CONTACTS 
020204 -

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 61 0000. ref SDS 60 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 34 QR3M
040904 - This was confirmed in Millie's letter to the medical team later that
040905 - day on 090423. ref SDS 35 ZL6T  Tara also found expanding IBC on the
040906 - lower left arm, ref SDS 34 DW6F, also confirmed in the letter to the
040907 - medical team. ref SDS 35 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 34 R15K
040913 - Collaboration plans were further confirmed in Millie's letter to the
040914 - medical team on 090423. ref SDS 35 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 34 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 34 FJ6K, and despite
040921 - confirming diagnosis of IBC relapse on the lower left arm, ref SDS 34
040922 - 5G4G, and despite growing doubts about vertical line of sking infected
040923 - either by IBC or radiation side effects. ref SDS 34 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 34 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 35 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 35 ZL4X, and notes the meeting scheduled
040935 - with Doctor Rugo on 090514. ref SDS 35 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 36 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 37 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 37 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 38 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 39 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 39 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 40 RF4J
040967 -  ..
040968 - On 090511 2313, Millie notified Doctor Rugo that case study on 090325,
040969 - ref SDS 25 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 41 YN4L
040973 -  ..
040974 - On 090512 Millie went to Kaiser for the lab.  ref SDS 42 6Z4F
040976 -  ..
040977 - On 090513 1654 Millie submitted results of Kaiser's lab to UCSF,
040978 - ref SDS 43 N54I, and notifies Doctor Mason at Kaiser's Outside
040979 - Referrals Department about more mistakes at Kaiser that causes poor
040980 - coordination of Millie's care at UCSF on referral from Kaiser.
040981 - ref SDS 43 ZH6W, and follows up Doctor Mason's plan on 090420 for
040982 - Kaiser to work harder with greater diligence to avoid mistakes in
040983 - order to continue doing labs at Kaiser rather than include labs for
040984 - referral at UCSF for Millie's treatments at UCSF. ref SDS 33 8G3N
040986 -  ..
040987 - Millie received a letter from Pam who works for Doctor Mason in
040988 - Kaiser's Outside Referrals Department, and asking why the Outside
040989 - Referrals Department was notified about mistakes at Kaiser performing
040990 - labs required for Millie's care at UCSF on referral from Kaiser.
040991 - ref SDS 44 2T5L
040993 -  ..
040994 - Millie replied to Pam's letter explaining patient history assists
040995 - Doctor Mason evaluate requirements for effective coordination because
040996 - chronic mistakes at Kaiser can be avoided by performing labs at UCSF
040997 - for Millie's care at UCSF. ref SDS 45 PQ5N
040999 -  ..
041000 - On 090514 0830 Millie met with Doctor Rugo, ref SDS 46 TP9L, and the
041001 - doctor prescribed treatment in the MPA clinical trial to help Millie
041002 - recover from the 8th relapse of cancer. ref SDS 46 A13N  The doctor
041003 - was encouraged about powerful new treatments becoming available to
041004 - treat Millie, ref SDS 46 3F7M, but was very discouraged saying Kaiser
041005 - would never get on board to treat Millie's cancer as a chronic
041006 - disease. ref SDS 46 3F82  As a first step to order treatment, Doctor
041007 - Rugo sent a letter to Kaiser recommending treatment for Millie with
041008 - the MPA protocol that is targeted to Millie's patient profile.
041009 - ref SDS 46 DI63
041011 -  ..
041012 - On 090514 2346, Millie sent a letter notifying the medical team,
041013 - ref SDS 47 LF3H, about the new MPA treatment prescribed by UCSF, and
041014 - cited the letter Doctor Rugo sent to Kaiser explaining prospects for
041015 - recover, ref SDS 47 WF9V; and Millie's letter further submitted the
041016 - agenda for meeting tomorrow with Doctor Johnson at Kaiser to perform
041017 - oversight review. ref SDS 47 WF9Y
041019 -  ..
041020 - On 090515 0952, Doctor Rugo sent a reply this morning to Millie and
041021 - the medical team saying that Kaiser notified UCSF that Kaiser refused
041022 - to treat Millie for recovering from the 8th relapse of cancer.
041023 - ref SDS 48 GR4O
041025 -  ..
041026 - On 090515 1017, Millie notified the medical team that Kaiser is
041027 - responsible for her care, must prescribe treatment based on the best
041028 - evidence, and that Millie will meet with the primary care physician
041029 - today at 090515 1140 and support review for ordering treatment
041030 - recommended by Doctor Rugo, and in time to effective. ref SDS 49 EY5L
041032 -  ..
041033 - On 090515 1140 Millie met with Doctor Johnson, primary care physician
041034 - at Kaiser to prescribe treatment for Millie's 8th relapse of cancer.
041035 - ref SDS 50 J47M  The doctor asked Millie to assist him preparing an
041036 - appleal to Memeber Services for clarification of incorrect guidance he
041037 - received from Doctor Mason. ref SDS 50 655R
041039 -  ..
041040 - On 090515 1518 Millie received a letter from Doctor Rugo wishing
041041 - Millie "good luck" assisting Kaiser perform the agreement to prescribe
041042 - standard of care treatment for Millie's 8th relapse of cancer.
041043 - ref SDS 51 PW7H
041045 -  ..
041046 - On 090515 1140 Doctor Johnson confirmed prior notice that Kaiser has
041047 - not treatments for Millie's patient profile, and he would get in
041048 - trouble if an audit shows he prescribed Gemzar or Navelbine for
041049 - Millie's 8th relapse of cancer. ref SDS 50 658J
041051 -  ..
041052 - On 090516 0858, Millie notified Doctor Rugo that Doctor Johnson was
041053 - going to bat for Millie at Kaiser to prescribe treatment by filing an
041054 - appeal with Memeber Services. ref SDS 52 SY4O
041056 -  ..
041057 - On 090518 0017 prepared a draft appeal for Doctor Johnson to file with
041058 - Member Services on requirements for prescribing Millie's treament to
041059 - recover from the 8th relapse of cancer. ref SDS 53 R16I
041061 -  ..
041062 - On 090519 1536 Doctor Johnson responded to Millie's letter submitted
041063 - to Kaiser yesterday on 090518 0017, ref SDS 53 R16I, and telling
041064 - Millie he changed his mind and so would not expedite treatment by
041065 - sending an appeal to Member Services, and instead tells Millie to
041066 - submit an appeal for treatment to recover from Millie's 8th relapse of
041067 - cancer. ref SDS 54 5K7H
041069 -  ..
041070 - On 090519 1613 Millie responded, ref SDS 55 8V8H, to the Doctor's
041071 - letter earlier yesterday afternoon on 090519 1536, ref SDS 54 5K7H;
041072 - and, Millie asks the doctor to prescribe treatment so she can recover
041073 - from cancer, as done previously in patient history, ref SDS 55 TY3X,
041074 - and further as planned by the doctor during the meeting on 090515
041075 - 1140. ref SDS 50 655R  Millie also asked the doctor to call on
041076 - expediting treatment in time to be effective, see again on 090520
041077 - 1613, ref SDS 55 TY4W; and Millie asks Doctor Rugo for a "drop dead"
041078 - date on how soon treatment must start in order to be effective, also,
041079 - reported on 090519 1613. ref SDS 55 TX4W
041081 -  ..
041082 - On 090520 1113 Millie received a letter from Doctor Johnson,
041083 - ref SDS 58 UC9G, responding to Millie's letter yesterday requesting
041084 - that Kaiser prescribe treatment for the 8th relapse of cancer.
041085 - ref SDS 55 TY3X
041087 -  ..
041088 - On 090520 1137 Millie responded to Doctor Johnson with copies
041089 - notifying the medical team of Kaiser's treatment plan for Millie's 8th
041090 - relapse of cancer. ref SDS 59 5K9M
041092 -  ..
041093 - On 090520 1153 called Paula and asked Member Services to assist the
041094 - Oncology Department prescribe urgent treatment
041096 -  ..
041097 - On 090520 1703 Millie received a letter from Doctor Johnson saying
041098 - Gemzar and Navelbine are viable options for treating Millie's patient
041099 - profile, ref SDS 60 HN4I, contrary to having told Millie in a meeting
041100 - on 090515 that he would get in trouble from a practice audit for
041101 - prescribing these treatments at this stage of Millie's care, reported
041102 - 090515 1140, ref SDS 50 658J
041103 -
041104 -
041106 -  ..
041107 - Treatment Plan After Gemzar What Will Kaiser Prescribe Next?
041108 -
041109 - Follow up ref SDS 61 P65H.
041110 -
041111 - On 090520 1710 Millie asked Kaiser to perform a work up, including a
041112 - Tumor Board to evaluate treatment options available at this time.
041113 - ref SDS 61 P65H
041115 -  ..
041116 - On 090521 0211 Millie sent a letter to Doctor Rugo with copy to Doctor
041117 - Hsu requesting alternative treatment to MPA prescribed by Doctor Rugo,
041118 - and to provide time for Kaiser to resolve administrative delays
041119 - ordering care Millie to recover from 8th relapse of cancer...
041120 -
041121 -    1.  Subject: Treatment Plan 8th Relapse of Cancer
041122 -        Date: Thu, 21 May 2009 02:39:22 -0700
041130 -         ..
041131 -    2.  I have asked Kaiser [in numerous letters] to prescribe
041132 -        treatment for my 8th relapse [e.g., reported on 090520 1710.
041133 -        ref SDS 61 ZF4Q] cited in your letter to Doctor Johnson on
041134 -        090514 0830. ref SDS 46 DI63
041136 -         ..
041137 -    3.  Doctor Mason in Kaiser's Outside Referrals has told Doctor
041138 -        Johnson not to prescribe your clinical trial in order to
041139 -        sustain Kaiser's view of Medicare on that issue [reported by
041140 -        Doctor Johnson during meeting at Kaiser on 090515 1140.
041141 -        ref SDS 50 T59N].  Resolving differences will take some time.
041143 -         ..
041144 -    4.  Since Kaiser has authorized treatment with hyperthermia and
041145 -        Doxil, can this be applied for continuity of care?
041147 -         ..
041148 -    5.  I am concerned about progression I see everyday at the
041149 -        periphery of areas Doctor Hsu treated in Feb and March.  Doctor
041150 -        Johnson told me on 090515 that Navelbine and Gemzar are not
041151 -        good choices for me as single agents [reported in the record
041152 -        for 090515 1140, ref SDS 50 658J], though, as he noted
041153 -        yesterday, they are standard of care for other patients
041154 -        [reported on 090520 1703. ref SDS 60 HN4I].  Actually, Doctor
041155 -        Benz proposed a combination of Gemzar and other agents in a
041156 -        UCSF 2nd opinion received on 041117 1015. ref SDS 4 OU5V
041157 -
041158 -            [On 090521 2006 Doctor Johnson's letter to Millie without
041159 -            copy to medical team refuses to prescribe treatment and
041160 -            tells Millie she can "choose" any treatment she wants,
041161 -            because no treatment is superior for Millie's patient
041162 -            profile, ref SDS 62 9Q9H; Doctor Johnson warns Millie that
041163 -            she needs treatment by the end of the week, which is in
041164 -            just 12 hours, because her 8th relapse of cancer is
041165 -            progressing rapidly, ref SDS 62 HC8O, and Kaiser tells
041166 -            Millie to call Medicare rather than Kaiser for prescribing
041167 -            her treatment to recover from 8th relapse of cancer.
041168 -            ref SDS 62 9Q9H
041170 -         ..
041171 -    6.  Notice Doctor Benz mentions combining Gemzar with Doxil, which
041172 -        was in your letter to Doctor Johnson on 090129, as part of the
041173 -        hyperthermia regimen [reported on 090130 1722, ref SDS 18
041174 -        HK3V], and which is currently authorized by Kaiser for
041175 -        treatment on referral at UCSF [reported on 090205 1426.
041176 -        ref SDS 20 278T].
041178 -         ..
041179 -    7.  A few years later in a follow up 2nd opinion received on 060929
041180 -        Doctor Benz discussed Navelbine and Gemzar in combination with
041181 -        capeticabine. ref SDS 6 WR3Y
041183 -         ..
041184 -    8.  I have had capecitabine twice with Taxotere.  The first time in
041185 -        2005 it was very effective; the second time in July 2006 I
041186 -        suffered recurrence in December, and came to you in January.
041188 -         ..
041189 -    9.  On 070510 Brigid mentioned you folks switched a patient from
041190 -        cetuximab and Carboplatin to Gemzar. ref SDS 11 FK4G
041192 -         ..
041193 -   10.  Is there some combination of hyperthermia, radiation, Doxil,
041194 -        Gemzar, Navelbine, anything that we can treat my cancer under
041195 -        current authorization, while Kaiser sorts out clinical trial
041196 -        issues?
041197 -
041199 -  ..
041200 - Lymphedema Permanent on Left Arm Risks Cellulitis Fever with IBC
041201 - Workup Treatment Plan Required for Millie Recover 8th Relapse Cancer
041202 -
041203 -
041204 -   11.  Right now I'm worried that as IBC advances on my left arm,
041205 -        lymphedema which has already occurred as a permanent condition
041206 -        the past 3 weeks, will increase, I won't be able to exercise
041207 -        the left arm, and Cellulitis will explode, causing a big mess
041208 -        to treat a compound problem.
041210 -         ..
041211 -   12.  I have asked Kaiser for a workup and treatment plan, including
041212 -        how long I have to start treatment [reported on 090520 1710,
041213 -        ref SDS 61 ZF4T].  I would be thrilled if you experts tell me
041214 -        don't worry I don't need treatment for a month or so.  But, so
041215 -        far I haven't heard that.
041216 -
041217 -            [On 090521 2006 Doctor Johnson's letter to Millie without
041218 -            copy to medical team refuses to prescribe treatment and
041219 -            tells Millie she can "choose" any treatment she wants,
041220 -            because no treatment is superior for Millie's patient
041221 -            profile, ref SDS 62 9Q9H; Doctor Johnson warns Millie that
041222 -            she needs treatment by the end of the week, which is in
041223 -            just 12 hours, because her 8th relapse of cancer is
041224 -            progressing rapidly, ref SDS 62 HC8O, and Kaiser tells
041225 -            Millie to call Medicare rather than Kaiser for prescribing
041226 -            her treatment to recover from 8th relapse of cancer.
041227 -            ref SDS 62 9Q9H
041229 -         ..
041230 -   13.  Your thoughts in collaboration with Doctor Hsu are greatly
041231 -        appreciated.
041232 -
041239 -
041240 -
041241 -
041242 -
041243 -
041244 -
041245 -
041246 -
0413 -