CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up
040502 -
040504 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 090121 Glenna, Doctor Rugo's coordinator for Millie's care, called
040902 - and asked Millie for a list of protocols to treat Millie's complex
040903 - patient profile. ref SDS 3 Y67L
040905 -  ..
040906 - On 090122 Doctor Rugo ended Millie's treatment for 6th relapse of
040907 - cancer, and scheduled treatment for the 7th relapse the following week
040908 - on 090129. ref SDS 4 J47F
040910 -  ..
040911 - On 090123 1322 Millie's primary care physician at Kaiser, Doctor
040912 - Johnson, called and advised that Millie's cancer has mutated to resist
040913 - treatments available at Kaiser, and so Millie should notify Doctor
040914 - Rugo that Kaiser authorizes treatment at UCSF, which must planned to
040915 - start quickly in time to be effectve for Millie's patient profile.
040916 - ref SDS 5 RK6O
040918 -  ..
040919 - On 090129 Doctor Rugo prescribed hyperthermia and Doxil to treat
040920 - Millie's rising cancer, and requested that Kaiser make a referral.
040921 - reported in Millie's letter on 090130 1722. ref SDS 6 4S8O
040923 -  ..
040924 - On 090129 Doctor Rugo's letter to Millie's primary care physician,
040925 - Doctor Johnson, asks Kaiser to make a referral, also reported on
040926 - 090130 1722, ref SDS 6 TZ6H
040928 -  ..
040929 - On 090202 Kaiser issued referral authorization #A023141470 approving
040930 - UCSF to provide medical services recommended by Doctor Rugo for Millie
040931 - to recover from 7th relapse of cancer, reported in the record on
040932 - 090205. ref SDS 10 278T
040934 -  ..
040935 - On 090204 0219 Millie requested planning from Doctor Rugo at UCSF
040936 - showing strategy and drug options for treating Millie's cancer as a
040937 - chronic disease, ordered by Doctor Johnson at Kaiser. ref SDS 7 278T
040939 -  ..
040940 - On 090204 1747 Millie received list of 10 additional treatments
040941 - targeted for Millie's patient profile, so there is a list for treating
040942 - Millie's cancer as a chronic disease, as recommended by Doctor
040943 - Johnson. ref SDS 8 4R3S
040945 -  ..
040946 - On 090205 Doctor Hsu changed UCSF treatment from hyperthermia and
040947 - Doxil to radiation and hyperthermia, because Millie's cancer had
040948 - become more severe while waiting to resolve at Kaiser and UCSF delays
040949 - starting treatment. ref SDS 9 EY5F
040951 -  ..
040952 - On 090213 1140 Doctor Johnson at Kaiser commended Doctor Rugo's
040953 - urgency for proactive planning to identify therapies for UCSF to treat
040954 - Millie's cancer as a chronic disease, ref SDS 11 ES7I, and cited
040955 - narrow margin for delay because Millie's patient profile is very
040956 - complex. ref SDS 11 AC6G
040958 -  ..
040959 - On 090219 Millie started treatment by Doctor Hsu at UCSF with
040960 - radiation and hyperthermia to recover from 7th relapse of cancer.
040961 - ref SDS 12 E57G
040963 -  ..
040964 - On 090312 0800, Doctor Rugo planning to implement authorization by
040965 - Doctor Johnson at Kaiser for UCSF to treat Millie's cancer as a
040966 - chronic disease. ref SDS 13 QQ9L
040968 -  ..
040969 - On 090312 0800 at 0930 Doctor Hsu advised Millie that UCSF has
040970 - additional treatments for Millie to recover from cancer using
040971 - hyperthermia and vaccines. ref SDS 13 576L
040973 -  ..
040974 - On 090317 Millie completed 4 weeks of treatment 4 days per week with
040975 - radiation and hyperthermia to recover from 7th relapse of cancer.
040976 - ref SDS 14 9L7K
040978 -  ..
040979 - On 090325 Doctor Johnson at Kaiser requested research on therapies for
040980 - treating Millie's cancer as a chronic disease. ref SDS 15 GO4O  On
040981 - 090326, Millie submitted a list of 10 treatments targeted to Millie's
040982 - patient profile, ref SDS 16 DW5S, and shown in the record on 090205.
040983 - ref SDS 8 4R3S
040985 -  ..
040986 - On 090331 2047 Millie reports new lightly sprinkled inflammation rash
040987 - on lower left arm, concerned may be IBC recurrence, 7th relapse.
040988 - ref SDS 18 Q69V
040990 -  ..
040991 - On 090401 0032 Doctor Hsu advises new red rash on lower left arm
040992 - likely IBC recurrence. ref SDS 19 R24X
040994 -  ..
040995 - On 090401 0046 Millie asks medical team for treatment of IBC spreading
040996 - diagnosed by Doctor Hsu. ref SDS 20 RE8P
040998 -  ..
040999 - On 090401 0121 Doctor Rugo reports Millie's wound in breastbone area
041000 - diagnosed as "reaction to radiation" must heal before starting
041001 - treatment for IBC relapse, and so defers meeting scheduled on 090402
041002 - 0800; expects recovery from IBC in areas with radiation and
041003 - hyperthermia to be very effective. ref SDS 21 K56O
041005 -  ..
041006 - On 090403 1107 Millie reports continual cough and shortness of breath
041007 - prevented sleep; all symptoms subsided in early morning OA 0400.
041008 - ref SDS 22 LN6H
041010 -  ..
041011 - On 090406 1512 Millie reports to medical team that breathing did not
041012 - recover normally during hiking at Lafayette Reservoir on 090402; was
041013 - only one time event, and so was attributed to lack of fitness; there
041014 - was no testing for PE nor pneumonia. ref SDS 24 RE3T
041016 -  ..
041017 - On 090412 2241 Millie's letter to medical team reports IBC worsening
041018 - on left arm, and occurs along a neat line at the perimeter of area
041019 - treated with radiation and hyperthermia, ref SDS 25 XN8J; requests
041020 - treatment next week to prevent cancer from cascading out of control.
041021 - ref SDS 25 9S9Y
041023 -  ..
041024 - On 090415 1424 Millie reports heavy chest for a week; requests
041025 - guidance. ref SDS 26 GU8X
041027 -  ..
041028 - On 090415 1519 Doctor Johnson called and advised that he reviewed the
041029 - CT scans for Millie's test on 090413 and determined that findings in
041030 - the test report of increased nodules in the lungs are likely caused by
041031 - radiation injury rather than spread of cancer. ref SDS 27 GT4M
041033 -  ..
041034 - On 090420 2352 Millie's letter to medical team submits agenda for
041035 - meeting at UCSF on 090423 cites new IBC on lower left arm; and, also,
041036 - reports breastbone area possible IBC or continuing reaction to
041037 - radiation. ref SDS 29 MS5Q
041039 -  ..
041040 - On 090423 0830 Tara, Doctor Rugo's Nurse Practitioner who examined
041041 - Millie in the Breast Care Clniic, indicated Millie's respiratory
041042 - problems reported on 090415, ref SDS 26 GU8X, require increased
041043 - scrutinty for cause and progression toward pneumonia and other lung
041044 - problem, ref SDS 30 HO4H, considered in prior correspondence submitted
041045 - by Doctor Hsu on 090403 1324. ref SDS 23 Z66M
041047 -  ..
041048 - On 090423 0830 Tara, Doctor Rugo's Nurse Practitioner who examined
041049 - Millie in the Breast Care Clniic, plans to discuss nodules in
041050 - breastbone area with Doctor Hsu to support the doctor's examination of
041051 - Millie in the Radiology Oncology Department at 1200. ref SDS 30 R15K
041053 -  ..
041054 - On 090423 0830 at 1200 Doctor Hsu does not mention during examination
041055 - discussions with Tara, ref SDS 30 CP4J; feels few light nodules in
041056 - breastbone area may or may not be IBC and will heal from continuing
041057 - effects of radiation that ended on 090317. ref SDS 30 EX4I
041059 -  ..
041060 - On 090510 1953 Millie reports worsening rash and open sore in the
041061 - breastbone area, ref SDS 31 LJ5T, and asks if this could be IBC that
041062 - was somehow not treated with radiation, ref SDS 31 FJ3G; Millie
041063 - therefore asks for biopsy again for early diagnosis and treatment
041064 - including surgery and/or radiation to prevent IBC from getting out of
041065 - control. ref SDS 31 LJ5X
041067 -  ..
041068 - On 090510 0301 Millie reports continuing breathing problems, and asks
041069 - about progression of nodules in the lungs caused by radiation
041070 - treatments. ref SDS 31 LJ6T
041072 -  ..
041073 - On 090514 0830 Doctor Rugo diagnosed Millie's breathing problems are
041074 - caused by radiation treatments at UCSF that increased nodules of
041075 - ground glass opacities in the lungs reported in the CT test on 090413.
041076 - ref SDS 32 NL9I
041078 -  ..
041079 - On 090514 0830 Doctor Rugo said that UCSF has a number of therapies
041080 - planned for treating Millie's cancer as a chronic disease, and
041081 - targeted to Millie's patient profile, ref SDS 32 YW48, as requested by
041082 - Doctor Johnson at Kaiser on 090123, ref SDS 5 OZ6N, and submitted to
041083 - the medical team on 090326, ref SDS 17 QM3V, Doctor Rugo sent a letter
041084 - to Doctor Johnson at Kaiser initially prescribing MPA for Millie to
041085 - recover from 7th relapse of cancer. ref SDS 32 DI63
041087 -  ..
041088 - On 090515 1140 Doctor Johnson verified during examination at Kaiser
041089 - that Millie requires immedicate treatment for progression of cancer.
041090 - ref SDS 33 OT8N  The doctor requested Millie's support for filing
041091 - authorization at Kaiser to start Millie's treatment of the 7th relapse
041092 - of cancer, which is required immediately to prevent cancer from
041093 - cascading out of control. ref SDS 33 655Y
041095 -  ..
041096 - On 090518 0017 Millie submitted a letter to Doctor Johnson with copy
041097 - to Doctor Rugo at UCSF, and transmitting a draft to assist Doctor
041098 - Johnson file his appeal with Member Services assisting Kaiser
041099 - implement Doctor Johnson's strategy to treat Millie's cancer as a
041100 - chronic disease in time for Millie to recover from the 8th relapse of
041101 - cancer. ref SDS 34 R16I
041103 -  ..
041104 - On 090519 1536 Doctor Johnson changed his mind; he sent the draft
041105 - appeal to Doctor Mason, and tells Millie to file an appeal with Member
041106 - Services, which is incorrect since at this time Millie has not been
041107 - denied services; the doctor refuses to prescribe treatment for Millie
041108 - to recover from cancer, because he believes people in Kaiser's Outside
041109 - Referrals Department have a better understanding of Medicare.
041110 - ref SDS 35 5K7H
041112 -  ..
041113 - On 090519 1613 Millie reminds Doctor Johnson to order her treatment
041114 - quickly in time to be effective; and, that the doctor's letter on
041115 - 090519 telling Millie to file an appeal conflicts with the record that
041116 - Doctor Johnson is responsible for prescribing care. ref SDS 36 TX6S
041118 -  ..
041119 - On 090520 1113 Millie received a letter from Doctor Johnson saying
041120 - Kaiser "offers" Millie Gemzar or Navelbine, and confirmed these
041121 - "single-agent" chemotherapy drugs are high risk of failure and causing
041122 - harm for Millie's patient profile, and said Member Services and
041123 - Outside Referrals interpret clinical trials for Millie to recover from
041124 - 8th relapse of cancer. ref SDS 37 UC9G
041126 -  ..
041127 - On 090520 1137 Millie notified the medical team that in the meeting at
041128 - Kaiser on 090515 the doctor advised Millie that Gemzar and Navelbine
041129 - were not appropriate for Millie's patient profile, and that he would
041130 - get in trouble from an audit for prescribing these treatments for
041131 - Millie at this stage of her care. ref SDS 38 SR5W
041133 -  ..
041134 - On 090520 1153 called Paula in Member Services Case Resolution; she
041135 - had read the letter to the medical team on 090520 1137, and advised
041136 - Kaiser requires evidence-based medical practice.  Paula recommended
041137 - Millie request assistance from Expedited Claims for timely
041138 - prescription of treatment appropriate for Millie's patient profile.
041139 - ref SDS 39 4M9G
041141 -  ..
041142 - On 090520 1203 Millie asks Kaiser Expedited Claims Department to
041143 - assist the Oncology Department prescribing urgent treatment
041144 - appropriate for Millie's patient profile and in time to be effective.
041145 - ref SDS 40 9595
041147 -  ..
041148 - On 090521 0902 Pamela in Kaiser Expedited Claims Department advised
041149 - that Millie's doctor has responsibility to prescribe her treatment,
041150 - and so Millie's claim for assisting the primary care physician
041151 - prescribe treatment cannot be denied by Kaiser. ref SDS 41 UD5H
041152 - Expedited Claims Department plans to contact the doctor. ref SDS 41
041153 - RW7M
041155 -  ..
041156 - On 090521 0902 Kaiser Expedited Claims sent Millie's claim for care to
041157 - Member Services Claims Resolution Department. ref SDS 41 X68I
041159 -  ..
041160 - On 090521 2006 Millie received a letter from Doctor Johnson in which
041161 - Kaiser fails to prescribe treatment, and says Millie can choose which
041162 - next treatment regimen that Millie wants, and that no treatment would
041163 - be considered more superior than another, ref SDS 42 UD5H; the doctor
041164 - says Millie needs urgent treatment and so should notify Kaiser which
041165 - treatment Millie chooses by the end of the week, which is the next day
041166 - in roughly 12 hours. ref SDS 42 HC8O; the doctor further tells Millie
041167 - to call Medicare for prescribing appropriate treatment. ref SDS 42
041168 - HC93
041170 -  ..
041171 - On 090522 1000 Millie notifies medical team that she chooses
041172 - additional treatment with hyperthermia and Doxil in order to implement
041173 - Doctor Rugo's treatment plan submitted to Kaiser on 090129 - reported
041174 - on 090130, ref SDS 6 HK3V, and to meet Doctor Johnson's warning today
041175 - that urgent treament is needed tomorrow, ref SDS 42 HC8O, that is
041176 - targeted to Millie's patient profile, shown by effective recovery the
041177 - past 4 months from treatment with radiation and hyperthermia.
041178 - ref SDS 43 715V
041180 -  ..
041181 - On 090522 1351 Millie asks Doctor Johnson if Kaiser's proposal to
041182 - treat Millie with Gemzar and Navelbine will be effective, or will
041183 - Millie just suffer weeks of agony from adverse side effects, and then
041184 - have progression of cancer that requires changing to treatment
041185 - "targeted" for Millie's patient profile? ref SDS 44 2T4S
041187 -  ..
041188 - On 090522 1953 Millie's doctor discloses that Kaiser has "no idea" how
041189 - treatment Kaiser propose for Millie with Gemzar and Navelbine will
041190 - affect Millie's complex patient profile; the doctor says these
041191 - single-agent chemotherapy treatments may not work at all for Millie to
041192 - recover from 8th relapse of cancer. ref SDS 45 UW6G
041194 -  ..
041195 - On 090523 0148 Millie presents claim for timely care to Kaiser Member
041196 - Services Claims Resolution Department, ref SDS 46 2P6J, based on
041197 - Expedited Claims Department sending Millie's claim on 090520,
041198 - ref SDS 40 9595, to Member Services Department on 090521, ref SDS 41
041199 - X68I, for Kaiser to prescribe treatment of 8th relapse of cancer, and
041200 - citing referral from Expedited Claims where Paula had previously
041201 - advised Millie to file a claim, reported on 090520 1153. ref SDS 39
041202 - T65H
041204 -  ..
041205 - On 090528 1228, Millie's letter to Kaiser Member Services Claims
041206 - Resolution Department with copy to medical team objects to delaying
041207 - treatment of worsening cancer being in a "loop" where Kaiser Expedited
041208 - Claims Department sent Millie's demand for care to Member Services
041209 - Claims Resolution Department, which then proposed further 5 - 10 day
041210 - delay sending demand for immediate treatment back to Expedited claims.
041211 - ref SDS 47 UD5H
041213 -  ..
041214 - On 090528 1228, Millie demands treatment under her insurance agreement
041215 - with Kaiser in EOC Section 2 that requires primary care physician to
041216 - provide medical services applying standard of care for Millie's
041217 - patient profile. ref SDS 47 4N3R
041219 -  ..
041220 - On 090528 1228, Millie notifies medical team that cancer progressing
041221 - and so to mitigate damages from Kaiser's failure to perform EOC
041222 - requirements, she will get care from others and bill Kaiser.
041223 - ref SDS 47 4N8X
041225 -  ..
041226 - On 090528 1334, Millie's letter authorizes payment for UCSF to
041227 - mitigate damages from Kaiser failure to perform duty to prescribe
041228 - treatment in time to be effective. ref SDS 48 UD5H
041230 -  ..
041231 - ON 090529 1109 Millie notifies medical team that Kaiser has not
041232 - prescribed treatment for Millie to recover from 8th relapse of cancer
041233 - despite continuous requests for standard of care begining on 090401.
041234 - ref SDS 49 0M5U
041236 -  ..
041237 - On 090529 1751 Doctor Johnson complains that patient email responding
041238 - to Kaiser correspondence is confusing, ref SDS 50 SZ9J, and complains
041239 - that the patient has not responded, which conflicts with the first
041240 - complaint, ref SDS 50 U34S, and indicates the doctor has ignored
041241 - patient requests for an explanation comparing treatment alternatives,
041242 - and further ignores Kaiesr guidance that Gemzar presents extreme risks
041243 - for Millie's patient profile.
041245 -  ..
041246 - On 090601 0818 at 1132 Brad in the Kaiser Pharmacy called and advised
041247 - that Doctor Johnson prescribed treatment for Millie with Gemzar to
041248 - start immediately this week; further reported side effects of Gemzar
041249 - will be very difficult for Millie to tolerate, and asked to verify
041250 - that Millie agrees to get this treatment. ref SDS 51 8J8L
041252 -  ..
041253 - On 090601 0818 at 1153 Sheree called in the Kaiser Chemotherapy
041254 - Infusion Clinic and advised that Millie cannot get a blood draw to
041255 - start Gemzar this week, because Doctor Johnson submitted the
041256 - chemoterhapy order without a signature, and then went home with a
041257 - headache, and so the order cannot be signed until the doctor recovers
041258 - and returns to work, ref SDS 51 I96J, reflecting emotional stress
041259 - expressed during the meeting at Kaiser on 090515 saying he would get
041260 - in trouble for prescribing single-agent treatments for Millie's
041261 - patient profile. ref SDS 33 658J
041263 -  ..
041264 - On 090605 1447 Millie received documentation from Kaiser that Gemzar
041265 - requires extreme caution given after a patient treated with radiation,
041266 - which Millie received for 4 weeks in February and March, and contiues
041267 - to suffer side effects; Kaiser further says treatment with Gemzar
041268 - requires avoiding blood thinners, and Millie is required to take blood
041269 - thinners every day for PE. ref SDS 52 V34K
041271 -  ..
041272 - On 090607 2253 Millie notified medical team that wound in the
041273 - breastbone area diagnosed as side effects of readiation treatment was
041274 - worse; requested additional treatment to recover from radiation side
041275 - effects, planned by UCSF. ref SDS 53 KS62
041277 -  ..
041278 - On 090609 Doctor Hsu reported that UCSF made a mistake performing
041279 - radiation treatments for Millie under referral from Kaiser during
041280 - February and March. ref SDS 54 W65W  This caused cancer in the
041281 - breastbone area to go untreated for 6 months, causing cancer to
041282 - spread, noted in Doctor Hsu's letter to Millie on 090401. ref SDS 19
041283 - R24X  On 090609 Doctor Hsu diagnosed Millie's breathing problems
041284 - beginning in April, were caused by untreated IBC in the breastbone
041285 - area, that may have migrated into Millie's lungs. ref SDS 54 R24G
041287 -  ..
041288 - On 090609 Doctor Hsu also diagnosed that Millie's breathing problems
041289 - may have been caused by progressive radiation injury to the lungs.
041290 - ref SDS 54 R24G
041292 -  ..
041293 - Doctor Hsu ordered a CT test for Millie at Kaiser to evaluate the
041294 - scope of injury caused by mistakes providing radiation services.
041295 - ref SDS 54 W66T
041297 -  ..
041298 - On 090609 0900 Doctor Hsu prescribed treatment with MPA at UCSF for
041299 - Millie to recover from medical mistakes performing radiation earlier
041300 - at UCSF. ref SDS 54 W66W
041302 -  ..
041303 - On 090616 1240 Doctor Rugo provided MPA treatment for Millie to
041304 - recover from cancer spreading and new breathing problems, ref SDS 55
041305 - D647, prescribed by Doctor Hsu on 090609. ref SDS 54 W66W
041307 -  ..
041308 - On 090626 1140 Doctor Johnson reports in Kaiser's medical chart that
041309 - assessment from examination finds some dyspnea on exertion (DOE) which
041310 - aligns with reports of rising breathing problems caused by progressive
041311 - lung injury from UCSF medical mistakes providing radiation medical
041312 - services on referral from Kaiser. ref SDS 57 EF7R
041314 -  ..
041315 - On 090627 Millie reported another episode of persistant coughing that
041316 - was caused by breathing problems Doctor Hsu diagnosed on 090607 was
041317 - caused by mistakes providing medical services for radiation.
041318 - ref SDS 58 BF4K
041320 -  ..
041321 - On 090701 1200 Millie reported another episode of prolonged and
041322 - persistent cough, and requested treatment from UCSF. ref SDS 59 9T5K
041324 -  ..
041325 - On 090701 1652 Millie received a letter from Doctor Hsu, ref SDS 60
041326 - SF8I, saying he looked at scan files for Millie's CT test at Kaiser on
041327 - 090612, and found decrease in lung volume, noting he is not a
041328 - diagnostic radiologist. ref SDS 60 4P4K  The doctor advises that UCSF
041329 - has a treatment for Millie's breathing problems with symptoms of
041330 - tightness in the left side of her chest. ref SDS 60 4P51
041332 -  ..
041333 - On 090701 2156 Millie responds to Doctor Hsu's letter earlier in the
041334 - day, ref SDS 60 SF8I, responding to Millie's request for treatment of
041335 - breathing problems, ref SDS 59 9T5K, and submitting 2 reports Kaiser
041336 - published for the CT test on 090612, ref SDS 61 4Z4F, because Doctor
041337 - Hsu reported he could not find the reports in UCSF's files; and which
041338 - needed to be reviewed together for a complete analysis of Millie's
041339 - breathing problems; Millie asks about adding a cardio pulmonary
041340 - specialist to the medical team for evaluating breathing problems and
041341 - prescribing treatment for Millie to recover from by mistakes
041342 - performing radiation at UCSF during February and March.
041344 -  ..
041345 - On 090702 2241 Millie's letter to the medical team, ref SDS 62 OP6I,
041346 - responds to Doctor Hsu's letter yesterday on 080701 1652, ref SDS 60
041347 - SF8I, responding to Millie's request for treatment of breathing
041348 - problems, ref SDS 59 9T5K, and notifies the medical team that UCSF
041349 - Triage Department provided prescription for temporary treatment of
041350 - cough symptoms, ref SDS 62 DZ6U, and Millie suffers pain on her left
041351 - side, which may correlate to Doctor Hsu's report that he can treat the
041352 - problem. ref SDS 62 D13Q
041354 -  ..
041355 - On 090705 2248 Millie notifies medical team coordinating examnation at
041356 - UCSF on 090716 to start second cycle of MPA treatment to recover from
041357 - medical mistakes caused by UCSF providing radiation medical services
041358 - on referral from Kaiser. ref SDS 63 FS6G  Millie asks UCSF for
041359 - analyst's reports on CT test scan files delivered to UCSF on 090612 at
041360 - the request of Doctor Rugo for evaluating severity of Millie's lung
041361 - injury from radiation mistakes. ref SDS 63 FT9U
041363 -  ..
041364 - On 090706 1009 telecon with Mike developed work plan and schedule for
041365 - UCSF to recover from medical mistakes providing radiation services
041366 - that caused evident lung injury that makes breathing difficult for
041367 - Millie, and has spread her cancer. ref SDS 64 QY5H
041369 -  ..
041370 - On 090706 1643 Millie receives letter from Mike reporting that UCSF
041371 - failed to use CT tests same-day hand-delivered to UCSF for evaluating
041372 - work plan for Millie to recover from medical mistakes that caused
041373 - radiation injury to Millie's lungs and spread of cancer. ref SDS 65
041374 - FS6G
041376 -  ..
041377 - On 090708 1343 Millie notifies medical team that Arlette called and
041378 - advised that Doctor Johnson, Millie's primary care physician at
041379 - Kaiser, who made the referral for radiation services to UCSF, has
041380 - ordered xray test to evaluate Millie's persistent breathing problems
041381 - from progressive radiation injury caused by medical mistake getting
041382 - radiation medical services at UCSF. ref SDS 66 FS6G
041384 -  ..
041385 - On 090708 1633 Millie notifies medical team that Doctor Johnson called
041386 - after Arlette's call, and advised that he has also ordered a pulmonary
041387 - function test (PFT) to further evaluate Millie's breathing problems
041388 - from progressive radiation injury caused by UCSF medical mistakes
041389 - providing medical services for Millie on referral from Kaiser.
041390 - ref SDS 67 FS6G
041392 -  ..
041393 - On 090709 1510 Millie notifies medical team that xray test was
041394 - completed today, and requests findings; Millie also asks for the date
041395 - the PFT test is scheduled at Kaiser. ref SDS 68 FS6G
041397 -  ..
041398 - On 090709 1646 Doctor Johnson letter notifies medical team that the
041399 - pulmonary function test (PFT) for Millie has not yet been scheduled,
041400 - and that Kaiser has not yet published findings for the xray test
041401 - Millie had earlier today. ref SDS 69 FS6G
041403 -  ..
041404 - On 090709 1914 Millie received a letter from Arlette, Doctor Johnson's
041405 - assistant at Kaiser, transmitting the radiology report on the xray
041406 - test performed earlier today at Kaisre to evaluate Millie's breating
041407 - problems, and finding no evident injury. ref SDS 70 FS6G
041409 -  ..
041410 - On 090715 0224 Millie submits agenda to medical team for meeting with
041411 - Doctor Rugo at UCSF on starting 2nd cycle of MPA prescribed by Doctor
041412 - Hsu for Millie to recover from progressive radiation injury caused by
041413 - medical mistakes providing radiation medical services for Millie on
041414 - referral from Kaiser. ref SDS 0 SY5H
041415 -
041417 -  ..
0415 -
0416 -
0417 - Progress
0418 -
041801 - Millie submitted the following agenda for the meeting at UCSF tomorrow
041802 - that will evaluate response to treatment with MPA started on
041803 - 090616...
041804 -
041805 -    1.  Subject: Agenda Meeting Jul 16 Progress Review Possible Improvement
041806 -        Date: Wed, 15 Jul 2009 02:48:54 -0700
041820 -         ..
041821 -    2.  Attached are results of the xray on 090709 1000 at Kaiser
041822 -        showing lungs are clear of disease.  Thanks to Arlette for
041823 -        expediting same-day submission of the report while Doctor
041824 -        Johnson is on vacation.
041825 -
041826 -            [On 090716 2106 Millie's letter notifies medical team
041827 -            results of meeting at UCSF, ref SDS 71 4463, and Tara's
041828 -            call in the evening. ref SDS 71 EE5W
041830 -         ..
041831 -    3.  Doctor Johnson ordered xray and a pulmonary function tests at
041832 -        Kaiser, in order to evaluate rising loss of breath and
041833 -        coughing.  PFT is still pending.  These tests supplement CT
041834 -        tests on 090413 and recently on 090612 finding progression of
041835 -        ground glass opacities in my lungs [reported on, 090415 1642,
041836 -        ref SDS 28 RV78], yet which seemed too minor to account for
041837 -        rising symptoms, based on review by Doctor Johnson of test on
041838 -        090413 [see the record on, 090415 1519, ref SDS 27 E09J], and
041839 -        later review on 090625 by Doctor Mates, head of radiology at
041840 -        Kaiser in Walnut Creek, commenting that the CT test on 090612
041841 -        does not explain symptoms of severe breathing loss, and cough
041842 -        [reported on 090625 1539. ref SDS 56 IJ4W].
041844 -         ..
041845 -    4.  Finally, Doctor Hsu looked at the scans for 090413 and 090612
041846 -        and   reported on 090701...
041848 -         ..
041849 -        "...I just took a quick look.  I don't see much fluid build up.
041850 -        There is a little bit of scaring anterior near the sternum.
041851 -        There may be some decrease volume of left lung.  Overall, I
041852 -        think it look pretty good---again I am not a diagnostic
041853 -        radiologist.  Are you having some tightness in your left chest?
041854 -        If so, let me know I think I have a treatment for that."
041855 -        ref SDS 60 4P51
041857 -         ..
041858 -    5.  I replied in a letter to the team on 090702 2326 that...
041859 -
041860 -        "I have had for a week or so a rising condition of discomfort
041861 -        on the left side, which I do not associate with breathing.
041862 -        This is a dull pain about 2" below the armpit, and occurs at
041863 -        odd times when I twist my shoulders to the left.  I don't feel
041864 -        a lump, so it may be deeper inside." ref SDS 62 D13T
041866 -         ..
041867 -    6.  This tightness on the left side could be a pulled muscle from
041868 -        work in the gym, but I really don't think so.  I'll be
041869 -        interested in assessment by the team tomorrow.
041871 -         ..
041872 -    7.  At this time, Doctor Hsu has not commented on how this
041873 -        condition on the left side, which persists, relates to the
041874 -        treatment he was considering in his letter on 090701.
041875 -        ref SDS 60 4P51  Again, hoping this can be addressed tomorrow.
041876 -
041877 -            [On 090716 0301 during meeting at UCSF Tara made
041878 -            examination; Doctor Rugo was out of town, so Tara planned
041879 -            to discuss Doctor Hsu's diagnosis and treatment later and
041880 -            advise. ref SDS 71 EE4W
041882 -         ..
041883 -    8.  Good news - possibly - IBC got much worse for several weeks
041884 -        after starting treatment, but in the past few days seems to
041885 -        have started to fade [similar to experience with Sunitinib
041886 -        treatment, reported on 081125 1033. ref SDS 1 XX3W, and
041887 -        confirmed by medical team on 081218 1000. ref SDS 2 VD4F].
041888 -        Additionally, the cough has definitely calmed to now being only
041889 -        an occasional distraction.  I have had to use the prescribed
041890 -        cough medication only a few times.  I think breathing has,
041891 -        also, improved.  Had to give up hiking altogether a few weeks
041892 -        ago, but now feel that if things keep improving will get back
041893 -        in the gym and on the trail at Lafayette.
041894 -
041895 -            [On 090716 2106 Millie's letter notifies medical team
041896 -            results of meeting at UCSF, ref SDS 71 4463, and Tara's
041897 -            call in the evening, relating UCSF ended MPA because
041898 -            examination found IBC worse on 090716, than on 090616,
041899 -            ref SDS 71 EE5W, and ignored the record today, showing IBC
041900 -            got much worse for several weeks after starting MPA, and
041901 -            then got better, per above. ref SDS 0 0I4Y
041903 -             ..
041904 -            [On 100111 1120 Millie had similar experience where
041905 -            shingles symptoms began to improve after 5 days of
041906 -            treatment, but after 2 days of recovery, still looked worse
041907 -            than when treatment began; this record indicates Millie
041908 -            should have full recovery in another 7 days. ref SDS 72 ML7H
041910 -             ..
041911 -            [On 100112 0047 Millie reported to medical team shingles
041912 -            got worse, then improved following prior pattern of cancer
041913 -            disease trajectory. ref SDS 73 IS8U
041915 -         ..
041916 -    9.  The happy scenario is that the extra 2 MPA pills which I
041917 -        started taking on 090703 has helped speed recovery.
041919 -         ..
041920 -   10.  Really good news is that I have had no evident side effects.  I
041921 -        feel stronger physically, and brighter emotionally after a
041922 -        difficult 6 months working through complex issues at Kaiser and
041923 -        UCSF.
041925 -         ..
041926 -   11.  Issue for Doctor Hsu.
041928 -         ..
041929 -        On 090423 Doctor Hsu seemed to indicate that "nothing can grow
041930 -        in my radiated skin..."
041931 -
041932 -           http://www.welchco.com/sd/08/00101/02/09/04/23/083025.HTM#V46K
041934 -         ..
041935 -   12.  My impression is that IBC has crept back into radiated areas.
041936 -        What are implications of this situation - will it be harder for
041937 -        systemic agents to reach IBC in radiated areas?  Do we need
041938 -        more radiation and/or hyperthermia?
041940 -         ..
041941 -   13.  Research on 090415 reviewing the CT test on 090413 that
041942 -        reported progression of ground glass opacities, indicated that
041943 -        in some cases these nodules can be excised...
041944 -
041945 -           http://www.welchco.com/sd/08/00101/02/09/04/15/164240.HTM#FI4J
041947 -         ..
041948 -   14.  Does UCSF support this procedure; might I be a candidate, and
041949 -        what is entailed in evaluating taking this action?
041951 -         ..
041952 -   15.  Untreated IBC sore on my breastbone is still messy and
041953 -        bleeding, indicating that recovery is still slow.  Is there
041954 -        another solution for this problem, e.g., surgery, radiation,
041955 -        anything?
041957 -         ..
041958 -   16.  Doctor Rugo mentioned during the meeting on 090616 that
041959 -        "everybody is now on board" at Kaiser and UCSF for my treatment
041960 -        going forward, and further discussed PARP technologies.  Based
041961 -        on experience with sunitinib, where we had a strong recovery
041962 -        for a few weeks in December, then the "wheels came off" in
041963 -        January, I am hoping to be better prepared to switch treatments
041964 -        smoothly next time.
041966 -         ..
041967 -   17.  Looking forward to seeing Catherine, Diane, and everyone in the
041968 -        Infusion Clinic for blood draw tomorrow morning OA 0800.
041969 -
041976 -
041977 -
041978 -
041979 -
041980 -
041981 -
0420 -