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: May 10, 2009 03:53 PM Sunday; Rod Welch

Millie letter to Doctor Rugo agenda for meeting at UCSF May 14.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 0000, ref SDS 5 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 090423 Millie met with Tara in the Breast Care Clinic at UCSF for
040902 - examination, which showed recovery from side effects of radiation and
040903 - hyperthermia treatments during February and March 2009. ref SDS 5 QR3M
040904 - This was confirmed in Millie's letter to the medical team later that
040905 - day on 090423. ref SDS 6 ZL6T  Tara also found expanding IBC on the
040906 - lower left arm, ref SDS 5 DW6F, also confirmed in the letter to the
040907 - medical team. ref SDS 6 ZL7P
040909 -  ..
040910 - At that time, on 090423 Tara planned to discuss with Doctor Hsu in the
040911 - UCSF Radition Oncology Department concerns about slow healing of
040912 - radiation side effects in Millie's breastbone area. ref SDS 5 R15K
040913 - Collaboration plans were further confirmed in Millie's letter to the
040914 - medical team on 090423. ref SDS 6 ZL7V
040916 -  ..
040917 - In the afternoon on 090423 1315 Millie met with Doctor Hsu to check on
040918 - recovery from radiation side effects. ref SDS 5 4H5G  Doctor Hsu gave
040919 - Millie a "thumbs up" that she was well enough to take time from
040920 - treatment to go on a 2-week vacation, ref SDS 5 FJ6K, and despite
040921 - confirming diagnosis of IBC relapse on the lower left arm, ref SDS 5
040922 - 5G4G, and despite growing doubts about vertical line of sking infected
040923 - either by IBC or radiation side effects. ref SDS 5 EX4I  The doctor
040924 - recommended against taking a biopsy because the skin was thought to be
040925 - radiated, and surrounding tissue was radiated, and so this would delay
040926 - and prevent normal recovery from a biopsy wound. ref SDS 5 456H
040928 -  ..
040929 - On 090423 2337 Millie's letter to medical team reports Doctor Hsu's
040930 - favorable report that IBC cannot recur in treated areas, because
040931 - nothing can grow in treated areas. ref SDS 6 ZL9V  The letter further
040932 - confirms UCSF plans to treat IBC recurrence on the lower left arm as a
040933 - chronic disease with systemic agents prescribed by Doctor Rugo in the
040934 - Breast Care Clinic, ref SDS 6 ZL4X, and notes the meeting scheduled
040935 - with Doctor Rugo on 090514. ref SDS 6 ZL5Q
040937 -  ..
040938 - Today, Millie submitted an agenda for the meeting on 090514 to start
040939 - treatment of the 8th relapse...
040940 -
040941 -    1.  Subject: Agenda Meeting Doctor Rugo May 14th Schedule Labs
040942 -        Date: Sun, 10 May 2009 16:01:27 -0700
040950 -         ..
040951 -    2.  Thanks to the team for patching me back together for a vacation
040952 -        with my daughter [cited in Millie's letter to the medical team
040953 -        on 090423 2337, ref SDS 6 ZL5W].  It was very tiring, but a
040954 -        delightful experience.  Today, I am still tired from the trip,
040955 -        but did a lap at Lafayette Reservoir celebrating Mother's day.
040956 -        It was just too nice a day to stay inside [aligns with Millie's
040957 -        ECOG performance score 0, in the medical chart for examination
040958 -        at Kaiser on 090325, ref SDS 3 YF9L; shows continuing candidate
040959 -        for favorable response to cancer treatment, citing the
040960 -        alternate Karnofsky score reported on 090205. ref SDS 1 LH3O]
040961 -
040962 -            [On 090510 1953 notify medical team to add agenda issues
040963 -            for meeting on 090514; expanding sore in breastbone area
040964 -            may be cancer rather than side effects of radiation
040965 -            treatment, ref SDS 7 LJ5Q; breathing problems and cough
040966 -            seem to be increasing. ref SDS 7 LJ6T
040968 -             ..
040969 -            [On 090511 0934 Millie called and talked to Amanda
040970 -            about requirements for blood draw at Kaiser to support
040971 -            meeting with Doctor Rugo at UCSF on 090514, ref SDS 8
040972 -            YM6I; Millie submitted a letter to Amanda confirming
040973 -            understandings from the telecon and with a link to this
040974 -            letter explaining issues related to getting another lab
040975 -            done at Kaiser. ref SDS 8 9P5P
040977 -             ..
040978 -            [On 090511 1427 Millie learned that Doctor Johnson has
040979 -            entered a standing order for Millie to get a monthly blood
040980 -            draw at Kaiser; she went to Kaiser and got the lab done in
040981 -            the Infusion Clinic; Millie notified the medical team that
040982 -            the lab was done, and report will be submitted to UCSF for
040983 -            the meeting with Doctor Rugo on Thursday, 090514.
040984 -            ref SDS 9 UK8R
040986 -         ..
040987 -    3.  I received a call from UCSF confirming schedule meeting with on
040988 -        Thursday, 090514 0830.
040990 -         ..
040991 -    4.  Patient profile on 090213 summarizes background for treating
040992 -        7th relapse of IBC, visibly on the left arm, beginning just
040993 -        below the area treated with radiation and hyperthermia by
040994 -        Doctor Hsu and Chris, ending on 090317. ref SDS 2 PL5K
040995 -
040996 -               [On 090514 0830 doctor spends 20 minutes looking through
040997 -               prior report on 070130 to assemble list of Millie's
040998 -               treatment history. ref SDS 10 AZ9N
041000 -         ..
041001 -    5.  I had some lymphedema the day before returning home, and the
041002 -        day I arrived on 090507.  Today after the hike the left arm
041003 -        swelled again, indicating we have a compound problem of IBC and
041004 -        lymphedema.  This arm has also been treated with Cellulitis
041005 -        numerous times in the ER.
041007 -         ..
041008 -    6.  Do we need a lab for Doctor Rugo's visit to check CA 15-3, and
041009 -        NEUTS.  NEUTS 1.406 (ANC 1406 for Kaiser's calibrations) was
041010 -        slightly low for the lab on 090413. ref SDS 4 B35J
041012 -         ..
041013 -    7.  Since I have been tired, expect this is still low.
041015 -         ..
041016 -    8.  We can do it tomorrow, so the numbers are available in time for
041017 -        the meeting on Thursday.  Please let me know.
041018 -
041028 -
041029 -
041030 -
041031 -
041032 -
041033 -
041034 -
0411 -