -   67.  On 090203 1417 Millie ask whether treatment at UCSF can be
041392 -        advanced from 090219.  If not, is the medical condition urgent
041393 -        enough to require another provider, and, if so, is VCI a good
041394 -        choice under the circumstances?  Is there another way to get
041395 -        this work done in time to be effective? ref SDS 82 IS5V
041397 -         ..
041398 -   68.  On 090203 1438 Jennette with UCSF Radiation Oncology Department
041399 -        called back and advised that Doctor Hsu advanced Millie's
041400 -        hypertermia treatment to begin on 090205 in time to be
041401 -        effective recovering from 6th relapse of IBC, ref SDS 83 XX5I,
041402 -        rather than risk waiting until 090219, as proposed yesterday on
041403 -        090202 1357. ref SDS 75 XO7G
041405 -         ..
041406 -   69.  On 090203 1444 Millie's letter notified medical team,
041407 -        ref SDS 84 6Q3J, that Jennette in Doctor Hsu's office at UCSF
041408 -        called on 090203 1438, ref SDS 83 XX5I, following Millie's
041409 -        letter on 090203 1417 notifying medical team that VCI offered
041410 -        to perform hypethermia treatment tomorrow on 090204 in time to
041411 -        be effective for Millie to recover from 6th relapse IBC,
041412 -        ref SDS 82 IS3P, and Jennette said UCSF changed their proposal
041413 -        for Millie to start treatment on 090219, and instead Millie is
041414 -        scheduled to meet Doctor Hsu in Radiation Oncology at UCSF to
041415 -        start hyperthermia treatment on 090205, ref SDS 83 XX5I, shown
041416 -        in Millie's letter. ref SDS 84 YQ5W
041418 -         ..
041419 -   70.  On 090203 1444 Millie sent copy of letter for the medical team
041420 -        to VCI, ref SDS 84 YQ6P, thanking Nash and Doctor Al-Bussam for
041421 -        timely, professional support investigating my case, ref SDS 81
041422 -        JZ4F, and offering a backup solution [reported in record on
041423 -        090203 1206. ref SDS 81 OE4F
041425 -         ..
041426 -   71.  On 090203 1444 Millie's letter notifies the medical team that
041427 -        communication with Doctor Hsu's office at UCSF in Radiation
041428 -        Oncology has not been established, ref SDS 84 YQ6S, previously
041429 -        noted in Millie's letter to the medical team on 090202,
041430 -        ref SDS 74 C95U].  Millie routinely gets blood draws on
041431 -        Thursdays at 0800, and so asks if this is needed to support the
041432 -        meeting with Doctor Hsu on Thursday 090205, and if not need to
041433 -        cancel the meeting with the Infusion Clinic on Thursday.  By
041434 -        copy alerted Catherine and Diane in Infusion that blood draw
041435 -        may not be needed on 090205. ref SDS 84 YQ6S
041437 -         ..
041438 -   72.  On 090203 1444 Millie commended Doctor Johnson, the primary
041439 -        care physician at Kaiser Oncology, and Doctor Rugo, Millie's
041440 -        oncologist on referral to UCSF, for support moving forward with
041441 -        hyperthermia treatment to recover from 6th relapse of IBC.
041442 -        ref SDS 84 YQ6V  Noting this might not work; citing research
041443 -        [on 090129] indicates there is a good chance. ref SDS 60 OI6N
041444 -        and ref SDS 60 SQ6L
041446 -         ..
041447 -   73.  On 090203 1632 Doctor Johnson, Millie's primary care physician
041448 -        at Kaiser advised that Millie does not need blood draw at UCSF
041449 -        on Thursday 090205 to support starting hyperthermia treatment
041450 -        meeting Doctor Hsu in the UCSF Radiation Oncology Department,
041451 -        ref SDS 85 3X6H, responding to Millie's letter to the medical
041452 -        team on 090203 1444 asking about labs. ref SDS 84 YQ6S
041454 -         ..
041455 -   74.  On 090203 2257 Doctor Rugo letter to medical team commends Dr
041456 -        Hsu on advancing the schedule by 2 weeks of Millie to getting
041457 -        hyperthermia treatment, ref SDS 87 WX8M, responding to Millie's
041458 -        letter earlier today on 090203 1444 notifying that Radiation
041459 -        Oncology changed the schedule from 090219 to 090205 in order to
041460 -        provide urgent treatment quickly enough to be effective, which
041461 -        was requested in Doctor Rugo's letter to the medical team on
041462 -        090202 1732. ref SDS 78 Y15J]
041464 -         ..
041465 -   75.  On 090203 2257 Doctor Rugo notifies medical team that Millie
041466 -        cannot get treatment at UCSF without authorization.  Millie
041467 -        does not have any regular blood draws, and the doctor
041468 -        recommends checking for authorization before Millie does
041469 -        anything at UCSF.  This includes clinic visits.  Infusion
041470 -        Clinic was notified Millie's meetings should be cancelled.
041471 -        ref SDS 87 L35Q  This responds to Millie's letter on 090203
041472 -        1444 asking about getting a blood draw before visiting Doctor
041473 -        Hsu in Radiation Oncology on 090205. ref SDS 84 YQ6S
041475 -         ..
041476 -   76.  On 090203 2257 Doctor Rugo is hopeful Millie can move on to
041477 -        another trial after the hyperthermia, that will continue a high
041478 -        quality of life experienced the past 2 years at UCSF.
041479 -        ref SDS 87 L36S
041481 -         ..
041482 -   77.  On 090203 2247 Doctor Rugo letter to Millie advises against
041483 -        getting hyperthermia treatment at VCI, ref SDS 88 DY4K,
041484 -        responding to Millie's letter earlier on 090203 1417 asking for
041485 -        medical opinion about getting hyperthermia treatment at VCI
041486 -        today on 090204, compared to waiting 3 weeks until 090219
041487 -        proposed for treatment by UCSF. ref SDS 82 IS4R
041489 -         ..
041490 -   78.  On 090204 0117 Millie's letter thanks Doctor Rugo for help
041491 -        advancing the schedule in Radiation Oncology for hyperthermia
041492 -        treatment 3 weeks, ref SDS 89 DY4K, with a letter to the
041493 -        medical team on 090202 1932 advising that Millie needs urgent
041494 -        treatment quickly enough to be effective. ref SDS 78 Y15J, and
041495 -        the doctor's letter on 090129 expedited referral from Kaiser
041496 -        authorizing hyperthermia treatment, reported in Millie's letter
041497 -        to the medical team on 090130. ref SDS 63 TZ6H
041499 -         ..
041500 -   79.  On 090204 0117 Millie notes in a letter to UCSF that VCI said
041501 -        they had treated patients on referral from UCSF, reported on
041502 -        090202. ref SDS 77 P67F  Did UCSF have a bad experience sending
041503 -        a patient to VCI?  Patients can make mistakes when rushed to
041504 -        find a solution, a la "clutching at straws," ref SDS 89 EL4U,
041505 -        which seemed to occur on 090202 when UCSF had earlier advised
041506 -        on 090122 that Millie should stop treatment to be prepared for
041507 -        starting new treatment on 090129, ref SDS 47 J47F, and on
041508 -        090129 UCSF advised there was a communication mixup that
041509 -        prevented getting treatment, reported on 090130, ref SDS 63
041510 -        AY8Q, and then writes a letter on 090202 saying Millie needs
041511 -        urgent treatment quickly in time to be effective, ref SDS 78
041512 -        Y15J, and UCSF schedules the work 3 weeks later on 090219.
041513 -        ref SDS 75 XO7G
041515 -         ..
041516 -   80.  On 090204 0219 Millie thanks Doctor Rugo for guidance on case
041517 -        management, ref SDS 90 135F, and notes innovation will be
041518 -        needed for continuing care after hyperthermia treatment at
041519 -        UCSF. ref SDS 90 277X  Millie requests Doctor Rugo at UCSF
041520 -        continue teamwork from past 2 years with Doctor Johnson at
041521 -        Kaiser, and maintain internal practice synergy with Doctor Hsu
041522 -        at UCSF to collaborate on designing effective treatment.
041523 -        ref SDS 90 278Q
041525 -         ..
041526 -   81.  On 090204 0219 Millie asks Doctor Rugo to submit an opinion on
041527 -        likely scenarios and possible treatment options so that
041528 -        proactive management will avoid scrambling at the last minute
041529 -        to get things done for the next treatment, ref SDS 90 278T,
041530 -        that were required for the current hyperthermia treatment
041531 -        scheduled to begin tomorrow on 090205, and shown by case study
041532 -        in this record listing chronology of delays, per above.
041533 -        ref SDS 94 MN5I
041535 -         ..
041536 -   82.  On 090204 1528 Millie letter to medical team reports calling
041537 -        Arlette returning her message on Millie's cell phone yesterday
041538 -        on 090203 with instructions on pain medication, ref SDS 92
041539 -        135F, and responding to Millie's letter reporting rising pain
041540 -        on 090203 1417, ref SDS 82 IS6U; following up request the
041541 -        before for pain relief, on 090202 1437. ref SDS 76 R23S, and
041542 -        further cited 2 days ago on 090201 1852, ref SDS 65 KN9T.
041543 -        Millie reported a bad flare up of pain the previous night on
041544 -        090203 2217, and got through it by taking more Vicodin.
041545 -        ref SDS 86 KE5I
041547 -         ..
041548 -   83.  On 090204 1528 Millie cited the record on 090203 2217 showing
041549 -        only 30% of prescribed pain medicine was being taken in order
041550 -        to avoid over-medicating, ref SDS 86 L74H, ignoring
041551 -        instructions during examination at UCSF a week earlier on
041552 -        090129 to take more medication reported to medical team on
041553 -        090130 1722, ref SDS 63 AY7T], but with everything going on
041554 -        lately, 53 case management tasks since 090129, per above,
041555 -        ref SDS 95 LQ3O, the patient got mixed up and forgot.
041556 -        ref SDS 92 D64P
041558 -         ..
041559 -   84.  On 090204 1528 following Arlette's instructions pain relieved
041560 -        Millie taking a double dose of Vicodin, and if that doesn't
041561 -        work then low-dose morphine will be prescribed. ref SDS 92 D64T
041563 -         ..
041564 -   85.  On 090204 1914 Doctor Rugo advised that UCSF has to wait for
041565 -        results of hyperthermia to arrange for comprehensive cancer
041566 -        care from teamwork practice synergy collaborating with Doctor
041567 -        Hsu applying Doctor Rugo's experience treating Millie weekly
041568 -        for 2 years, as requested in Millie's letter to UCSF on 090204
041569 -        0219, ref SDS 90 278Q, and further Millie's request for Doctor
041570 -        Rugo to plan strategy for treatment after hyperthermia, also in
041571 -        Millie's letter to UCSF on 090204 0217, ref SDS 90 278Q.  Since
041572 -        Millie's case is very complex, proactive planning to be
041573 -        prepared for alternate scenarios, which was successful applying
041574 -        2nd opinions from Doctor Benz in 2005 and 2007, won't work in
041575 -        2009, because UCSF proposes scheduling is not a simple
041576 -        prescription like when you first saw Doctor Benz, and so UCSF
041577 -        now proposes getting a scan to support consultation after
041578 -        hyperthermia to talk about the options. ref SDS 94 278T
041580 -         ..
041581 -   86.  On 090204 1914 the cost to collaborate with Doctor Hsu for
041582 -        practice synergy and proactive planning for treating cancer as
041583 -        a chronic disease requires talking with the clinic manager or
041584 -        patient services to determine the scope of services covered by
041585 -        the Kaiser referral for hyperthermia treatment. ref SDS 94 T43Y
041587 -         ..
041588 -   87.  On 090204 1930 Millie thanks the medical team for explaining
041589 -        strategy to defer planning treatment of cancer as a chronic
041590 -        disease for Millie's 7th relapse in 8 years, until after
041591 -        results of hyperthermia, because Millie's case is too complex
041592 -        for proactive management to plan for alternate scenarios.
041593 -        ref SDS 95 278T
041595 -         ..
041596 -   88.  On 090204 1930 Millie notifies medical team of risks failing to
041597 -        apply collaboration synergy of a winning team demonstrated over
041598 -        the past 26 months. ref SDS 95 W84Q  Continuity of care from
041599 -        doctors experienced with the case provides the best security
041600 -        for effectiveness, as requested in Millie's letter to UCSF and
041601 -        Kaiser on 090204 0219 for Doctor Rugo to collaborate on
041602 -        continuing care based on 2 years of weekly treatments.
041603 -        ref SDS 90 278Q
041605 -         ..
041606 -   89.  On 090204 1930 Millie's letter to medical team asks if Doxil
041607 -        will be given in the Infusion Clinic, since this is a
041608 -        chemotherapy drip treatment, ref SDS 95 W84T, which Doctor Rugo
041609 -        prescribed in the recommendation for Millie's treatment
041610 -        submitted to Kaiser on 090129, reported on 090130, ref SDS 63
041611 -        HK3V, and UCSF stated in a letter on 090203 2257 that Millie
041612 -        would no longer be treated in the Infusion Clinic. ref SDS 87
041613 -        L35Q and ref SDS 87 L35Y
041615 -         ..
041616 -   90.  On 090204 1930 Millie reports side effects of sunitinib and
041617 -        cyclophosphamide seem mostly gone.  Still have pain from IBC
041618 -        and mostly the shoulder (actually the arm). ref SDS 95 W84W
041619 -        Doctor Johnson has prescribed treatment that is working tody,
041620 -        reported in the record earlier on 090204 1528. ref SDS 92 D64T
041622 -         ..
041623 -   91.  On 090205 1318 primary care physician at Kaiser, Doctor
041624 -        Johnson, asks Millie to start using Kaiser's "closed" email
041625 -        system that is part of Kaiser's "Health[Connect" Knowledge
041626 -        Management system rather than public domain email, because
041627 -        checking multiple email systems complicates and so delays
041628 -        communication.  Since the doctor checks Health Connect
041629 -        regularly, correspondence sent through public domain email
041630 -        increases risks that Millie will "fall through the cracks," at
041631 -        a time when Millie is reporting rising symptoms of pain.
041632 -        ref SDS 97 278T
041634 -         ..
041635 -   92.  On 090205 1318 review shows most of Millie's care is now
041636 -        performed at UCSF which requires coordination with Kaiser.
041637 -        Since Kaiser's Health Connect system has limitations that
041638 -        prevent communication with UCSF, using the public domain email
041639 -        for efficient, uniform distribution of correspondence among
041640 -        Millie's large medical team increases chances to prevent urgent
041641 -        care from falling through the cracks. ref SDS 97 YU4L
041643 -         ..
041644 -   93.  On 090209 0018 Millie submits the record of meeting on 090205
041645 -        with Doctor Hsu, ref SDS 99 278T, launching the hyperthermia
041646 -        treatment project at UCSF, ref SDS 96 0001, for Millie to
041647 -        recover from the 6th relapse of IBC.  Doctor Linda Chang
041648 -        facilitated a productive meeting. ref SDS 96 O47G  Millie
041649 -        requests feedback to verify accuracy of patient history for
041650 -        effective care. ref SDS 99 744V
041652 -         ..
041653 -   94.  On 090209 0018 Millie requests starting treatment 090210 or
041654 -        090211.  IBC accelerating, reflects UCSF treatment plan for 4 -
041655 -        5 treatments per week for 4 - 6 weeks, and changing from Doxil
041656 -        to low dose radiation. ref SDS 99 745X
041657 -
041658 -
041659 -
0417 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
0504 - Progress
050501 -  ..
050502 - Hyperthermia Treatment UCSF 090219 1315 Confirm Schedule
050503 -
050504 - Follow up ref SDS 99 278T, ref SDS 97 278T.
050505 -
050506 - Millie's letter requests clarification of hyperthermia treatment plan
050507 - scheduled to start tomorrow at UCSF on 090219...
050508 -
050509 -    1.  Subject: Hyperthermia Treatment Feb 19 0115p
050510 -        Date: Wed, 18 Feb 2009 12:17:47 -0800
050519 -         ..
050520 -    2.  This confirms planning for treatment tomorrow in your office at
050521 -        0115p.  Typically, I get a call a few days prior confirming
050522 -        meetings at UCSF.  In this case no one has called, so I am
050523 -        letting you know I will arrive OA 1245 to allow for admin
050524 -        tasks, if any.  Please let me know, if the schedule has changed
050525 -        since our meeting on 090209. ref SDS A0 VU76
050526 -
050527 -
0506 -

SUBJECTS
Default Null Subject Account for Blank Record

0603 -
060401 -  ..
060402 - Schedule Treatments Start 0800 - 0900 Optimize Work Time
060403 -
060404 -
060405 -    3.  Meetings in the City work better for me starting OA 0800.  So,
060406 -        starting from 0700 - 0900, or earlier works.  I arrive about
060407 -        0600 and work there until the meeting.  This optimizes work by
060408 -        avoiding traffic delays going both ways.  If your schedule
060409 -        needs me in the afternoon, of course I am fine with that.
060410 -
060411 -            [On 090220 0157 Millie thanks Doctor Hsu for accomodating
060412 -            schedule to optimize travel requirements. ref SDS A4 EA3U
060413 -
060414 -
060415 -
0605 -

SUBJECTS
Default Null Subject Account for Blank Record

0703 -
070401 -  ..
070402 - Treatment Plan Scope Prescribed Doxil Now Using Lower Dose Radiation
070403 -
070404 -
070405 -    4.  Can you please submit an explanation of the treatment plan.
070406 -        Doctor Rugo's letter to Kaiser on 090129 discussed hyperthermia
070407 -        with Doxil, reported on 090130. ref SDS 63 TZ6H
070409 -         ..
070410 -    5.  Has the plan changed to use "lower dose" radiation rather than
070411 -        Doxil.  Will both be used, or some other agent?  I'm confused
070412 -        about the scope.  Please explain initial assessment, and
070413 -        prognosis.  If this has already been submitted to Doctor
070414 -        Johnson and Doctor Rugo, just send me a copy.
070416 -  ..
070417 - Problems communicating are a major cause of health care problems,
070418 - reported on 041125. ref SDS 6 4P61  Failure to understand scope of
070419 - treatment is also listed by HHS guidance published by AHRQ on 20
070420 - requirements for preventing medical mistakes, reviewed on 041125.
070421 - ref SDS 6 9O3N
070423 -             ..
070424 -            [On 090219 during meeting with Doctor Hsu and Chris at UCSF
070425 -            requested medical orders for Millie's radiation and
070426 -            hyperthermia treatments, similar to Chemotherapy Orders
070427 -            issued to the Infusion Clinic for Millie's care the past 2
070428 -            years. ref SDS A3 4254
070430 -             ..
070431 -            [On 090220 0157 Millie's letter to the medical team
070432 -            confirms request today for an explanation of the treatment
070433 -            plan, including the doctor's orders for radiation and
070434 -            hyperthermia treatments, similar to Chemotherapy Orders
070435 -            Millie received for care in the Infusion Clinic.
070436 -            ref SDS A4 EA4Q
070438 -             ..
070439 -            [On 090220 0915 UCSF submitted Notes memorandum dated
070440 -            090209 and which explains general planning for Millie's
070441 -            hyperthermia treatments at UCSF; additionally Chris
070442 -            submitted a paper published in 2002 by BSD Medical that
070443 -            explains theory and practice using hyperthermia treatment
070444 -            for cancer. ref SDS A5 4254
070446 -             ..
070447 -            [On 090220 reviewed UCSF notes for Radiation Oncology
070448 -            department planning Millie's hyperthermia treatments to
070449 -            recover from 6th relapse of IBC, ref SDS A6 PR4Y; describes
070450 -            Millie meeting on 090209 with Doctor Hsu, Chris and Abby,
070451 -            and that this team explained the plan for radiation and
070452 -            hyperthermia treatments. ref SDS A6 VU54  Millie met with
070453 -            the team on 090209 and there is no record of submitting the
070454 -            treatment plan. ref SDS A0 PP8R
070456 -             ..
070457 -            [On 090223 0237 Millie's letter to the medical team thanks
070458 -            Chris for submitting the UCSF memo on 090209 that seems to
070459 -            explain the treatment plan for hyperthermia. ref SDS A7
070460 -            T47U  Millie requests similar plan for radiation treatment
070461 -            that complements hyperthermia. ref SDS A7 3N9J
070463 -             ..
070464 -            [On 090310 0351 Millie's letter submits agenda to medical
070465 -            team for meeting UCSF to evaluate response to treatment
070466 -            with radiation and hyperthermia, and cites evident
070467 -            worsening IBC conditions; issue of discussion for meeting
070468 -            on 090312 is requirements for adjusting treatment plan.
070469 -            ref SDS A9 TH5I
070471 -             ..
070472 -            [On 090312 0800 UCSF reports examination after 3 weeks of
070473 -            treatment with radiation and hyperthermia shows strong
070474 -            response to treatment, and says no adjustments to treatment
070475 -            are required, and so proposes ending treatment on schedule
070476 -            originally set for 090317. ref SDS B0 8P7G
070477 -
070478 -
070479 -
070480 -
070481 -
0705 -

SUBJECTS
Default Null Subject Account for Blank Record

0803 -
080401 -  ..
080402 - Kaiser Referral to UCSF Millie's Treatment Plan by Doctor Rugo
080403 - Meeting Doctor Rugo 090312 Strategic Planning after Radiation Hyperthermia
080404 - Prognosis 3 - 6 Months Recovery Then Millie Needs Treatment Doctor Rugo
080405 -
080406 -
080407 -    6.  I had a good meeting with Doctor Johnson at Kaiser last week on
080408 -        090213. ref SDS A2 4W5I  He seemed optimistic that I might have
080409 -        3 - 6 months of recovery, but will need treatment from Doctor
080410 -        Rugo for cancer as a "chronic disease." ref SDS A2 GD3I [and
080411 -        citing prior instructions from Doctor Johnson for UCSF to begin
080412 -        planning Millie's next treatment in time to be effective
080413 -        without delays, also listed on 090213. ref SDS A2 WZ6K].  A
080414 -        week or so ago on 090210, I got a call from Lena scheduling me
080415 -        to meet with Doctor Rugo on 090312 0830, ref SDS A1 XU5N, so
080416 -        I'm thrilled comprehensive follow up has been ordered by
080417 -        Kaiser.
080418 -
080419 -            [On 090312 0800 Millie met with Tara for examination in the
080420 -            Breast Care Clinic, ref SDS B0 9L7K, and later at 0930 she
080421 -            met with Doctor Hsu and Chris to evaluate radiation and
080422 -            hyperthermia treatment. ref SDS B0 02AC
080423 -
080424 -
080425 -
080426 -
0805 -

SUBJECTS
Default Null Subject Account for Blank Record

0903 -
090401 -  ..
090402 - Radiation Risks Compared to Patient Radiation History 2002
090403 -
090404 -
090405 -    7.  Were you able to get records from Mt Diablo Medical of prior
090406 -        radiation in 2002, discussed during the meeting at UCSF on
090407 -        090205. ref SDS 96 PN8H [citing Benz 2nd opinion on 041018
090408 -        saying Millie likely cannot tolerate more radiation.
090409 -        ref SDS 96 YO9G]
090411 -         ..
090412 -    8.  That was so long ago, there may be no correlation with
090413 -        additional radiation now.
090414 -
090415 -
0905 -

SUBJECTS
Default Null Subject Account for Blank Record

1003 -
100401 -  ..
100402 - Side Effects Radiation Hyperthermia Treatment Plan
100403 -
100404 -
100405 -    9.  The letter to the medical team on 090209 discussed side effects
100406 -        of radiation and hyperthermia, ref SDS 99 745R, following your
100407 -        comments during the meeting on 090205. ref SDS 96 GM4N  Does
100408 -        the treatment plan address this prospectively, or as needed?
100409 -        For example, as noted in the letter on 090209, research found
100410 -        that side effects of radiation are sometimes treated with
100411 -        Vitamin E plus pentoxifylline (Trental), ref SDS 99 745R, which
100412 -        can be problematic with Coumadin, so Gloria in the Coagulation
100413 -        Control Clinic at Kaiser will need input.
100414 -
100415 -               [On 090312 0800 Doctor Hsu discloses that severe side
100416 -               effects from radiation and hyperthermia, which were
100417 -               reported on 090310 to look worse than IBC, ref SDS A9
100418 -               O56X, will be treated beginning on 090317 after ending
100419 -               treatment with cream, ref SDS B0 F860; the doctor did
100420 -               not discuss Vitamin E plus pentoxifylline (Trental),
100421 -               ref SDS B0 6P8K, but proposed providing "cream" to treat
100422 -               radiation side effects. ref SDS B0 F852
100424 -                ..
100425 -               [On 090317 Millie receives Silvadene Cream 1% from
100426 -               Doctor Hsu, ref SDS B1 M442, and also received
100427 -               instructions from Miranda for application, including an
100428 -               orientation for bandaging expanding sores from radiation
100429 -               and hyperthermia treatments. ref SDS B1 ET46
100430 -
100431 -
100432 -
100433 -
100434 -
1005 -

SUBJECTS
Default Null Subject Account for Blank Record

1103 -
110401 -  ..
110402 - Emotional Trauma Delaying Treatment Required Urgently Recover IBC
110403 - Hope Hyperthermia Treatment Starting in Time to be Effective
110404 - Commend Doctor Hsu and Doctor Rugo Expediting Treatment 6th Relapse IBC
110405 -
110406 -
110407 -   10.  I'm looking forward to getting started tomorrow.  I was worried
110408 -        I wouldn't make it, but here I am just one day to go.  Thanks
110409 -        very much to you for expediting my care, and to Doctor Rugo for
110410 -        guiding me through troubled waters.
110411 -
110418 -
110419 -
110420 -
110421 -
110422 -
110423 -
110424 -
110425 -
110426 -
1105 -