CONTACTS 

SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
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 15 QR3M
040904 - This was confirmed in Millie's letter to the medical team later that
040905 - day on 090423. ref SDS 16 ZL6T  Tara also found expanding IBC on the
040906 - lower left arm, ref SDS 15 DW6F, also confirmed in the letter to the
040907 - medical team. ref SDS 16 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 15 R15K
040913 - Collaboration plans were further confirmed in Millie's letter to the
040914 - medical team on 090423. ref SDS 16 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 15 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 15 FJ6K, and despite
040921 - confirming diagnosis of IBC relapse on the lower left arm, ref SDS 15
040922 - 5G4G, and despite growing doubts about vertical line of sking infected
040923 - either by IBC or radiation side effects. ref SDS 15 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 15 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 16 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 16 ZL4X, and notes the meeting scheduled
040935 - with Doctor Rugo on 090514. ref SDS 16 ZL5Q
040937 -  ..
040938 - Yesterday on 090510 1553, Millie submitted an agenda for the meeting
040939 - on 090514 to start treatment of the 8th relapse. ref SDS 17 QH9J  The
040940 - letter was hurried to fit commitments for attending Mother's Day
040941 - family event.  In the afternoon on 090510 1953, after retrurning home,
040942 - Millie sent a second letter to further explain the agenda for meeting
040943 - on Thursday 090514 at UCSF with Doctor Rugo. ref SDS 18 FJ3G
040945 -  ..
040946 - This morning, called and talked to Amanda about coordinating to
040947 - facilitate the agenda for meeting with Doctor Rugo on Thursday,
040948 - 090514, particularly on requirements for blood tests at Kaiser, as
040949 - discussed in Millie's letter on 090510 1953. ref SDS 18 LJ7X
040951 -  ..
040952 - Amanda requested a copy of Millie's letter to the medical team that
040953 - explains details about getting a lab.  Millie sent the letter to
040954 - Amanda and requested clarification on requirements for a lab.
040955 - ref SDS 19 YN33  After sending the letter to Amanda this afternoon,
040956 - Kaiser notified Millie on 090511 1427 that Doctor Johnson has a
040957 - standing order at Kaiser for Millie to get a monthly blood test,
040958 - ref SDS 20 FJ5L; so, Millie then sent a letter notifying the medical
040959 - team that the blood draw will be done on 090512, so that people can be
040960 - prepared for a productive meeting at UCSF on 090514. ref SDS 20 FJ6G
040962 -  ..
040963 - On 090511 2013, Doctor Rugo sent a letter saying that scope for labs
040964 - at Kaiser performed to support examinations at UCSF should be
040965 - determined by Kaiser rather than by UCSF. ref SDS 21 RF4J
040967 -  ..
040968 - On 090511 2313, Millie notified Doctor Rugo that case study on 090325,
040969 - ref SDS 10 KZ6N, shows UCSF has been setting the scope on labs at
040970 - Kaiser for the past 3 years that are used to guide the work for
040971 - Millie's care at UCSF on referral from Kaiser, ref SDS 22 YN4L
040973 -  ..
040974 - On 090512 Millie went to Kaiser for the lab.  ref SDS 23 6Z4F
040976 -  ..
040977 - This afternoon, Millie submitted results of Kaiser's lab to UCSF...
040978 -
040979 -    1.  Subject: Labs for test at Kaiser on 090512 Prepare for Meeting at UCSF on 090514
040980 -        Date: Wed, 13 May 2009 17:06:58 -0700
040989 -         ..
040990 -    2.  Here are results from the lab yesterday at Kaiser [on 090512
040991 -        0830. ref SDS 23 S65I  [planned in agenda for meeting with
040992 -        Doctor Rugo tomorrow on 090514, reported in Millie's letter to
040993 -        medical team on 090510 1553, ref SDS 17 QH9J, and further
040994 -        scheduled the next day on 090511 1554. ref SDS 20 FJ6G]
040996 -         ..
040997 -    3.  It was ordered to follow the scope for the last lab at UCSF
040998 -        when you made the examination on 090129.  Cathy who did the
040999 -        blood draw said she prepared and labeled tubes for everything
041000 -        on the list, but a number of elements are still missing.  This
041001 -        aligns with difficulties coordinating prior labs shown in case
041002 -        study considered by Doctor Johnson on 090325 ordering labs
041003 -        performed at UCSF to treat my cancer as a chronic disease,
041004 -        since 90% of my care is now at UCSF. ref SDS 10 KZ6N
041006 -         ..
041007 -    4.  Doctor Mason in Outside Referrals advised on 090420 that Kaiser
041008 -        is working to strengthen coordination on timely lab work with
041009 -        UCSF for treating my 8th relapse of cancer. ref SDS 14 8G3N  By
041010 -        copy to Pam, please submit to Doctor Mason for review of
041011 -        referral requirements.
041012 -
041013 -            [On 090514 0811 Pam in Doctor Mason's office asked why
041014 -            Doctor Mason was notified about results of Kaiser's failure
041015 -            to make referral for blood work at UCSF to support Millie's
041016 -            treatment on referral to UCSF. ref SDS 24 KV3I
041018 -         ..
041019 -    5.  CA 15-3 has not yet been reported by the outside lab.  May get
041020 -        the figure tomorrow afternoon after the meeting, so I will let
041021 -        you know.
041023 -         ..
041024 -    6.  Right now, I have a good feeling about the cancer marker,
041025 -        because  there seems to be substantial recovery from primary
041026 -        IBC sites, as Doctor Rugo expected in her letter on 090331.
041027 -        The sliver of intense condition along a vertical line left of
041028 -        the right breast [reported in Millie's letter on 090510 1953,
041029 -        ref SDS 18 LJ5T], seems at last to be getting lighter, i.e.,
041030 -        healing.  Even new IBC on the lower left arm seems less intense
041031 -        today.  Doctor Benz reported in his 2nd opinion received on
041032 -        041117 that my IBC seemed to wax and wane during 2003.
041033 -        ref SDS 2 OS6W
041035 -         ..
041036 -    7.  Since IBC on the lower left arm is an entirely new location,
041037 -        maybe it is not spreading so fast.  Just a hope.
041039 -         ..
041040 -    8.  NEUTS 1.320 (ANC 1320). ref SDS 23 B35J
041042 -         ..
041043 -    9.  For some reason, ANC was not reported by the Kaiser lab.  I
041044 -        called and talked to Cisi this afternoon in the Chemotherapy
041045 -        Infusion Clinic.  She said the staff calculated ANC 1320, so
041046 -        that is posted in the report online, per above.
041048 -         ..
041049 -   10.  Dropping blood counts 2 months in a row without getting chemo
041050 -        seems troubling.
041052 -         ..
041053 -   11.  Looking forward to planning treatment tomorrow for the 8th
041054 -        relapse.
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0411 -