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 12, 2009 08:30 AM Tuesday;
Rod Welch
Millie Blood test at Kaiser CBC with diff, INR, CA 15-3 and flush port.
1...Summary/Objective
2...Lab Blood Test CBC to Evaluate Neupogen and Cancer Treatment Plan
3...Laboratory Blood Test Results Posted Kaiser's Computer
..............
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 70 0000. ref SDS 62 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - 1. On 090108 Millie's blood counts were very low at UCSF.
040902 - ref SDS 48 YN8O Millie had a follow up blood draw at Kaiser on
040903 - 090116, showing further decline in blood counts. ref SDS 52
040904 - 075H A week later on 090122, Doctor Rugo stopped treatment
040905 - with sunitinib clinical study, ref SDS 57 AT6N; she scheduled
040906 - Millie for meeting at UCSF a week later to begin new treatment
040907 - for recovering from a 6th relapse of IBC.
040909 - ..
040910 - 2. On 090129 Millie had a blood draw at UCSF to guide examination
040911 - by the medical team in the Breast Care Clinic. ref SDS 58 075H
040913 - ..
040914 - Millie did not start a new treatment on 090129 due a
040915 - communication glitch, reported in the letter to the medical
040916 - team on 090130. ref SDS 59 AY8Q
040918 - ..
040919 - 3. On 090210 Doctor Rugo's office scheduled Millie to meet with
040920 - the doctor at UCSF on 090312 to evaluate response to treatment
040921 - which was delayed from 090129 to 090219. ref SDS 60 XU5N
040923 - ..
040924 - 4. On 090213 1140 Doctor Johnson ordered a blood draw for 090310
040925 - (today) testing INR, and other diagnostics, including CA 15-3,
040926 - and to flush Milli'e port according to Kaiser requirements.
040927 - ref SDS 61 6P3F
040929 - ..
040930 - 5. On 090309 1500 after getting radiation and hyperthermia
040931 - treatmnet in San Francisco at UCSF, Millie went to Kaiser on
040932 - the way home for the lab. ref SDS 62 VF6G
040934 - ..
040935 - 6. On 090317 1120 called Kaiser and talked to Arlette; hectic
040936 - schedule on 090313 prevented following up on plans to
040937 - discuss CA 15-3 results for blood test on 090309.
040938 - ref SDS 65 Y077
040940 - ..
040941 - 7. On 090317 1120 Arlette ordered make up blood draw to test CA
040942 - 15-3. ref SDS 65 YP6S
040944 - ..
040945 - 8. On 090317 1120 Millie went to Kaiser on the way home from
040946 - treatment at UCSF and got another blood draw to test CA 15-3.
040947 - ref SDS 65 PQ6R
040949 - ..
040950 - 9. On 090323 results of blood draw on 090317 shows CA 15-3 251,
040951 - ref SDS 66 Y077, significant decline from 303 for the test on
040952 - 090116. ref SDS 52 A16M
040954 - ..
040955 - 10. On 090325 Doctor Johnson ordered a blood draw for 090413 1500,
040956 - and to also access Millie's Power Port required to inject
040957 - contrast medium for a test in the CT Department at 1520. This
040958 - also requires coordinating with Interventional Radiology
040959 - Services to support connecting contrast medium to the Power
040960 - Port for injection required for the CT test. ref SDS 67 TE4O
040962 - ..
040963 - 11. On 090407 1442 called Kaiser CT Department; Loretta said that
040964 - Interventional Radiology Services (IS) had not been notified to
040965 - support the test; she did this during the call, ref SDS 69
040966 - WB6G; Loretta advised that IS requested to change the time of
040967 - the test from 1520 to 1500, because the nurses work day ends at
040968 - 1530; IS wants to avoid overtime; so the time was changed to
040969 - 1500. ref SDS 69 1163
040971 - ..
040972 - 12. On 090407 1442 called Kaiser CT Department; Loretta said that
040973 - the CT consult referral dos not specify a consolidated report
040974 - for the CT test.
040976 - ..
040977 - 13. On 090413 1330 Millie went to Kaiser for a blood draw,
040978 - implementing plans to prepare for meeting at UCSF on 090423.
040979 - ref SDS 70 6Z4F
040980 -
040981 -
040982 -
040984 - ..
040985 - Lab Blood Test CBC to Evaluate Neupogen and Cancer Treatment Plan
040986 -
040987 - Follow up ref SDS 70 6Z4F, ref SDS 62 6Z4F.
040988 -
040989 - This morning Millie went to the Chemotherapy Infusion Clinic in the
040990 - Oncology Department at Kaiser in Walnut Creek, CA, for the blood draw
040991 - using a standing order by the doctor on 090325. ref SDS 67 TE4O
040993 - ..
040994 - This lab is for data that enables the medical team at UCSF to be
040995 - prepared for a productive meeting on Thursday, 090514 0830.
040997 - ..
040998 - Cathy is Millie's nurse today.
041000 - ..
041001 - Cathy asked Millie for the scope of the test in order to determine the
041002 - number of test tubes to draw.
041004 - ..
041005 - Millie submitted a list from the lab for the last meeting with Doctor
041006 - Rugo on 090129. ref SDS 58 075H
041007 -
041009 - ..
041010 - Laboratory Blood Test Results Posted Kaiser's Computer
041011 -
041012 - Follow up ref SDS 70 S65I, ref SDS 62 S65I.
041013 -
041014 - Previous lab at Kaiser on 090413, ref SDS 70 S65I, followed up test on
041015 - 090309, ref SDS 62 OT8J, and a week later on 090317 to get CA 15-3
041016 - that was omitted on 090309. ref SDS 65 Y04R Prior test at UCSF on
041017 - 090129, ref SDS 58 075H, and 2 weeks earlier at Kaiser on 090116.
041018 - ref SDS 52 S65I
041019 -
041020 - [On 090513 1654 Millie submits lab results at Kaiser to
041021 - UCSF for the meeting on 090514. ref SDS 71 ZH6R
041023 - ..
041024 - Patient Provider Category View FR Date To Date
041038 - ..
041039 - 72/F Lab Results Summary
041041 - ..
041042 - Log#: 510913201222 090512 09:00
041043 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041044 - Type Results Units Normal Type Units Normal ACRO
041045 - CBC with DIFF & PLT CT CBCD
041046 - WBC 4.0 K/uL 3.4 - 10.0 WBC x10-3 x10E9/L 3.4 - 10 WBC
041047 - RBC 3.92 M/uL 3.60 - 5.70 RBC x10-6 x10E12/L 4 - 5.2 RBC
041048 - Hemoglobin L 11.2 g/dL 11.5 - 15.0 Hemoglobin g/dL 12 - 15.5 HGB
041049 - Hematocrit 35.1 % 34.0 - 46.0 Hematocrit PERCENT 36 - 46 HCT
041050 - MCV 90 fL 80.0 - 100.0 MCV fL 80 - 100 MCV
041051 - RDW, RBC 14.3 % 11.9 - 14.3 [Not Reported at UCSF]
041052 - MCH [Not Reported] MCH pg 26 - 34 MCH
041053 - MCHC [Not Reported] MCHC g/dL 31 - 36 MCHC
041054 - Lymphocytes 38 % 13 - 46 LYMPHS x10E9/L 0.9 - 2.9 L-A
041055 - Monocyte H 19 % 4 - 12 MONOS x10E9/L 0.2 - 0.8 M-A
041056 - ..
041057 - Eosinophils H 9 % 0 - 4 EOS x10E9/L 0.0 - 0.4 E-A
041059 - ..
041060 - On 090118 Millie letter to medical team asks about eosinophils 700%
041061 - high. ref SDS 54 PZ4Q
041063 - ..
041064 - Lab report continues...
041065 -
041066 - Basophil 1 % 0 - 1 BASOS x10E9/L 0.0 - 0.1 B-A
041067 - Diff Method AUTO DIFF
041068 - Atypical Lymph [Not Reported] %
041069 - Anisocytosis [Not Reported]
041070 - PLT Estimate [Not Reported]
041071 - PLT Morphology [Not Reported]
041072 - RBC Morphology [Not Reported]
041074 - ..
041075 - Platelets 238 K/uL 140 - 400 Plt x10-3 x10E9/L 140 - 450 PLT
041076 -
041078 - ..
041079 - CBC blood test continues...
041080 -
041081 - Log#: 510913201222 090512 09:00
041082 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041083 - Type Results Units Normal Type Units Normal ACRO
041084 - (posted 090323, ref SDS 66 Y077 for test on 090317, ref SDS 65 PQ6R,
041085 - CA 15-3 H* 320 U/mL < 39 CA 15-3 U/mL < 33 CA153
041087 - ..
041088 - CA 15-3 320 on the test today is another increase from Cancer marker
041089 - CA 15-3 271 for the test last month on 090413, shown in the case study
041090 - on 090323. ref SDS 66 J13O
041092 - ..
041093 - May reflect cancer spreading to the lower left arm, and new nodularity
041094 - on the left of the right breast. There now signs of of IBC above and
041095 - slightly right of the left shoulder, near and below the left
041096 - supraclavicular (collar bone).
041098 - ..
041099 - CBC blood test continues...
041100 -
041101 - Log#: 510913201222 090512 09:00
041102 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041103 - Type Results Units Normal Type Units Normal ACRO
041104 - (calculated with formula on 081205. ref SDS 23 JG6F)
041105 - ANC 1320 -> 1500 NEUTS x10E9/L 1.8 - 6.8 N-A
041106 - Neutrophils L 33 % 41 - 81 Neutrophils
041107 - Bands [Not Reported] % 0 - 5
041108 - Neutrophils Absolute
041109 - Automated Count L 1.3 K/uL 2.1 - 7.7
041110 -
041111 - ANC = WBC x 1000 x (Neutrophils + Bands)
041113 - ..
041114 - 4.0 x 1000 x (.33 + .00) = 1320
041116 - ..
041117 - Appears that Kaiser may have added ANC and rounded off the calculation
041118 - called "Neutrophils Absolute Automated Count".
041120 - ..
041121 - ANC 1320 is another significant drop from ANC (NEUTS 1.406 at UCSF)
041122 - for the test last month on 090413, continuing the decline from ANC
041123 - 2120 for the test on 090309, ref SDS 62 B35J, since Millie has not had
041124 - chemotherapy since 090122.
041126 - ..
041127 - CBC blood test continues...
041128 -
041129 - Log#: 510913201222 090512 09:00
041130 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041131 - Type Results Units Normal Type Units Normal ACRO
041132 - PT, Patient H 22.2 sec 8.2 - 10.6 PT s 12.0 - 14.1 PT
041133 - PT INR H 2.2 INL NRM Ratio 0.9 - 1.1 INR
041134 -
041136 - ..
041137 - Log#: 510913201222 090512 09:00
041138 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041139 - Type Results Units Normal Type Units Normal ACRO
041140 - Total Protein [No Report] g/dL 6.0 - 7,7 PROTEIN, TOTAL g/dL 5.8 - 8.0 TP
041141 - ALBUMIN 4.3 g/dL 3.3 - 4.7 ALBUMIN g/dL 3.4 - 4.7 ALB
041142 - Alkaline Phos [No Report] U/L 37 - 117 ALKALINE PHOSPHATASE U/L 29 - 111 ALKP
041143 - Calcium 9.4 mg/dL 8.5 - 10.3 CALCIUM mg/dL 8.7 - 10.1 CA
041144 - ..
041145 - Magnesium 1.9 mg/dL 1.6 - 2.3 MAGNESIUM mg/dL 1.8 - 2.3 MG
041146 - Sodium 137 mEq/L 137 - 145 SODIUM
041147 - Potassium 4.6 mEq/L 3.5 - 5.3 POTASSIUM
041148 - Glucose Random [No Report] mg/dL 60 - 159 GLUCOSE mg/dL 70 - 199 GLU
041149 - ALT (SGPT) 21 U/L 11 - 66 ALT U/L 11 - 54 ALT
041150 - AST (SGOT) 35 U/L 10 - 40 AST U/L 11 - 54 ALT
041152 - ..
041153 - Log#: 510913201222 090512 09:00
041154 - <------------------- KAISER -----------------------><----------------- UCSF --------------------->
041155 - Type Results Units Normal Type Units Normal ACRO
041156 - Bili Tot Adult 0.2 mg/dL 0.2 - 1.3 BILIRUBIN TOTAL mg/dL 8.7 - 10.1 CA
041157 - Creat with GFR
041158 - Creatinine 0.68 mg/dL -< 1.11 CREATININE mg/dL 0.42 - 1.06 CR
041160 - ..
041161 - Note: Creatinine assay changed to IDMS standardization on
041162 - February 4, 2008 causing decrease in results of approximately
041163 - 0.09 mg/dL
041165 - ..
041166 - GFR Non-Afr Am >60 mL/min > 60 - eGFR if Caucasian >60 mL/min GFRC
041167 - GFR African AM >60 mL/min > 60 eGFR if African Amer >60 mL/min GFRA
041168 - GFR Note **
041169 -
041170 -
041171 -
041172 -
041173 -
041174 -
041175 -
041176 -
041177 -
041178 -
0412 -