CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 71 0000. ref SDS 70 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 71 6Z4F, ref SDS 70 6Z4F.
040988 -
040989 - This afternoon after working out in the gym, Millie drove to the
040990 - Kaiser Infusion Clinic in Martinez California to get a blood test
040991 - ordered by Sheree in the Oncology Department Kaiser Walnut Creek,
040992 - because the Walnut Creek clinic was too busy due to being
040993 - under staffed because several nurses called and reported they were
040994 - sick yesterday and today.
040996 -  ..
040997 - The lab test today was requested yesterday on 090601 by Brad in the
040998 - Oncology Pharmacy to evaluate Millie's blood counts for safely getting
040999 - treatment with Gemzar on Thursday or Friday, prescribed by Doctor
041000 - Johnson on Monday, 090601. ref SDS 72 5K94
041002 -  ..
041003 - After Brad's call on 090601 1132, Sheree called on 090601 1153.  She
041004 - used Doctor Johnson's standing order for Millie to get a monthly blood
041005 - draw testing CBC, CA 15-3, INR, and flushing the port, to prepare an
041006 - order that follows the Gemzar treatment protocol. ref SDS 72 H26K
041008 -  ..
041009 - Mary Beth is Millie's nurse today.
041011 -  ..
041012 - Mary Beth found the lab ordered entered by Sheree yesterday on 090601.
041013 - ref SDS 72 LS7F
041015 -  ..
041016 - She drew blood with test tubes for the lab order.
041017 -
041019 -  ..
041020 - Laboratory Blood Test Results Posted Kaiser's Computer
041021 -
041022 - Follow up ref SDS 71 S65I, ref SDS 70 S65I.
041023 -
041024 - Previous lab at Kaiser on 090512, ref SDS 71 S65I, followed the lab
041025 - on 090413, ref SDS 70 S65I, followed up test on 090309, ref SDS 62
041026 - OT8J, and a week later on 090317 to get CA 15-3 that was omitted on
041027 - 090309. ref SDS 65 Y04R  Prior test at UCSF on 090129, ref SDS 58
041028 - 075H, and 2 weeks earlier at Kaiser on 090116. ref SDS 52 S65I
041029 -
041030 -        [On 090612 1030 partial lab at Kaiser to test Creatinine for CT
041031 -        test on 090612. ref SDS 74 S65I
041033 -     ..
041034 -    Patient   Provider  Category   View      FR Date   To Date
041042 -                       ..
041043 -              SITE:   Kaiser Clinical Laboratory
041044 -                      Marina Way South
041045 -                      Walnut Creek, CA
041046 -                      San Francisco, CA  94115
041048 -     ..
041049 -    72/F Lab Results Summary
041051 -     ..
041052 -    Log#: 510915300689       090602 13:01
041053 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041054 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041055 -    CBC with DIFF & PLT CT                                                                                    CBCD
041056 -    WBC                     5.2    K/uL     3.4  -  10.0      WBC x10-3             x10E9/L     3.4  -  10      WBC
041057 -    RBC                     3.98   M/uL    3.60  -  5.70      RBC x10-6             x10E12/L      4  -  5.2     RBC
041058 -    Hemoglobin     L       11.3    g/dL    11.5  -  15.0      Hemoglobin            g/dL         12  -  15.5    HGB
041059 -    Hematocrit             34.7    %       34.0  -  46.0      Hematocrit            PERCENT      36  -  46      HCT
041060 -    MCV                    87      fL      80.0  -  100.0     MCV                   fL           80  -  100     MCV
041061 -    RDW, RBC       H       14.6    %       11.9  -  14.3      [Not Reported at UCSF]
041062 -    MCH                [Not Reported]                         MCH                   pg           26  -  34      MCH
041063 -    MCHC               [Not Reported]                         MCHC                  g/dL         31  -  36      MCHC
041064 -    Lymphocytes            25      %         13  -  46        LYMPHS                x10E9/L     0.9  -  2.9     L-A
041065 -    Monocyte         H     15      %          4  -  12        MONOS                 x10E9/L     0.2  -  0.8     M-A
041066 -     ..
041067 -    Eosinophils      H      7      %          0  -  4         EOS                   x10E9/L     0.0  -  0.4     E-A
041068 -    Basophil                1      %          0  -  1         BASOS                 x10E9/L     0.0  -  0.1     B-A
041070 -  ..
041071 - On 090118 Millie letter to medical team asks about eosinophils 700%
041072 - high. ref SDS 54 PZ4Q
041074 -  ..
041075 - Lab report continues...
041076 -
041077 -    Diff Method     AUTO DIFF
041078 -    Atypical Lymph [Not Reported]  %
041079 -    Anisocytosis   [Not Reported]
041080 -    PLT Estimate   [Not Reported]
041081 -    PLT Morphology [Not Reported]
041082 -    RBC Morphology [Not Reported]
041084 -     ..
041085 -    Platelets             240      K/uL     140  -  400       Plt x10-3             x10E9/L     140  -  450     PLT
041086 -
041088 -  ..
041089 - CBC blood test continues...
041090 -
041091 -    Log#: 510915300689       090602 13:01
041092 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041093 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041094 -       (posted 090323, ref SDS 66 Y077 for test on 090317, ref SDS 65 PQ6R,
041095 -    CA 15-3      H*       289      U/mL             <  39     CA 15-3               U/mL              <  33     CA153
041097 -  ..
041098 - CA 15-3 289 on the test today is an unexpected decline from Cancer
041099 - marker CA 15-3 320 for the tests the past 2 months on 090512,
041100 - ref SDS 71 PQTQ, and the test previously CA 15-3 271 on 090413, shown
041101 - in the case study on 090323. ref SDS 66 J13O
041103 -  ..
041104 - May reflect cancer spreading to the lower left arm, and new nodularity
041105 - on the left of the right breast.  There now signs of of IBC above and
041106 - slightly right of the left shoulder, near and below the left
041107 - supraclavicular (collar bone).
041109 -  ..
041110 - CBC blood test continues...
041111 -
041112 -    Log#: 510915300689       090602 13:01
041113 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041114 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041115 -    (calculated with formula on 081205. ref SDS 23 JG6F)
041116 -    ANC                  2756                    -> 1500      NEUTS                 x10E9/L     1.8  -  6.8     N-A
041117 -    Neutrophils            53      %         41  -  81        Neutrophils
041118 -    Bands        [Not Reported]    %          0  -  5
041119 -    Neutrophils Absolute
041120 -    Automated Count         2.7    K/uL     2.1  -  7.7
041121 -
041122 -              ANC = WBC x 1000 x (Neutrophils + Bands)
041124 -                     ..
041125 -                    5.2 x 1000 x (.53 + .00) = 2756
041127 -  ..
041128 - Appears that Kaiser may have added ANC and rounded off the calculation
041129 - called "Neutrophils Absolute Automated Count".
041131 -  ..
041132 - ANC 2756 is a significnt and very favorable increase in labs, more
041133 - than doubling Millie's blood counts from the prior test 3 weeks ago on
041134 - 090512 when ANC 1320, ref SDS 71 B35J, was continuing serious decline
041135 - from ANC (NEUTS 1.406 at UCSF) for the test last month on 090413,
041136 - continuing the decline from ANC 2120 for the test on 090309,
041137 - ref SDS 62 B35J, since Millie has not had chemotherapy since 090122.
041139 -  ..
041140 - Sudden reversal of falling blood counts give Millie a chance to get
041141 - treatment with Gemzar, if other issues about safety and efficacy can
041142 - be resolved.
041144 -  ..
041145 - CBC blood test continues...
041146 -
041147 -    Log#: 510915300689       090602 13:01
041148 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041149 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041150 -    PT, Patient   H        29.9    sec      8.2  -  10.6      PT                    s          12.0  -  14.1    PT
041151 -    PT INR        H         2.9                               INL NRM Ratio                     0.9  -  1.1     INR
041152 -
041154 -     ..
041155 -    Log#: 510915300689       090602 13:01
041156 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041157 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041158 -    Total Protein      [No Report] g/dL     6.0  -  7,7       PROTEIN, TOTAL        g/dL        5.8  -  8.0     TP
041159 -    ALBUMIN            [No Report] g/dL     3.3  -  4.7       ALBUMIN               g/dL        3.4  -  4.7     ALB
041160 -    Alkaline Phos      [No Report] U/L       37  -  117       ALKALINE PHOSPHATASE  U/L          29  -  111     ALKP
041161 -    Calcium            [No Report] mg/dL    8.5  -  10.3      CALCIUM               mg/dL       8.7  -  10.1    CA
041162 -     ..
041163 -    Magnesium          [No Report] mg/dL    1.6  -  2.3       MAGNESIUM             mg/dL       1.8  -  2.3     MG
041164 -    Sodium             [No Report] mEq/L    137  -  145       SODIUM
041165 -    Potassium          [No Report] mEq/L    3.5  -  5.3       POTASSIUM
041166 -    Glucose Random     [No Report] mg/dL     60  -  159       GLUCOSE               mg/dL        70  -  199     GLU
041167 -    ALT (SGPT)             22      U/L       11  -  66        ALT                   U/L          11  -  54      ALT
041168 -    AST (SGOT)         [No Report] U/L       10  -  40        AST                   U/L          11  -  54      ALT
041169 -
041170 -            [On 090611 1627 Mike called and said that UCSF needs lab
041171 -            for AST,
041172 -            that was not reported in the lab at Kaiser today on
041173 -            090602, per above, and this is needed to evaluate safely
041174 -            treating Millie with MPA protocol replacing Gemzar
041175 -            prescribed by Kaiser and scheduled to start on 090611 1400,
041176 -            for Millie to recover from the 8th relapse of cancer.
041178 -     ..
041179 -    Log#: 510913201222       090512 09:00
041180 -    <------------------- KAISER -----------------------><-----------------  UCSF --------------------->
041181 -    Type                 Results   Units        Normal        Type                  Units         Normal       ACRO
041182 -    Bili Tot Adult  L       0.1    mg/dL    0.2  -   1.3      BILIRUBIN TOTAL       mg/dL       8.7  -  10.1    CA
041183 -    Creat with GFR
041184 -    Creatinine              0.67   mg/dL         -< 1.11      CREATININE            mg/dL      0.42  -  1.06    CR
041186 -       ..
041187 -      Note: Creatinine assay changed to IDMS standardization on
041188 -      February 4, 2008 causing decrease in results of approximately
041189 -      0.09 mg/dL
041191 -     ..
041192 -    GFR Non-Afr Am        >60      mL/min  > 60  -            eGFR if Caucasian     >60      mL/min                      GFRC
041193 -    GFR African AM        >60      mL/min  > 60               eGFR if African Amer  >60      mL/min                      GFRA
041194 -    GFR Note               **
041195 -
041196 -
041197 -
041198 -
041199 -
041200 -
041201 -
041202 -
041203 -
041204 -
0413 -