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: March 28, 2009 09:14 PM Saturday; Rod Welch

Doctor Hsu requests meeting Millie Mar 30th 1200 evaluate pain relief.

1...Summary/Objective
2...Pain Relief Radiation Side Effects Advance Meeting Expedite Recovery


..............
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SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS A1 0000. ref SDS A0 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - The letter today follows up patient history...
040902 -
040903 -        1.  Examination at Kaiser found significant
040904 -            recovery with sunitinib protocol
040905 -            at UCSF........................... 081219, ref SDS 38 QW5J
040907 -             ..
040908 -        2.  Primary care physician calls about
040909 -            Millie's fall and treatment in ER for
040910 -            separated shoulder, and explains rise
040911 -            in Millie's cancer marker signals
040912 -            severe relapse for the 6th time,
040913 -            and Millie needs immediate treatment
040914 -            for her cancer as chronic
040915 -            disease........................... 090123, ref SDS 48 RK6O
040917 -             ..
040918 -        3.  Sudden reversal with severe relapse
040919 -            of IBC that requires immediate
040920 -            change of treatment reported
040921 -            from examination at
040922 -            UCSF.............................. 090130, ref SDS 51 4S8O
040924 -             ..
040925 -        4.  Doctor Rugo prescribes immediate
040926 -            treatment at UCSF in radiation
040927 -            oncology department for
040928 -            7th relapse....................... 090130, ref SDS 51 TZ6H
040930 -             ..
040931 -        5.  Urgent treatment was delayed a week
040932 -            due to communication problems
040933 -            at UCSF........................... 090130, ref SDS 51 AY8Q
040935 -             ..
040936 -        6.  Approval for Kaiser referral to UCSF
040937 -            was delayed by documentation
040938 -            errors............................ 090202, ref SDS 53 SP6H
040940 -             ..
040941 -        7.  Kaiser expedites referral authorization
040942 -            in order for UCSF to provide urgent
040943 -            treatment quickly enough for
040944 -            Millie to recover................. 090202, ref SDS 52 LC7H
040946 -             ..
040947 -        8.  UCSF proposes 3-week delay to begin
040948 -            planning Millie's treatment for
040949 -            recovering from 6th relapse of
040950 -            of IBC............................ 090202, ref SDS 53 SP7M
040952 -             ..
040953 -        9.  Doctor Rugo notifies medical team
040954 -            Millie needs urgent treatment quickly
040955 -            in time to be effective recovering
040956 -            from 6th relapse of
040957 -            IBC............................... 090202, ref SDS 54 Y15J
040959 -             ..
040960 -       10.  Millie's letter to UCSF implements Doctor
040961 -            Johnson's requests for UCSF strategy
040962 -            to treat Millie's cancer as a
040963 -            chronic disease................... 090203, ref SDS 55 278T
040965 -             ..
040966 -       11.  Doctor Rugo's letter explains planning
040967 -            to evaluate response to hyperthermia
040968 -            treatment and arrange continuing
040969 -            care based on another
040970 -            CT scan........................... 090204, ref SDS 57 278T
040972 -             ..
040973 -       12.  UCSF advances Millie's care in Radiation
040974 -            Oncology Department 3 weeks; scope of
040975 -            radiation and hyperthermia evaluated
040976 -            by Dcotor Hsu and Doctor
040977 -            Chang............................. 090205. ref SDS 59 0001
040979 -             ..
040980 -       13.  CT and xray tests taken, and layout
040981 -            of treatment fields performed to
040982 -            build molds for Millie's
040983 -            radiation......................... 090209. ref SDS 63 9R61
040985 -             ..
040986 -       14.  Examination primary care physician
040987 -            at Kaiser finds severe progression
040988 -            of IBC in 6th
040989 -            relapse........................... 090213, ref SDS 65 4W5I
040991 -             ..
040992 -       15.  Millie lucky to survive stage IV cancer
040993 -            for 8 years because cancer mutates to
040994 -            defeat treatments; and medical maladies
040995 -            increase which makes recovery
040996 -            more difficult to
040997 -            achieve........................... 090213, ref SDS 65 NY7L
040999 -             ..
041000 -       16.  Complexity of case management grows
041001 -            during long term survival prevents
041002 -            keeping a well ordered record
041003 -            essential for effective
041004 -            care.............................. 090213, ref SDS 65 9L8O
041006 -             ..
041007 -       17.  Emotional trauma occurs from surprise
041008 -            by medical professionals that Kaiser
041009 -            and UCSF have enabled long term surivial
041010 -            for a disease that normally is
041011 -            difficult to control.............. 090213, ref SDS 65 ML4I
041013 -             ..
041014 -       18.  Communication leverages synergy
041015 -            for Millie's care at Kaiser and UCSF
041016 -            which helps prevent problems from
041017 -            "falling through the cracks; fewer
041018 -            mistakes, and timely response
041019 -            helps the medical team
041020 -            increase longevity,
041021 -            also seems very
041022 -            annoying.......................... 090213, ref SDS 65 FZ4H
041024 -             ..
041025 -       19.  Doctor urges proactive management to
041026 -            plan Millie's next treatment because
041027 -            there will be less time to recover
041028 -            before cancer gets out of control
041029 -            for Millie's next
041030 -            relapse........................... 090213, ref SDS 65 UP6L
041032 -             ..
041033 -       20.  Millie's efforts the past 8 years to
041034 -            combine medical treatment with vigorous
041035 -            exercise was supported by research
041036 -            showing exercise can be a strong
041037 -            component of cancer
041038 -            care.............................. 090213, ref SDS 65 GC40
041040 -             ..
041041 -       21.  Indian fable illustrates long-term survival
041042 -            getting continuous treatment for cancer
041043 -            becomes increasingly difficult to perform
041044 -            complex clinical, logistical, and financial
041045 -            case management; study of Millie's patient
041046 -            history shows level of effort to maintain
041047 -            well ordered record for effective
041048 -            management increases exponentially
041049 -            into a crushing burden
041050 -            for patients and
041051 -            providers......................... 090213, ref SDS 65 IG5O
041053 -             ..
041054 -       22.  Graph prepared by primary care physician
041055 -            shows Millie's good fortune surviving a
041056 -            very aggressive cancer with relatively
041057 -            high quality of life into an 8th year
041058 -            of continuous treatment that normally
041059 -            causes early demise due to emotional
041060 -            trauma and clincial failures from
041061 -            complex case management........... 090213, ref SDS 65 4W72
041063 -             ..
041064 -       23.  Millie felt life was slipping away in
041065 -            October when the 5th relapse was diagnosed
041066 -            leading Millie to ask what was going to
041067 -            happen to her; Doctor Rugo provided
041068 -            encouragement saying "We're not
041069 -            going to let anything happen
041070 -            to you"........................... 090213, ref SDS 65 F148
041072 -             ..
041073 -       24.  Collaboration between Kaiser and UCSF
041074 -            combines experience with research;
041075 -            communication optimizes Millie's care
041076 -            beating the odds for long-term survival
041077 -            by integrating Kaiser's team care
041078 -            practice with UCSF model
041079 -            of comprehensive
041080 -            care.............................. 090213, ref SDS 65 685I
041082 -             ..
041083 -       25.  Multiple relapse of cancer causes cells
041084 -            to mutate into disease that resists
041085 -            treatment; Millie surviving 6 relapses
041086 -            needs highly specialized care and
041087 -            so should ask Doctor Rugo to begin
041088 -            planning for the next relapse
041089 -            to treat Millie's cancer as
041090 -            a chronic disease................. 090213, ref SDS 65 R75G
041092 -             ..
041093 -       26.  Doctor Rugo has responded by scheduling
041094 -            a meeting with Millie at UCSF on
041095 -            090312............................ 090213, ref SDS 65 6P7G
041097 -             ..
041098 -       27.  Doctor Johnson underscored importance
041099 -            timely care for Millie by offering
041100 -            religious perspective on transition
041101 -            from a vigorous life that may end
041102 -            for Millie in less than a
041103 -            year.............................. 090213, ref SDS 65 646L
041105 -             ..
041106 -       28.  Hospice care helps patients and families
041107 -            cope with final days of life without
041108 -            suffering significant physical
041109 -            and emotional pain................ 090213, ref SDS 65 VW63
041111 -             ..
041112 -       29.  Life ending scenarios have been presented
041113 -            to Millie many times the past 5 years;
041114 -            case study reflects Millie's physical
041115 -            resiliance and strength of character
041116 -            that enables exceptional longevity
041117 -            for her aggressive
041118 -            cancer............................ 090213, ref SDS 65 L19H,
041120 -             ..
041121 -       30.  Collaboration on case management for
041122 -            long-term survivors of cancer becomes
041123 -            frustrating because everybody loses
041124 -            control of increasingly
041125 -            complex medical
041126 -            records........................... 090213, ref SDS 65 JL9L
041128 -             ..
041129 -       31.  Lab and CT test reports illustrate
041130 -            frustration, because providers do not
041131 -            have enough time to enter results
041132 -            from other doctorsrs in the medical
041133 -            chart, because doctors prefer to
041134 -            rely on local diagnostics
041135 -            rather than referral
041136 -            data.............................. 090213, ref SDS 65 NY4H
041138 -             ..
041139 -       32.  Cancer marker CA 15-3 wide disparities
041140 -            between Kaiser and UCSF illustrates
041141 -            why doctor's rely on local data
041142 -            rather than referral
041143 -            diagnostics....................... 090213, ref SDS 65 A46O
041145 -             ..
041146 -       33.  Case management takes a lot of will
041147 -            power for due diligence to
041148 -            maintain a well ordered
041149 -            record............................ 090213, ref SDS 65 J27J
041151 -             ..
041152 -       34.  Meeting at Kaiser changed to 4 week
041153 -            interval, rather than 8, as done the
041154 -            past 2 years, provides effective support
041155 -            for UCSF to start next treatment in
041156 -            time to avoid losing control of
041157 -            Millie's cancer................... 090213, ref SDS 65 QX5O
041159 -             ..
041160 -       35.  Millie requests explanation of treatment
041161 -            plan.  Doctor Rugo's letter to Kaiser on
041162 -            090129 discussed hyperthermia with Doxil,
041163 -            reported on 090130. Has the plan changed
041164 -            to use "lower dose" radiation rather
041165 -            than Doxil.  Will both be
041166 -            used, or some other
041167 -            agent............................. 090218, ref SDS 66 TH5W
041169 -             ..
041170 -       36.  Millie reports to medical team meeting
041171 -            with Doctor Johnson at Kaiser on 090213
041172 -            was optimistic Millie might have 3 - 6
041173 -            months of recovery, but will need
041174 -            treatment from Doctor Rugo for
041175 -            cancer as a "chronic
041176 -            disease".......................... 090218, ref SDS 66 TH6U
041178 -             ..
041179 -       37.  Millie requests reponse from UCSF to the
041180 -            letter on 090209 requesting explanation
041181 -            of treatments for side effects from
041182 -            radiation and hyperthermia described by
041183 -            Doctor Hsu during the meeting on
041184 -            090205. Does the treatment
041185 -            plan address side effects
041186 -            prospectively..................... 090218, ref SDS 66 TH7V
041188 -             ..
041189 -       38.  Radiation and hyperthermia begins
041190 -            at UCSF for Millie to recover from
041191 -            6th relapse of
041192 -            IBC............................... 090219, ref SDS 67 E57G
041194 -             ..
041195 -       39.  Millie's letter to UCSF requests
041196 -            explanation of radiation and hyperthermia
041197 -            treatments for recovering from
041198 -            IBC............................... 090220, ref SDS 68 EA4Q
041200 -             ..
041201 -       40.  Hyperthermia treatment planning
041202 -            on 090209 report received
041203 -            from UCSF......................... 090220, ref SDS 69 PR4Y
041205 -             ..
041206 -       41.  Hyperthermia science, theraputic
041207 -            rationale and applications with
041208 -            other modalities presented in
041209 -            BSD professional paper received
041210 -            from UCSF......................... 090220, ref SDS 69 GK6F
041212 -             ..
041213 -       42.  Millie's letter to UCSF requests work
041214 -            plan for radiation treatments to
041215 -            recover from 6th relapse of
041216 -            IBC............................... 090223, ref SDS 70 3N9J
041217 -            and asks for scientific paper
041218 -            using radiation to treat
041219 -            IBC............................... 090223, ref SDS 70 T49U
041221 -             ..
041222 -       43.  Radiation combined with hyperthermia
041223 -            treatment plan received from
041224 -            UCSF.............................. 090226, ref SDS 71 D452
041226 -             ..
041227 -       44.  Blood test at Kaiser for meeting
041228 -            at UCSF on 090312 to evaluate
041229 -            effectiveness of radiation
041230 -            and hyperthermia after
041231 -            3 weeks........................... 090309, ref SDS 73 6Z4F
041233 -             ..
041234 -       45.  Agenda submitted to medical team to
041235 -            be prepared for productive meetings
041236 -            at UCSF scheduled on 090312 to evaluate
041237 -            response to treatment after getting
041238 -            3 weeks of radiation and hyperthermia
041239 -            to recover from 6th relapse
041240 -            of IBC............................ 090310, ref SDS 74 PR4Y
041242 -             ..
041243 -       46.  Called Kaiser to get results of blood
041244 -            test on 090309 for submission to medical
041245 -            team for being prepared to meet at
041246 -            UCSF on 090312; Florida says results
041247 -            pending from lab; says to call back
041248 -            on 090311 to get the report
041249 -            for distribution.................. 090310, ref SDS 75 JH4H
041251 -             ..
041252 -       47.  UCSF letter from Tara proposed canceling
041253 -            meeting scheduled by Doctor Rugo for
041254 -            090312 to evaluate response to
041255 -            treatment, and also Millie's
041256 -            concern about growing
041257 -            side effects...................... 090310, ref SDS 76 PR4Y
041259 -             ..
041260 -       48.  Millie letter to primary care physician
041261 -            at Kaiser coordinates getting report
041262 -            for blood test on 090309 for
041263 -            meeting at UCSF on
041264 -            090312............................ 090311, ref SDS 77 S84F
041266 -             ..
041267 -       49.  Blood test report for Millie's lab on
041268 -            090209 was not submitted by Kaiser to
041269 -            UCSF due to telephone and fax machine
041270 -            problems; UCSF relied on backup
041271 -            copy hand delivered by
041272 -            Millie............................ 090312, ref SDS 80 XE3K
041274 -             ..
041275 -       50.  Examination at UCSF Breast Care Clinic
041276 -            finds signs of recovery from 6th relapse
041277 -            of IBC; Millie responding well after
041278 -            3 weeks of treatment with radiation
041279 -            and hyperthermia; severe side
041280 -            effects observed.................. 090312, ref SDS 80 YX9F
041282 -             ..
041283 -       51.  Cancer marker CA 15-3 missing from
041284 -            blood test for Millie's lab at Kaiser
041285 -            on 090309; missing diagnostic
041286 -            complicates evaluating
041287 -            response to treatment............. 090312, ref SDS 80 YX5F
041289 -             ..
041290 -       52.  Doctor Rugo planning to implement
041291 -            request by Doctor Johnson at Kaiser
041292 -            for UCSF to treat Millie's cancer
041293 -            as a chronic disease.............. 090312, ref SDS 80 QQ9L
041295 -             ..
041296 -       53.  Examination at UCSF Radiation Oncology
041297 -            department concurs Millie recovering
041298 -            from 6th relapse of IBC by responding
041299 -            to radiation and
041300 -            hyperthermia...................... 090312, ref SDS 80 F88K
041301 -            discloses side effects severely
041302 -            blistering skin will worsen for a
041303 -            month, and then gradually
041304 -            recover........................... 090312, ref SDS 80 F860
041305 -            that radiation and hyperthermia
041306 -            will continue to destroy cancer cells
041307 -            for weeks and even months after ending
041308 -            treatments on
041309 -            090317............................ 090312, ref SDS 80 VL4O
041311 -             ..
041312 -       54.  After meeting with UCSF at 0800, called
041313 -            Kaiser at 1437; was on "hold" for 90
041314 -            minutes; Cisi in the Chemotherapy
041315 -            Clinic came online and advised that
041316 -            CA 15-3 was not listed in Kaiser's
041317 -            for Millie's lab on
041318 -            090309............................ 090312, ref SDS 81 JO8O
041320 -             ..
041321 -       55.  Millie's letter to medical team reports
041322 -            productive meetings at UCSF on 090312
041323 -            with favorable findings that Millie
041324 -            is recovering from 6th
041325 -            relapse of
041326 -            IBC............................... 090313, ref SDS 82 Q49L
041328 -             ..
041329 -       56.  Millie's final treatment at UCSF with
041330 -            radiation and hyperthermia to
041331 -            recover from 6th relapse
041332 -            IBC............................... 090317, ref SDS 84 9L7K
041334 -             ..
041335 -       57.  Millie received at UCSF orientation and
041336 -            medications for home care to treat severe
041337 -            side effects from radiation treatments
041338 -            that will get worse for a few weeks
041339 -            before starting to get
041340 -            better............................ 090317, ref SDS 84 M442
041342 -             ..
041343 -       58.  Arlette checked the computer and
041344 -            concluded a mistake occurred at the
041345 -            lab not testing for the cancer marker
041346 -            on the blood test for 090309.  Arlette
041347 -            entered a supplemental order for
041348 -            Millie to get another blood
041349 -            draw at no charge
041350 -            later today....................... 090317, ref SDS 85 Y04R
041352 -             ..
041353 -       59.  Kaiser reported CA 15-3 251 for blood
041354 -            test on 090317 that corrected problems
041355 -            with lab on 090309 which omitted cancer
041356 -            marker needed for the meeting at UCSF
041357 -            on 090312 to evaluate response to
041358 -            treatment; results today indicate
041359 -            strong recovery from 6th relapse
041360 -            of IBC............................ 090323, ref SDS 86 Y077
041362 -             ..
041363 -       60.  Millie's letter notifies medical team
041364 -            radiation and hyperthermia treatments
041365 -            were completed on 090317; submits agenda
041366 -            for meeting today evaluating response
041367 -            to treatment with, and recovery from
041368 -            side effects from radiation
041369 -            and hyperthermia on
041370 -            referral to
041371 -            UCSF.............................. 090324, ref SDS 87 PR4Y
041373 -             ..
041374 -       61.  Meeting at Kaiser reveiw response to
041375 -            treatment at UCSF for 6th relapse of
041376 -            cancer, planning arrangements
041377 -            for treating next
041378 -            relapse........................... 090325, ref SDS 88 E54L
041380 -             ..
041381 -       62.  Shoulder injury recovering on schedule
041382 -            following treatment in ER on 090122,
041383 -            physical therapy; increased energy
041384 -            after ending chemotherapy enables
041385 -            faster recovery with
041386 -            exercise.......................... 090325, ref SDS 88 YU6K
041388 -             ..
041389 -       63.  Examination finds strong response to
041390 -            treatment with radiation and hyperthermia
041391 -            at UCSF ended on 090317 aligns with
041392 -            significant decline in cancer
041393 -            marker reversing continuous
041394 -            rising tread for the
041395 -            past year......................... 090325, ref SDS 88 D452
041397 -             ..
041398 -       64.  Disease trajectory graph shows Millie
041399 -            may be nearing a point of rapid
041400 -            decline with next relapse
041401 -            of cancer......................... 090325, ref SDS 88 P39M
041403 -             ..
041404 -       65.  Hospice care can be investigate in order
041405 -            to be prepared for smooth transition
041406 -            as patient enters decline phase
041407 -            of cancer trajectory.............. 090325, ref SDS 88 JS5I
041409 -             ..
041410 -       66.  Streamlined referral procedures
041411 -            delivering care required in order
041412 -            for the medical team to be
041413 -            prepared treating cancer
041414 -            as a chronic
041415 -            disease........................... 090325, ref SDS 88 P43G
041417 -             ..
041418 -       67.  Stress increases beyond capacity to cope
041419 -            managing chronic disease with procedures
041420 -            designed for routine cancer care;
041421 -            doctor approves Millie for
041422 -            vacation to get needed
041423 -            rest.............................. 090325, ref SDS 88 M35H
041425 -             ..
041426 -       68.  Lab mistakes and delays hamper delivering
041427 -            referral care in time to be effective
041428 -            treating stage IV cancer; patient facing
041429 -            7th relapse at risk; providers under
041430 -            stress angry that someone is
041431 -            changing doctor's orders
041432 -            for patient care.................. 090325, ref SDS 88 RB3G
041434 -             ..
041435 -       69.  Lab mistakes and delays chronic problems
041436 -            prevent treating cancer as chronic
041437 -            disease on referral to UCSF
041438 -            case study........................ 090325, ref SDS 88 KZ6N
041440 -             ..
041441 -       70.  Cancer chronic disease timely treatment
041442 -            essential for Millie's 7th relapse
041443 -            stage IV IBC; Kaiser has no chemotherapy
041444 -            agents for Millie's narrow patient profile
041445 -            triple negative; prescribes care
041446 -            on referral to UCSF;
041447 -            case study........................ 090325, ref SDS 88 L15M
041449 -             ..
041450 -       71.  Pain relief needed; Millie suffering
041451 -            physically and emotionally from severe
041452 -            radiation side effects; pain and
041453 -            suffering will get worse for several
041454 -            more weeks until Millie begins to recover
041455 -            from radiation burn; Doctor Johnson
041456 -            prescribes zink and Domeboro supplement
041457 -            treatment prescribed at UCSF for
041458 -            severe radiation side
041459 -            effects........................... 090325, ref SDS 88 P39I
041461 -             ..
041462 -       72.  Medical tests ordered at Kaiser for
041463 -            examinations at UCSF on planning
041464 -            Millie's treatment for the
041465 -            next relapse of
041466 -            IBC............................... 090325, ref SDS 88 P36O
041468 -             ..
041469 -       73.  Medical tests ordered 10 days prior to
041470 -            meetings at UCSF allows enough time
041471 -            for correcting mistakes and expediting
041472 -            delays so that data is delivered
041473 -            when needed....................... 090325, ref SDS 88 LX5I
041475 -             ..
041476 -       74.  Patient asked to coordinate on correcting
041477 -            mistakes in CT Department by consolidating
041478 -            findings in a single report, rather than
041479 -            publising multiple reports for
041480 -            each test......................... 090325, ref SDS 88 P53O
041482 -             ..
041483 -       75.  Letter to Kaiser confirms understandings
041484 -            from meeting on 090325 that reported a
041485 -            favorable response after completeing
041486 -            treatment at UCSF on 090317 with
041487 -            radiation and hyperthermia
041488 -            protocol.......................... 090326, ref SDS 89 5V7O
041490 -             ..
041491 -       76.  Kaiser plans visual examination with
041492 -            CT tests to evaluate response to treatment
041493 -            at UCSF with hyperthermia and
041494 -            radiation......................... 090326, ref SDS 90 1V4N
041496 -             ..
041497 -       77.  Millie submits patient history showing
041498 -            Kaiser has had problems relying on visual
041499 -            examination and CT tests to assess IBC;
041500 -            she submits research showing enhanced
041501 -            MRI is reported to be effective
041502 -            supplementing visual and
041503 -            CT test modalities................ 090326, ref SDS 91 5V7O
041505 -             ..
041506 -       78.  Millie's letter asks about progress
041507 -            reviewing research to solve problem
041508 -            of diminishing treatments for
041509 -            Millie's expanding patient
041510 -            profile........................... 090326, ref SDS 91 QM3V
041512 -             ..
041513 -       79.  Millie's letter thanks Doctor Stritter
041514 -            for continued interest in her case, and
041515 -            advises that Stritter 2nd opinion research
041516 -            to solve problems of diminishing treatments
041517 -            for Millie's expading patient profile
041518 -            were submitted to the medical
041519 -            team.............................. 090326, ref SDS 92 1V4N
041521 -             ..
041522 -       80.  Millie's letter reports to Doctor
041523 -            Stritter suffering caused by radiation
041524 -            side effects; does not feel well
041525 -            after 4 weeks of intense
041526 -            treatments........................ 090326, ref SDS 92 PX6Y
041528 -             ..
041529 -       81.  Doctor Johnson responds to Millie's
041530 -            submission of research showing enhanced
041531 -            MRI technology can effectively supplement
041532 -            visual and CT modalities to assess
041533 -            response to treatment of IBC 6th
041534 -            relapse, saying he will talk about
041535 -            it at the next visit in 6
041536 -            weeks............................. 090326, ref SDS 93 T64N
041538 -             ..
041539 -       82.  Doctor Johnson responds to Millie's
041540 -            request for progress reviewing research
041541 -            to solve problems of diminishing treatments
041542 -            for expanding patient profile, saying
041543 -            he will talk about it at the
041544 -            next visit in 6
041545 -            weeks............................. 090326, ref SDS 93 T64N
041547 -             ..
041548 -       83.  Millie letter from Doctor Stritter asks
041549 -            to be notified about progress considering
041550 -            2nd opinion options for solving problem
041551 -            of diminishing treatments for
041552 -            Millie's 7th relapse
041553 -            of IBC............................ 090326, ref SDS 94 Q16O
041555 -             ..
041556 -       84.  Millie letter to medical team reports
041557 -            rising pain from radiation side effects,
041558 -            asks about using Domeboro
041559 -            to supplement
041560 -            silvadene......................... 090328, ref SDS 95 4S9W
041562 -             ..
041563 -       85.  Millie reports continued recovery from
041564 -            IBC after completing radiation and
041565 -            hyperthermia 2 weeks
041566 -            earlier........................... 090328, ref SDS 95 4S4V
041568 -             ..
041569 -       86.  Doctor Hsu letter to Millie schedules
041570 -            examination to relieve pain and suffering
041571 -            side effects from radiation side
041572 -            effects following treatment
041573 -            to recover from IBC that
041574 -            ended on 090317................... 090328, ref SDS 96 H27I
041576 -             ..
041577 -       87.  Millie's letter to UCSF confirms meeting
041578 -            with Doctor Hsu on 090401 to get pain
041579 -            relief from radiation side
041580 -            effects........................... 090328, ref SDS 97 H27I
041582 -             ..
041583 -       88.  Doctor Hsu asks Millie to change time
041584 -            of meeting on 090401 to afternoon
041585 -            to accomodate tumor board
041586 -            meeting........................... 090328, ref SDS 98 SA4J
041588 -             ..
041589 -       89.  Millie letter to UCSF asks Doctor Hsu
041590 -            to meet on Monday 090330, rather than
041591 -            Wedensday 090401 to expedite
041592 -            pain relief....................... 090328, ref SDS 99 CM5K
041594 -             ..
041595 -       90.  Doctor Hsu agrees to advance examination
041596 -            of Millie for prescribing pain relief
041597 -            proposes meeting on 090330 in the
041598 -            afternoon......................... 090328, ref SDS A0 4Z6I
041600 -             ..
041601 -       91.  Millie letter to UCSF asks to meet on
041602 -            090330 0800 rather than in the
041603 -            afternoon to expedite getting
041604 -            pain relief....................... 090328, ref SDS A1 MR3K
041605 -
041606 -
041607 -
041608 -
041609 -
0417 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Pain Relief Radiation Side Effects Advance Meeting Expedite Recovery
050403 -
050404 - Follow up ref SDS A1 E54L, ref SDS A0 E54L.
050405 -
050406 - Millie completed 4 weeks of treatment at UCSF with radiation and
050407 - hyperthermia on 090317. ref SDS 84 9L7K  On 090312 Doctor Hsu advised
050408 - that suffering severe side effects of radiation would increase for
050409 - several weeks or more, then Millie would begin to recover. ref SDS 80
050410 - F860  The doctor further advised that this period of "suffering" would
050411 - correlate with radiation continuing treatment causing theraputic
050412 - recovery from IBC for possibly several months after ending radiation
050413 - and hyperthermia treatments on 090317. ref SDS 80 VL4O
050415 -  ..
050416 - Examination at Kaiser on 090325 Doctor Johnson observed severe side
050417 - effects described as radiation "burn." Millie reported reported not
050418 - feeling well physically and emotionally due to radiation side effects.
050419 - ref SDS 88 P39I
050421 -  ..
050422 - At that time on 090325, Doctor Johnson suggested Millie try zink and
050423 - Domeboro to increase relief from radiation side effects. ref SDS 88
050424 - 6E5I
050426 -  ..
050427 - Millie reported in a letter to Doctor Stritter on 090326 not feeling
050428 - well due to rising side effects of radiation treatments that ended on
050429 - 090317. ref SDS 92 PX6Y
050431 -  ..
050432 - Millie reported in a letter this morning to the medical team pain and
050433 - suffering have increased since the meeting at Kaiser on 090325.
050434 - ref SDS 95 4S9W
050436 -  ..
050437 - Millie received a letter from Doctor HSU ordering examination at UCSF
050438 - to prescribe relief from pain and suffering caused by radiation side
050439 - effects. ref SDS 96 H27I
050441 -  ..
050442 - Millie sent a letter to UCSF confirming meeting with Doctor Hsu on
050443 - 090401. ref SDS 97 RG9H
050445 -  ..
050446 - Doctor sent a letter to Millie changing the time for meeting at UCSF
050447 - on 090401 to the afternoon. ref SDS 98 SA4J
050449 -  ..
050450 - Millie responded to Doctor Hsu asking to advance the meeting from
050451 - 090401 to 090330. ref SDS 99 CM5K
050453 -  ..
050454 - Doctor Hsu responded to Millie agreeing to advance meeting from
050455 - Wednesday 090401 to 090330 in the afternoon. ref SDS A0 4Z6I
050457 -  ..
050458 - Millie responded to Doctor Hsu asking to epedite meeting at UCSF on
050459 - 090330 0800 for pain relief. ref SDS A1 MR3K
050461 -  ..
050462 - Doctor Hsu responded to Millie saying...
050463 -
050464 -    1.  Subject:  Meeting UCSF Mar 30 Evaluate Pain Radiation Side Effects
050465 -        Date: Sat, 28 Mar 2009 21:04:35 -0700
050469 -         ..
050470 -    2.  Let stay with 12:00.  I will be in the OR 7:30.
050471 -
050472 -            [On 090328 2127 Millie's letter to UCSF confirms meeting on
050473 -            090330 1200 to expedite pain relief from radiation side
050474 -            effects. ref SDS A2 F34O
050475 -
050476 -
050494 -
050495 -
050496 -
050497 -
050498 -
050499 -
050500 -
050501 -
050502 -
050503 -
050504 -
050505 -
050506 -
050507 -
050508 -
0506 -