CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 13 0000. ref SDS 12 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 091019 Millie notified medical team that IBC shows progression,
040902 - ref SDS 6 0Z9S, and asks about work plans to change treatment in order
040903 - to maintain local control and recover from the 9th relapse of cancer.
040904 - ref SDS 6 0Z4P  Millie submitted patient history and treatment
040905 - options, ref SDS 6 0Z5V, presented prevously on 090326. ref SDS 3 QM3V
040907 -  ..
040908 - On 091027 0830 Millie meeting with primary care physician, Doctor
040909 - Johnson, with Pam observing; the doctor reported significant drop on
040910 - cancer marker CA 15-3 299 from 350 a few weeks earlier, and indicating
040911 - possible continuing response to treatment. ref SDS 7 DR6M  The Doctor
040912 - Johnson reported examination shows stable cancer, ref SDS 7 GN7W, and
040913 - so orders another cycle of Gemzar rather than switch to a treatment
040914 - targeted to Millie's patient profile. ref SDS 7 BK9M
040916 -  ..
040917 - On 091112 Millie letter confirms report Doctor Johnson's report on 09
040919 -  ..
040920 - findings from examination on 091027,
040921 - ref SDS 8 L64X
040923 -  ..
040924 - and notified medical team that IBC seems worse,
040925 -
040927 -  ..
040928 - On 091202 Millie had the 3rd treatment in the 1st cycle of Navelbine.
040929 - ref SDS 12 625I
040931 -  ..
040932 - She is experiencing some possible recovery, but also evident worsening
040933 - of cancer due to lack of treatment targeted to her patient profile.
040935 -  ..
040936 - On 091203, Millie submitted a letter notifying the medical team about
040937 - possible progression of disease after the 1st cycle with Navelbine,
040938 - and requesting treatment targeted to her patient profile, ref SDS 13
040939 - 4P7G, following up the letter on 091112, ref SDS 8 IL8L, and meeting
040940 - with Doctor Johnson at Kaiser later that day on 091112. ref SDS 9 UT7M
040941 - The following letter confirms understandings from meeting on 091112,
040942 - and sets agenda for meeting at Kaiser on 091210.
040943 -
040944 -
040946 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Main issues today are treatment for bulge on left side above armpit,
041302 - that may be severe lymphedema caused by IBC.
041304 -  ..
041305 - Evaluate continuing Navelbine.
041307 -  ..
041308 - Review next treatment from lists submitted to the medical team on
041309 - 090326. ref SDS 3 QM3V
041311 -  ..
041312 - During the meeting on 091112, reminded Doctor Johnson that the record
041313 - on 090121 lists abraxane in combination with other drugs. ref SDS 2
041314 - 8T5H  Doctor Johnson cited abraxane in the medical chart, and also
041315 - mentions Ixempra
041317 -  ..
041318 - Doctor Johnson examined Millie.  He observed swelling now occurring
041319 - in the right arm, though at this time without evidence of IBC rash.
041321 -  ..
041322 - The doctor observed swelling in the left arm where IBC is evident, and
041323 - noticed the large bulge on the upper left side of the chest, and above
041324 - the left armpit, reported in the letter to the medical team on 091203.
041325 - ref SDS 13 A95W
041327 -  ..
041328 - The doctor further observed IBC rash progressing across the right
041329 - chest, and with lymphedema spreading, including on the right breast,
041330 - also, reported as clinically worsening cancer in the letter on 091203.
041331 - ref SDS 13 A43X
041332 -
041333 -        [On 100112 0830 Doctor Johnson examination finds substantial
041334 -        recovery from IBC with lesions significantly subsiding on left
041335 -        arm and across Millie's chest. ref SDS 20 3U7H
041337 -  ..
041338 - Millie reported rising pain in the left arm and across her chest.
041340 -  ..
041341 - Doctor Johnson seemed to diagnose Millie's pains occurs from rising
041342 - IBC, observed today.
041344 -  ..
041345 - The doctor prescribed taking 2 percocet pills to control pain from
041346 - progression of IBC, and advised that morphine based pain relief can be
041347 - prescribed, if this becomes necessary.
041348 -
041349 -        [On 091211 0018 Millie's letter to medical team confirms
041350 -        approval to take 2 pills of oxychodone (Percocet) to control
041351 -        rising pain from progression of IBC, and that a stronger
041352 -        morphine-based treatment can be prescribed when necessary.
041353 -        ref SDS 14 XM4Q
041355 -         ..
041356 -        [On 091215 0852 Millie's letter notifies Kaiser that, as of
041357 -        091215, she has not had to take 2 percocet pills at once for
041358 -        pain. ref SDS 18 I15X
041360 -  ..
041361 - Doctor Johnson prescribed continuing Navelbine to start the 2nd cycle
041362 - on 091216, based on a drop in the cancer marker CA 15-3 262 for the
041363 - test on 091124, which was after starting the 1st cycle.  The cancer
041364 - marker will be tested again with the lab on 091215.  If the marker
041365 - declines or rises moderately, this can signal continuing response to
041366 - the Navelbine for recovering from the 9th relapse of cancer.  If the
041367 - marker increases say 100 points, continuing Navelbine will be
041368 - reconsidered in favor of another treatment.
041370 -  ..
041371 - Millie's next treatment is the critical decision.
041373 -  ..
041374 - Doctor Johnson recalled that Kaiser has PARP treatments for cancer
041375 - patients, also, planned for Millie by Doctor Rugo on 090616.  He left
041376 - the examination room to consult with the Clinical Trial Manager.  The
041377 - doctor returned about 20 minutest later.  He reported that Kaiser does
041378 - not have treatments with PARP therapies.  The doctor reviewed
041379 - advantages of this treatment for Millie's patient profile.  He also
041380 - reported that Kaiser has another new treatment being tried, but it
041381 - requires HER2 positive, and Millie is triple negative.
041383 -  ..
041384 - Doctor Johnson reported receiving email from Doctor Rugo advising that
041385 - treating Millie with Gemzar and Navelbine supports the UCSF treatment
041386 - plan for Millie to recover from UCSF medical mistakes providing
041387 - medical services on referral from Kaiser during February and March.
041389 -  ..
041390 - Doctor Johnson plans to write a letter to Doctor Rugo asking about
041391 - additional treatments for Millie, since at this time Kaiser only has
041392 - abraxane and Iximpra.  Doctor Johnson will ask UCSF about the PARP
041393 - clincial trials Doctor Rugo planned for Millie to recover from UCSF
041394 - medical mistakes, reported during the meeting at UCSF on 090616.
041395 - ref SDS 5 KD6L
041396 -
041397 -         [On 091211 0018 Millie's letter to the medical team confirms
041398 -         Kaiser's work collaborating with Doctor Rugo at UCSF to
041399 -         prescribe treatment targeted to Millie's patient profile for
041400 -         recovering from UCSF medical mistakes. ref SDS 14 XM3X
041402 -          ..
041403 -         [On 091211 1452 Doctor Johnson notifies Millie he sent the
041404 -         letter to Doctor Rugo collaborating on treatment targeted to
041405 -         Millie's patient profile, ref SDS 15 BW8I, as planned in the
041406 -         meeting today, per above. ref SDS 0 0J65
041408 -          ..
041409 -         [On 091215 1557 Millie notifies medical team blood counts are
041410 -         high enough to start 1st treatment 2nd cycle of Navelbine, but
041411 -         have fallen substantially, and so asks about prescribing 2
041412 -         treatments with Neupogen to complete 2nd cycle, ref SDS 19
041413 -         BW8I, Millie also asks about UCSF progress prescribing
041414 -         treatment targeted to Millie's patient profile, so that low
041415 -         blood counts will not prevent getting treatment required for
041416 -         quality of life. ref SDS 19 5U6V
041418 -  ..
041419 - There was further discussion again that Kaiser should send any and all
041420 - correspondence on Millie's health care to Millie under HIPAA
041421 - requirements for patients to make informed choices, reviewed on 071009
041422 - 1644. ref SDS 1 TG3K
041424 -  ..
041425 - The doctor asked for the name of Doctor Rugo's assistant.  He wants to
041426 - send a copy of Kaiser's letter to the assistant, who can help Doctor
041427 - Rugo invest time on Millie's complex patient history.
041429 -  ..
041430 - Tara Lacy is the nurse practitioner who has treated Millie the past
041431 - year, while Brigid has been on assignment to reserve military service.
041432 -
041433 -         [On 091211 0018 Millie's letter to the medical team confirms
041434 -         request for correspondence on her health care, including
041435 -         collaboration between Doctor Johnson and Doctor Rugo; and
041436 -         Millie also submits contact information for Tara, so that she
041437 -         can assist Doctor Rugo in Millie's case. ref SDS 14 XM4T
041439 -          ..
041440 -         [On 091211 1648 Millie's letter thanking Doctor Johnson for
041441 -         his letter collaborating with Doctor Rugo on prescribing
041442 -         treatment targeted to Millie's patient profile, and
041443 -         confirms request for copies of all correspondence on her
041444 -         health care, and further asks if Doctor Johnson sent a copy
041445 -         of his letter to Tara for assisting Doctor Rugo on Millie's
041446 -         case. ref SDS 16 174W
041448 -          ..
041449 -         [On 091214 1649 Doctor Johnson notifies Millie that Doctor
041450 -         Rugo has not responded to Kaiser's letter on 091211; the
041451 -         doctor does not submit a copy of Kaiser's letter to Doctor
041452 -         Rugo, nor indicate that a copy went to Tara for assisting
041453 -         Doctor Rugo in prescribing treatment targeted to Millie's
041454 -         patient profile. ref SDS 17 BW8I
041456 -          ..
041457 -         [On 091215 0852 Millie asks Doctor Johnson if a copy of
041458 -         Kaiser's letter to UCSF went to Tara for assisting Doctor
041459 -         Rugo prescribing treatment targeted to Millie's patient
041460 -         profile. ref SDS 18 I15R
041461 -
041462 -
041463 -
041464 -
0415 -