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: April 15, 2009 02:24 PM Wednesday; Rod Welch

Millie coordinates sending test data and notifies persistent heavy chest.

1...Summary/Objective
2...Coordinate Care Millie's 8th Relapse Treat Cancer Chronic Disease
3...Heavy Chest Reported Concern about Lung Damage from Radiation
4...Heavy Chest Persistant for Week Concern about CT Test Findings


..............
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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS E6 0000. ref SDS E3 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - The letter today follows up patient history...
040902 -
040903 - Patient history of 106 tasks from 081219 to 090331 arranging care for
040904 - Millie to recover from 8th relapse of cancer by treating cancer as a
040905 - "chronic disease" is reported in the record on 090409 1520 telecon
040906 - with Doctor Johnson. ref SDS E3 4W5I
040908 -             ..
040909 -        1.  Doctor Hsu letter asks beside fever and
040910 -            chill any other symptoms? cough, pain, etc.
040911 -            Did Silvadine help with the skin
040912 -            pain.............................. 090401, ref SDS B9 E54L
040914 -             ..
040915 -        2.  Doctor Hsu letter says rash on
040916 -            lower left arm likely
040917 -            IBC............................... 090401, ref SDS B9 R24X
040919 -             ..
040920 -        3.  Millie reports to medical team temperature
040921 -            came down to 97.8 with aspirin, and
040922 -            drinking water; no other symptoms
040923 -            of cough and pain responding
040924 -            to Doctor Hsu's
040925 -            inquiry........................... 090401, ref SDS C0 AE4G
040927 -             ..
040928 -        4.  Millie advises medical team that UCSF
040929 -            instructions on 090330 to apply generous
040930 -            thickness of Silvadine cream may relieve
040931 -            pain slightly from radiation
040932 -            side effects...................... 090401, ref SDS C0 RE6V
040934 -             ..
040935 -        5.  Millie more resolved to tolerate severe
040936 -            side effects from radiation and hyperthermia
040937 -            in order to recover from 6th relapse of
040938 -            IBC because examination at UCSF shows
040939 -            results; and further side effects are
040940 -            subsiding in some areas; signs of recovery
040941 -            helps overcome the trauma of dressing
040942 -            the wound several times a day;
040943 -            which is very scary to
040944 -            observe............................ 090401, ref SDS C0 RE6Y
040946 -             ..
040947 -        6.  Millie's letter to medical team reports
040948 -            UCSF has not clarified schedule for meeting
040949 -            with Doctor Rugo on Thursday 090402,
040950 -            which seems like a
040951 -            mistake............................ 090401, ref SDS C0 RE8S
040953 -             ..
040954 -        7.  Doctor Rugo advises Millie will not be
040955 -            ready for examination on 090402 to plan
040956 -            treatment for 7th relapse of IBC; proposes
040957 -            meeting at UCSF on 090416; notes Millie
040958 -            suffering wound from radiation
040959 -            side effects, and advises
040960 -            treatment will be very
040961 -            effective.......................... 090401, ref SDS C1 K56O
040963 -             ..
040964 -        8.  Millie's letter to medical team explains
040965 -            Kaiser's schedule for medical tests on
040966 -            on 090413 to support meetings at
040967 -            090423............................. 090401, ref SDS C2 R43V
040969 -             ..
040970 -        9.  Millie cites concern about new IBC on
040971 -            lower left arm and asks UCSF to
040972 -            confirm meetings on
040973 -            090423............................. 090401, ref SDS C2 R43V
040975 -             ..
040976 -       10.  Telecon Kaiser Outside Referral Department
040977 -            advises the referral for Millie's treatment
040978 -            at UCSF expires on 090602 is automatically
040979 -            extended 1 year to 100202 in order
040980 -            to implement Kaiser prescription
040981 -            for UCSF to treat Millie's
040982 -            cancer as a chronic
040983 -            disease............................ 090401, ref SDS C3 KT8G
040985 -             ..
040986 -       11.  Kaiser Outside Referral Department lists
040987 -            UCSF professionals providing services
040988 -            for Millie's care to ensure
040989 -            continuity of treatment to
040990 -            resolve IBC........................ 090401, ref SDS C3 5W4G
040992 -             ..
040993 -       12.  Kaiser Outside Referral Department explains
040994 -            primary care physician can amend referral for
040995 -            Millie's treatment with hyperthermia and
040996 -            radiation to have labs done at UCSF in order
040997 -            to reduce mistakes and save lives,
040998 -            time and money..................... 090401, ref SDS C3 RG5K
041000 -             ..
041001 -       13.  Millie's letter notifies medical team
041002 -            Kaiser Outside Referrals indicates
041003 -            current authorization enables continuity
041004 -            of care at UCSF from Doctor Rugo in Breast
041005 -            Care Clinic, and Doctor Hsu in
041006 -            Radiation Oncology................. 090401, ref SDS C4 LG4G
041008 -             ..
041009 -       14.  Millie's letter notifies team that Kaiser
041010 -            Outside Referrals authorizes continuity
041011 -            of care by automatically extending
041012 -            payment for 6 months until
041013 -            100202............................. 090401, ref SDS C4 WC6Y
041015 -             ..
041016 -       15.  Millie's letter notifies team that
041017 -            referral for Millie's hyperthermia and
041018 -            ratiation can be amended by primary care
041019 -            physician to add labs at UCSF in order
041020 -            streamline care for medical necessity
041021 -            to reduce mistakes and save
041022 -            time and money..................... 090401, ref SDS C4 WC7Y
041024 -             ..
041025 -       16.  Doctor Rugo thanks Millie for facilitating
041026 -            Kaiser clarifying referral authorization
041027 -            for UCSF to treat Millie's 7th relapse
041028 -            of cancer as a chronic disease; and
041029 -            advises information should be sent
041030 -            to the UCSF authorization
041031 -            person............................. 090402, ref SDS C5 LA6H
041033 -             ..
041034 -       17.  Doctor Rugo advises that clarifying
041035 -            confusion in scheudling next meeting
041036 -            should be resolved by UCSF schedule
041037 -            department because UCSF has a
041038 -            complex schedule system............ 090402, ref SDS C5 117O
041040 -             ..
041041 -       18.  Millie letter asks Doctor Rugo if Lena
041042 -            who called Millie in February about
041043 -            scheduling meetings with the doctor
041044 -            can clarify the schedule in
041045 -            April, as requested by
041046 -            the doctor......................... 090402, ref SDS C6 WM8M
041048 -             ..
041049 -       19.  Millie sent a letter to Glenna who
041050 -            coordinated Millie's treatment on pior
041051 -            sunitinib clinical trial, and asking
041052 -            for assistance finding who to notify
041053 -            about Kaiser referral authorization,
041054 -            who can assist clarifying the
041055 -            schedule for meeting with
041056 -            Doctor Rugo........................ 090402, ref SDS C7 WM8M
041058 -             ..
041059 -       20.  Glenna called and advised she coordinated
041060 -            contacts at UCSF for Millie's referral
041061 -            authorization, and to clarify schedule
041062 -            for Millie to meet with Doctor
041063 -            Rugo on planning treatment
041064 -            for the 7th relapse
041065 -            of IBC............................. 090402, ref SDS C8 JA6L
041067 -             ..
041068 -       21.  Millie letter notified medical team
041069 -            elevated temperature 99.7 fever occurred
041070 -            again; icing upper left arm, and is
041071 -            monitoring fever to
041072 -            evaluate........................... 090402, ref SDS C9 684J
041074 -             ..
041075 -       22.  Millie letter to medical team thanks Doctor
041076 -            Rugo for Glenna's support coordinating case
041077 -            management on referral authorizations,
041078 -            and on scheduling a meeting to plan
041079 -            treatment for recovering from 7th
041080 -            relapse of IBC..................... 090402, ref SDS C9 H94R
041082 -             ..
041083 -       23.  Millie letter to Doctor Rugo's assistant
041084 -            requests confirmation of schedule to
041085 -            with the doctor at UCSF on 090423
041086 -            for planning treatment of
041087 -            Millie's 8th relapse of
041088 -            cancer............................. 090403, ref SDS D0 375Y
041090 -             ..
041091 -       24.  Millie letter notifies medical team that
041092 -            temperature 99.7 subsided by midnight;
041093 -            cough and shortness of breath persisted
041094 -            and prevented sleep; evantually
041095 -            recovered about
041096 -            0400............................... 090403, ref SDS D1 XZ6I
041098 -             ..
041099 -       25.  Doctor Hsu letter asks Millie to get
041100 -            examination at Kaiser for
041101 -            pneumonia.......................... 090403, ref SDS D2 Z66M
041103 -             ..
041104 -       26.  Doctor Rugo letter asks Millie to
041105 -            get examination at Kaiser for
041106 -            shortness of breath................ 090403, ref SDS D3 3G3N
041108 -             ..
041109 -       27.  Millie notifies medical team that UCSF
041110 -            recommends examination for pneumonia
041111 -            with symptoms of shortness of
041112 -            breath............................. 090403, ref SDS D4 NW4N
041114 -             ..
041115 -       28.  Millie notifies medical team fever occurs
041116 -            for 3rd time with temperature 99.4; explains
041117 -            home care has previously been
041118 -            effective.......................... 090403, ref SDS D4 DX7S
041120 -             ..
041121 -       29.  Millie notifies medical team side effects
041122 -            of radiation and hyperthermia skin "burn"
041123 -            healing, and pain subsides
041124 -            substantially...................... 090403, ref SDS D4 DX8R
041126 -             ..
041127 -       30.  Millie letter to Doctor Johnson 090403
041128 -            2012 supplements letter sent 20 minutes
041129 -            earlier 1941 to explain symptoms subside
041130 -            proposes monitoring and then assess
041131 -            need for examination at
041132 -            Kaiser............................. 090403, ref SDS D5 ZG7H
041134 -             ..
041135 -       31.  Letter from Doctor Johnson responds to
041136 -            Mil's first letter sent 090403 1954,
041137 -            ref SDS D4 NW4N, but not this 2nd letter
041138 -            sent 20 minutes later, and reporting symptoms
041139 -            subside, see 090403 2012, ref SDS D5 OA4R;
041140 -            doctor evidently did not see the 2nd letter;
041141 -            asks Millie to call Kaiser and schedule
041142 -            a meeting, recommends medical team use
041143 -            Kaiser's internal proprietary Knowledge
041144 -            Management system for email to
041145 -            increase efficiency
041146 -            performing case
041147 -            management......................... 090406, ref SDS D6 M19I
041149 -             ..
041150 -       32.  Millie letter to medical team relates
041151 -            report in Millie's 2nd letter on 090403
041152 -            that symptoms have not repeated, and
041153 -            so proposes deferring examination
041154 -            at Kaiser.......................... 090406, ref SDS D7 OC5F
041156 -             ..
041157 -       33.  Called UCSF talked to Roy, who advises
041158 -            there is no record scheduling meeting
041159 -            on 090423; Roy plans to notify Amanda,
041160 -            who is another assistant for Doctor Rugo,
041161 -            about scheduling meeting on 090423
041162 -            0830, which Doctor Rugo
041163 -            ordered............................ 090407, ref SDS D8 PP8X
041165 -             ..
041166 -       34.  Amanda called, she assists Doctor Rugo;
041167 -            advised UCSF cannot find Millie's letter
041168 -            to medical team on 090401 1520, ref SDS C4
041169 -            LG4G, and further advised that UCSF has no
041170 -            record Kaiser has authorized referral for
041171 -            Millie to meet with Doctor Rugo on 090423,
041172 -            and so a meeting has not been scheduled;
041173 -            Millie's letter on 090401 1520 was
041174 -            resubmitted to Amanda
041175 -            at UCSF............................ 090407, ref SDS E0 MV5K
041177 -             ..
041178 -       35.  Amanda called after receiving Millie's
041179 -            letter on 090401 1520, and schedules
041180 -            Millie for another meeting with Tara,
041181 -            because Doctor Rugo will be
041182 -            out of town again
041183 -            on 090423 0830..................... 090407, ref SDS E0 4N3F
041185 -             ..
041186 -       36.  Called Kaiser CT Department Loretta confirmed
041187 -            test scheduled on 090413 allows 10 days
041188 -            for Kaiser to send report in time to meet
041189 -            at UCSF 090423; CT Department changes time
041190 -            for test from 1520 to 1500 requested by
041191 -            Interventional Radiology Services to avoid
041192 -            overtime for Millie's CT test; Loretta
041193 -            asks Millie to coordinate with Chemotherpay
041194 -            Infusion Department to change the time
041195 -            for Millie's blood on 090413 from
041196 -            1500 to 1430, so that the CT Department
041197 -            can make use of the nurse accessing
041198 -            Millie's Power Port with a Huber
041199 -            needle that can be used to
041200 -            inject contrast medium
041201 -            for the CT test
041202 -            at 1500............................ 090407, ref SDS E1 L76N
041204 -             ..
041205 -       37.  Kaiser CT Department discloses the
041206 -            computer indicates somebody changed
041207 -            doctor's order for consolidating findings
041208 -            into single report to correct mistakes
041209 -            in past reports; Loretta to investigate
041210 -            why doctor's order was
041211 -            changed............................ 090407, ref SDS E1 1163
041213 -             ..
041214 -       38.  Called Kaiser Oncology Department and
041215 -            changed time for blood draw from 090413
041216 -            1500 to 1430 to facilitate request by
041217 -            IS to avoid overtime
041218 -            expense............................ 090407, ref SDS D9 R16X
041220 -             ..
041221 -       39.  Kaiser CT Department called back; Katie
041222 -            advised that the doctor's order for Millie's
041223 -            CT test was changed by the department
041224 -            to eliminate requirement for consolidated
041225 -            findings because government regulations
041226 -            require separate reports for scans above
041227 -            the neck from scans below the
041228 -            neck............................... 090407, ref SDS E1 L87J
041230 -             ..
041231 -       40.  CT Department called back and Katie advised
041232 -            test scheduled on 090414 1500, which
041233 -            conflicted with doctor's order for
041234 -            test on 090413..................... 090407, ref SDS E1 YK64
041236 -             ..
041237 -       41.  CT Department called back and advised
041238 -            an error occurred in data entry changing
041239 -            the time for the test on 090413 from 1520
041240 -            to 1500, resulting to scheduling the
041241 -            test on 090414; Katie corrected
041242 -            mistake............................ 090407, ref SDS E1 W47V
041244 -             ..
041245 -       42.  CT Department investigates why doctor's
041246 -            order for consolidating findings into
041247 -            a single report for each CT test
041248 -            was changed........................ 090407, ref SDS E1 YZ95
041250 -             ..
041251 -       43.  UCSF notified Millie will be examined
041252 -            in breast care clinic on 090423 0830
041253 -            evaluate progression IBC 7th
041254 -            relapse and plan for next
041255 -            treatment.......................... 090408, ref SDS E2 E54L
041257 -             ..
041258 -       44.  Medical team notified Kaiser CT Department
041259 -            changed time of test on 090413 to accomodate
041260 -            IS overtime cost containment objectives;
041261 -            requires coordinating with Chemotherapy
041262 -            Infusion Clinic to correlate time of
041263 -            blood draw with revised time
041264 -            for CT test........................ 090408, ref SDS E2 QW4X
041266 -             ..
041267 -       45.  Fever high temperature occurred for several
041268 -            days during 3 - 5 hours in late evening
041269 -            but this stopped several days ago, and other
041270 -            symptoms cough and shortness of breath
041271 -            subside, so no need for examination at
041272 -            Kaiser by primary care physician
041273 -            requested by Doctor Hsu and
041274 -            Doctor Rugo at
041275 -            UCSF............................... 090408, ref SDS E2 QW6R
041277 -             ..
041278 -       46.  Arlette coordinated with Bella to change
041279 -            time of blood test to 1330 that aligns
041280 -            with CT Department changing time of CT
041281 -            test on 090413 from 1520 to
041282 -            1500............................... 090409, ref SDS E3 E54L
041284 -             ..
041285 -       47.  Examination to evaluate treatment of
041286 -            radiation side effects requested by
041287 -            Doctor Hsu and Doctor Rugo at UCSF
041288 -            was deferred by Doctor Johnson because
041289 -            patient reports symptoms
041290 -            subsided........................... 090409, ref SDS E3 TH61
041292 -             ..
041293 -       48.  Notified Doctor Johnson on progress with
041294 -            coordination he requested for CT Department
041295 -            to consolidate findings into single report
041296 -            for each CT test in order to enable
041297 -            efficient case management; under
041298 -            review by Doctor
041299 -            Davidson........................... 090409, ref SDS E3 FU6J
041301 -             ..
041302 -       49.  Doctor Johnson amended Kaiser referral
041303 -            authorization for Millie's treatment
041304 -            at UCSF with hyperthermia and related
041305 -            modalities to include labs at UCSF
041306 -            required for efficient case
041307 -            management......................... 090409, ref SDS E3 6O6N
041309 -             ..
041310 -       50.  Doctor Davidson Director of Radiology
041311 -            for Kaiser Diablo Service Region disclosed
041312 -            CT Department made mistakes issuing multiple
041313 -            reports for a single CT test in order to
041314 -            increase revenues from billings; advised
041315 -            this practice would be changed to consolidate
041316 -            findings that enable efficient patient
041317 -            care for saving lives time
041318 -            and money.......................... 090409, ref SDS E4 L14I
041320 -             ..
041321 -       51.  Letter to Doctor Davidson with copy to
041322 -            medical team confirms Kaiser will correct
041323 -            CT test reports for efficient
041324 -            patient care....................... 090409, ref SDS E5 WB6G
041326 -             ..
041327 -       52.  Millie notifies medical team Doctor Johnson
041328 -            amended Kaiser's referral to include labs
041329 -            at UCSF for efficient case
041330 -            management......................... 090410, ref SDS E6 JT7H
041332 -             ..
041333 -       53.  Medical team notified Doctor Davidson
041334 -            corrected past problems in Kaiser CT
041335 -            Department so that test reports
041336 -            will consolidate findings
041337 -            for efficient case
041338 -            management......................... 090410, ref SDS E6 JT9Y
041340 -             ..
041341 -       54.  Millie asks medical team if anything
041342 -            else is needed for efficient case management
041343 -            to prepare for meeting at UCSF on 090423
041344 -            on planning to treat her cancer at UCSF
041345 -            as a chronic disease, as requested
041346 -            by primary care physician at
041347 -            Kaiser............................. 090410, ref SDS E6 JT5V
041349 -             ..
041350 -       55.  Millie recovering from severe side effects
041351 -            caused by radiation treatments that
041352 -            ended on 090317.................... 090410, ref SDS E6 JT4T
041354 -             ..
041355 -       56.  Millie reports energy improves so that
041356 -            she is a good candidate for cancer
041357 -            treatment.......................... 090410, ref SDS E6 JT5S
041359 -             ..
041360 -       57.  Millie's letter to medical team
041361 -            reports IBC worsening on
041362 -            left arm........................... 090412, ref SDS E7 XN8J
041364 -             ..
041365 -       58.  Millie letter to medical team requests
041366 -            treatment next week to prevent cancer
041367 -            from cascading out of
041368 -            control............................ 090412, ref SDS E7 9S9Y
041370 -             ..
041371 -       59.  Millie went to Kaiser for lab to evaluate
041372 -            progression of cancer, and suitability
041373 -            for treatment, and to access the port
041374 -            for a CT test also on 090413 to
041375 -            assess cancer...................... 090413. ref SDS E8 VF6G
041377 -             ..
041378 -       60.  Millie had CT test at
041379 -            Kaiser............................. 090413, ref SDS E9 0E4I
041381 -             ..
041382 -       61.  Millie notifies medical team IBC
041383 -            spreading.......................... 090415, ref SDS F1 KG8Q
041385 -             ..
041386 -       62.  Millie assists Kaiser coordinating with
041387 -            UCSF on getting results of the blood test
041388 -            and CT test on 090413 to UCSF for
041389 -            meeting on 090423 to plan next
041390 -            treatment of 8th
041391 -            relapse............................ 090415, ref SDS F1 KG8Y
041392 -
041393 -
041394 -
041395 -
041396 -
041397 -
041398 -
041399 -
041400 -
041401 -
041402 -
0415 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Coordinate Care Millie's 8th Relapse Treat Cancer Chronic Disease
050403 - Heavy Chest Reported Concern about Lung Damage from Radiation
050404 -
050405 - Follow up ref SDS E6 6O6N, ref SDS E3 6O6N.
050406 -
050407 - Background on Doctor Johnson asking Millie to coordinate with UCSF on
050408 - arrangements for treating Millie's 8th relaspe of cancer as a chronic
050409 - disease, as listed in the record on 090409. ref SDS E3 4W5I
050411 -  ..
050412 - Millie sent a letter to the medical team saying...
050413 -
050414 -    1.  Subject: CT Test Apr 13 Evaluate Heavy Chest
050415 -        Date: Wed, 15 Apr 2009 14:33:17 -0700
050427 -         ..
050428 -    2.  I sent a letter this morning [on 090415 0947] to Doctor
050429 -        Davidson asking for the report on the CT test via email for
050430 -        expedited review at UCSF. ref SDS F1 KG8Y  Have not received
050431 -        it.  I also asked to get a printed copy at the Oncology front
050432 -        desk, if Kaiser can't send it electronically.  When I stopped
050433 -        at your office a few minutes ago (1248) to get the blood test
050434 -        report for submission to the medical team, there was no report
050435 -        for the CT test, so possibly it has not yet been posted.
050437 -         ..
050438 -    3.  The report I received [from Kaiser on 090415 0911] for the lab
050439 -        was only for 1 of the 30 or so items tested [on 090413 1330].
050440 -        ref SDS E8 OT8J  Not sure why it was done that way.  I had
050441 -        difficulty using the white phone in the lobby coordinating with
050442 -        the Chemotherapy Clinic to get the full report. ref SDS F0 RY4Y
050443 -        The attendant at the front desk went into the Chemotherapy
050444 -        Infusion Clinic and got the blood test report, but it does not
050445 -        list ANC, which was requested in the call this morning, and
050446 -        typically is written in ink on the report.  Normally, Arlette
050447 -        resolves coordination issues, but she was at lunch when I
050448 -        arrived.
050449 -
050450 -               [On 090415 1519 Doctor Johnson disappointed about
050451 -               difficulty getting test data submitted to UCSF for
050452 -               Millie's referral care; asks Arlette to facilitate
050453 -               submission in time for Millie's meeting at UCSF on
050454 -               090423. ref SDS F2 MJ4G
050456 -                ..
050457 -               [On 090420 1451 Doctor Mason reported that other
050458 -               patients do not have problems getting lab reports from
050459 -               Kaiser for referral work at UCSF. ref SDS F4 2H8J
050461 -                ..
050462 -               [On 090423 0830 UCSF did not receive lab reports nor for
050463 -               the CT test on 090413. ref SDS F6 TP9L
050465 -         ..
050466 -    4.  This reflects your analysis on 090213 that communication is a
050467 -        rising factor in health care productivity. ref SDS 77 WZ6K [...
050468 -        and aligns with case study from patient history on 090325
050469 -        citing problems getting labs at Kaiser for medical care at
050470 -        UCSF. ref SDS A0 KZ6N
050472 -         ..
050473 -    5.  Please advise ANC for the lab on 090413 [1330]. ref SDS E8
050474 -        OT8J
050476 -         ..
050477 -    6.  By copy to Doctor Davidson ask again about getting the report
050478 -        for the CT test on 090413 submitted via email for the medical
050479 -        team to take a look.
050480 -
050481 -               [On 090423 0830 UCSF did not receive lab reports nor for
050482 -               the CT test on 090413. ref SDS F6 TP9L
050483 -
050485 -  ..
050486 - Heavy Chest Persistant for Week Concern about CT Test Findings
050487 -
050488 -
050489 -    7.  I am a little concerned about heavy chest the past week.  There
050490 -        has been no temperature nor cough, as occurred on 090402.  My
050491 -        energy is up, working out in th gym and hiking, getting back in
050492 -        shape.
050493 -
050494 -            [...in another record today on 090415 0914 there is a
050495 -            report of a telephone call with Arlette at 1454 who finally
050496 -            reviewed the report for the CT test and advised there are
050497 -            findings of progression of lung nodules, which may be
050498 -            cancer. ref SDS F0 RM56
050500 -         ..
050501 -    8.  Heavy chest is not severe, as occurred with the shortness of
050502 -        breath episode on 090402 [reported to the medical team on
050503 -        090403 1107, ref SDS D1 UV4U], but this has been mildly
050504 -        persistent.  At that time on 090402, Doctor Hsu at UCSF was
050505 -        concerned about pneumonia, and Doctor Rugo also asked me to
050506 -        check with you.  Since the condition subsided and did not
050507 -        recure for several days, and further since my temperature also
050508 -        subsided, we deferred an examination for the 090402 problem.
050510 -         ..
050511 -    9.  The new heavy chest issue may require examination, and elevate
050512 -        timely review of CT test results [requested in Millie's letter
050513 -        today, per above. ref SDS 0 JT7H]
050514 -
050515 -            [...another record today on 090415 0911 reports Arlette
050516 -            called in late afternoon OA 1511 and advised CT test on
050517 -            090413 1500 finds progression of nodules in the lungs that
050518 -            appear to be cancer. ref SDS F0 RZ4U
050520 -             ..
050521 -            [On 090415 1519 Doctor Johnson called and advised that he
050522 -            reviewed the CT scans for Millie's test on 090413 and
050523 -            determined that findings in the CT test report of increased
050524 -            nodules in the lungs are likely caused by radiation injury
050525 -            rather than spread of cancer. ref SDS F2 GT4M
050527 -             ..
050528 -            [On 090415 1642 Millie received Doctor's letter
050529 -            transmitting a report for the CT test on 090413, and
050530 -            confirms explanation in phone call today on 090415 1519
050531 -            that there are no findings of lung cancer in the test
050532 -            report, and that direct review by the primary care
050533 -            physician shows only minimal if any progression of nodules
050534 -            in the lungs, and nothing in the lungs is causing
050535 -            resperatory compromise for symptoms of heavy chest.
050536 -            ref SDS F3 YO7M
050538 -             ..
050539 -            [On 090420 2352 Millie notified medical team that Doctor
050540 -            Johnson made an independent review of CT scans and
050541 -            determined CT test report findings of lung nodules do not
050542 -            present health care threats of cancer nor other resperatory
050543 -            problems. ref SDS F5 MS4U
050545 -             ..
050546 -            [On 090423 0800 Tara, Doctor Rugo's Nurse Practitioner who
050547 -            made examination, advised that Millie's new beathing
050548 -            problems require increased scrutiney for diagnosis and
050549 -            treatment. ref SDS F6 HO4H
050551 -             ..
050552 -            [On 090609 Doctor Hsu advises there was a mistake
050553 -            performing radiation in February and March at UCSF that
050554 -            missed treating IBC in the breastbone area to the left of
050555 -            the right breast, and this untreated IBC tumor may be
050556 -            causing problems in Millie's lungs. ref SDS F8 TP9L
050558 -             ..
050559 -            [On 090706 0301 Millie received a letter from Mike, Doctor
050560 -            Rugo's coordinator, saying his investigation discovered
050561 -            that nobody at UCSF ordered review of Millie's CT test scan
050562 -            files, ref SDS G1 1L6N, which were same-day hand- delivered
050563 -            to UCSF on 090612, ref SDS F0 UD5H, per Mike's request on
050564 -            090610 for timely review by UCSF. ref SDS F1 S537
050566 -             ..
050567 -            [On 090708 1343 Doctor Johnson ordered further tests to
050568 -            evaluate Millie's breathing problems caused by progressive
050569 -            radiation injury from medical mistakes providing radiation
050570 -            services provided by UCSF. ref SDS G2 FS6G
050572 -         ..
050573 -   10.  Please advise.
050574 -
050581 -
050582 -
050583 -
050584 -
050585 -
050586 -
0506 -