CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  On 090310 Millie had a blood test at Kaiser.
040902 -
040903 -    2.  On 090312 Kaiser did not submit results for CA 15-3.
040905 -         ..
040906 -    3.  On 090317 Arlette advised that Kaiser failed to perform CA
040907 -        15-3, ref SDS 6 YM4K, and so ordered another blood draw.
040908 -        ref SDS 6 Y04R
040910 -         ..
040911 -    4.  On 090323 CA 15-3 251 for the test on 090317, ref SDS 7 Y077,
040912 -        showing first reduction in a year, and down from CA 15-3 303
040913 -        for the test at Kaiser on 090116.
040915 -         ..
040916 -    5.  On 090413 Millie had a blood test at Kaiser, and a CT test to
040917 -        support meeting with UCSF on 090423.
040918 -
040919 -
040921 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Called Kaiser for resulst of labs and CT testing on 090413.  Was on
041302 - hold for 35 minutes.  This improves prior calls on 090311 that took
041303 - over 60 minutes on hold, ref SDS 4 6Z4F, and 090312 that took 90
041304 - minutes, ref SDS 5 JO8O, and Arlette reported she was on hold trying
041305 - to contact the Chemotherapy Clinic to order a blood test, that she
041306 - finally had to walk to the clinic and talk to folks directly.
041307 - ref SDS 6 YP6S
041309 -  ..
041310 - Finally, talked to Becky in the Triage unit.
041312 -  ..
041313 - Explained Millie has a rising cancer situation and needs diagnostics
041314 - for examination at UCSF to evaluate starting treatment of 7th relapse
041315 - of cancer.
041317 -  ..
041318 - Becky asked why the patient is calling for the report, rather than
041319 - UCSF.
041321 -  ..
041322 - Reviewed background on 990625 showing Kaiser's Healthwise Handbook
041323 - calls for a doctor/patient partnership to optimize care, ref SDS 1
041324 - 4185, and further recommends that patients use an assistant to
041325 - facilitate work with doctors and hospital staff. ref SDS 1 JY9J  More
041326 - recently, on 080403 Millie's physician at UCSF, Doctor Rugo, requested
041327 - patient assistance coordinating with Kaiser, because coordinating with
041328 - Kaiser takes a lot of time, and the doctor has a hectic schedule.
041329 - ref SDS 3 SG7I
041331 -  ..
041332 - Becky will print the report for Millie's lab at Kaiser on 090413, and
041333 - leave it in an envelope at the front desk for Millie to pickup after
041334 - the meeting at the Wellness Community ends at 1230.
041336 -  ..
041337 - Asked Becky to have someone calculate ANC and write it on the report,
041338 - which UCSF needs for what they call NEUTS.
041340 -  ..
041341 - Becky said she will do this.
041343 -  ..
041344 - Becky said CA 15-3 271 has been reported for the lab on 090413.
041346 -  ..
041347 - Thanked Becky for assistance.
041348 -
041350 -  ..
0414 -
0415 -
0416 - 1346
0417 -
041701 - Millie arrived home.
041702 -
041703 - She explained that the report received from Kaiser at the front desk
041704 - was only for CA 15-3.  None of the other blood elements were listed in
041705 - the report for the test at Kaiser on 090413 1345. ref SDS 10 OT8J
041707 -  ..
041708 - Millie used the white phone in the waiting area to call the
041709 - Chemotherapy Infusion Clinic.  The phone rang and rang and rang until
041710 - Millie finally hung up.  She waited 5 minutes and tried again.  This
041711 - was repeated several times; after about 30 minutes someone finally
041712 - answered.  This experience aligns with Arlette's problems contacting
041713 - the Chemotherapy Clinic by phone, reported on 090317. ref SDS 6 YP6S
041715 -  ..
041716 - The person who answered was unable to connect Millie with Bella, Cisi,
041717 - Barbara, Anne, Diane, Julie, Bonnie, or anyone who typically is able
041718 - to print the report on blood tests.
041720 -  ..
041721 - This call was very frustrating for Millie.
041723 -  ..
041724 - She walked back to the front desk.  The attendant went into the clinic
041725 - and got a copy of the complete blood test report.
041727 -  ..
041728 - However, it does not have ANC (NEUTS at UCSF), needed to evaluate
041729 - Millie's suitability to get treatment.
041731 -  ..
041732 - On 090325 0830 primary care physician was disappointed by continual
041733 - delays submittng data to UCSF, and notes conflict with requirements to
041734 - streamline delivery of care in order to treat Millie's 6th relapse of
041735 - cancer as a chronic disease. ref SDS 8 RB3G
041736 -
041737 -            [On 090420 1451 Doctor Mason reported that other patients
041738 -            do not have problems getting lab reports from Kaiser for
041739 -            referral work at UCSF. ref SDS 17 2H8J
041741 -  ..
041742 - Millie's letter to the medical team today reported work on getting the
041743 - report for the lab at Kaiser on 090413 in time for people to prepare
041744 - for a productive meeting at UCSF on 090423.
041746 -  ..
041747 - Millie asked about results for the CT test on 090413.  She is
041748 - concerned about having some heaviness in her chest the past week,
041749 - which has not been previously reported.
041750 -
041751 -            [On 090415 1424 Millie letter to primary care physician
041752 -            Doctor Johnson advises that report for labs and CT test on
041753 -            090413 was not available for pick up at front desk in
041754 -            afternoon on 090415 1300. ref SDS 13 GU7S
041756 -  ..
041757 - This occurred previously as a one time event on 090330.
041758 -
041759 -
041760 -
041762 -  ..
0418 -
0419 -
0420 - 1454
0421 -
042101 - Called Kaiser and talked to Arlette.
042102 -
042103 - She calculated ANC 1406; posted this to the report on 090413.
042104 - ref SDS 10 B35J
042106 -  ..
042107 - Arlette checked the computer and said the report for the CT test on
042108 - 090413 1500 has been posted. ref SDS 11 0E4I
042110 -  ..
042111 - Arlette read through and noticed progression of nodules in the lungs
042112 - are reported.
042114 -  ..
042115 - She feels this is not pneumonia, but sounds more systemic, like
042116 - cancer.
042118 -  ..
042119 - Millie explained her letter to the doctor earlier this afternoon
042120 - asking for results of the CT test in order to assess heavy chest the
042121 - past week, reported in another record today on 090415 1423.
042122 - ref SDS 13 GU8X
042124 -  ..
042125 - Millie is very concerned this reflects new symptoms that began this
042126 - past week, reported to the medical team just an hour ago in her letter
042127 - on 090415 1424. ref SDS 13 GU8X  If cancer has spread to Millie's lungs
042128 - this is a major change in her status, and requires immediate
042129 - treatment.
042131 -  ..
042132 - Arlette feels the doctor should know about this new test finding
042133 - right away because Millie has relapsed so many times, she needs
042134 - treatment right away.
042136 -  ..
042137 - Millie explained her letters the past few days have requested starting
042138 - treatment right away, beginning on 090412 1532, ref SDS 9 9S9Y and
042139 - also, ref SDS 9 9S5R, and again in the letter this morning to Doctor
042140 - Johnson, reported 090415 0941. ref SDS 12 8E7L
042142 -  ..
042143 - Arlette will check with Doctor Johnson about seeing Millie to get
042144 - treatment started.  She feels adding lung cancer to IBC is nothing to
042145 - play around with.  Previously, on 060807 Arlette described IBC as very
042146 - serious, because the cancer goes through the patient like a hot knife
042147 - through butter. ref SDS 2 7Q8H
042148 -
042149 -        [On 090415 1458 Millie's letter notifies medical team that CT
042150 -        test on 090413 shows progression of nodules in the lungs, which
042151 -        may indicate lung cancer. ref SDS 14 R18A
042153 -         ..
042154 -        [On 090415 1519 Doctor Johnson called and advised that he
042155 -        reviewed the CT scans for Millie's test on 090413 and
042156 -        determined that findings in the report do not indicate lung
042157 -        cancer, ref SDS 15 GT4M; and that any progression of nodules in
042158 -        the lungs reflects radiation side effects. ref SDS 15 E09J
042160 -         ..
042161 -        [On 090415 1642 Millie received Doctor's letter transmitting a
042162 -        report for the CT test on 090413, and confirms explanation in
042163 -        phone call today on 090415 1519 that there are no findings of
042164 -        lung cancer in the test report, and that direct review by the
042165 -        primary care physician shows only minimal if any progression of
042166 -        nodules in the lungs, and nothing in the lungs is causing
042167 -        resperatory compromise for symptoms of heavy chest. ref SDS 16
042168 -        YO7M
042170 -         ..
042171 -        [On 090420 2352 Millie notified medical team that Doctor
042172 -        Johnson made an independent review of CT scans and
042173 -        determined CT test report findings of lung nodules do not
042174 -        present health care threats of cancer nor other resperatory
042175 -        problems. ref SDS 18 MS4U
042176 -
042177 -
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0422 -