THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: January 4, 2010 01:55 PM Monday; Rod Welch

Millie meeting Kaiser Opthalmology evaluate shingles impact on eyes.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 28 0000. ref SDS 27 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040506 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - On 091202 Millie had the 3rd treatment in the 1st cycle of Navelbine.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040902 - ref SDS 14 625I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040904 -  ..
040905 - She is experiencing some possible recovery, but also evident worsening                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040906 - of cancer due to lack of treatment targeted to her patient profile.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040908 -  ..
040909 - On 091203, Millie submitted a letter notifying the medical team about                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040910 - possible progression of disease, and requesting treatment targeted to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040911 - her patient profile, ref SDS 15 4P7G, following up the letter on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040912 - 091112, ref SDS 10 IL8L, and meeting with Doctor Johnson at Kaiser                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040913 - later that day on 091112. ref SDS 11 UT7M  The following letter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040914 - confirms understandings from meeting on 091112, and sets agenda for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040915 - meeting at Kaiser on 091210.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040917 -  ..
040918 - On 091211 0018 Millie letter confirms understandings from meeting at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040919 - Kaiser and thanks thanked medical team for excellent care, ref SDS 17                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040920 - BW8I, based on Doctor Johnson's report in the meeting at Kaiser on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040921 - 091210 that Kaiser is collaborating with Doctor Rugo for UCSF to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040922 - prescribe treatment targeted to Millie's patient profile. ref SDS 17                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040923 - XM3X                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040925 -  ..
040926 - On 091211 1452 Doctor Johnson reports collaborating with Doctor Rugo                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040927 - for UCSF as planned during the meeting yesterday. ref SDS 18 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040929 -  ..
040930 - On 091211 1648 Millie notifies Doctor Johnson to submit correspondence                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040931 - of Kaiser collaborating with Doctor Rugo at UCSF on prescribing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040932 - treatment targeted to Millie's patient profile. ref SDS 19 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040934 -  ..
040935 - On 091214 1649 Doctor Johnson notifies Millie that Doctor Rugo has not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040936 - replied to Kaiser's letter on 091211. ref SDS 20 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040938 -  ..
040939 - On 091215 0852 Millie asks Doctor Johnson about sending a copy of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040940 - Kaiser's letter to Tara for assisting Doctor Rugo developing UCSF's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040941 - treatment plan targeted to Millie's patient profile. ref SDS 21 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040943 -  ..
040944 - On 091215 1557 Millie reports blood counts fall, still permit getting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040945 - 1st treatment 2nd cycle Navelbine, ref SDS 22 BW8I, asks about                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040946 - progress collaborating on prescribing next treatment to recover from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040947 - 10th relapse of cancer.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040949 -  ..
040950 - On 100103 1147 Millie asks medical team about progress prescribing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040951 - treatment targeted to Millie's patient profile to recover from 10th                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040952 - relapse of cancer. ref SDS 23 BW8I  Millie reports new symptom of rash                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040953 - on right side of forehead, which is swelling the right eye; requests                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040954 - examination tomorrow to prescribe immediate remedy. ref SDS 23 FZ6V                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040956 -  ..
040957 - On 100103 1652 Millie receives automated reply that Doctor Johnson is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040958 - out of the office until 100105, and so cannot make examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040959 - tomorrow on 100104 requested in Millie's letter this afternoon.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040960 - ref SDS 24 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040962 -  ..
040963 - On 100103 2023 Millie reponds to notice that Doctor Johnson is out of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040964 - the office tomorrow and so cannot make examination requested in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040965 - Millie's letter earlier today. ref SDS 25 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040967 -  ..
040968 - On 100104 0830 Millie needs examination of facial blisters today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040969 - ref SDS 26 BW8I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040971 -  ..
040972 - On 100104 1115 Millie met with Doctor Zhang in Adult Primary Care,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040973 - ref SDS 27 BW8I, who diagnosed shingles, ref SDS 27 0P9S, and prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040974 - treatment, which may yield full recovery in 2 weeks. ref SDS 27 QB5K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040975 - Doctor Zhang ordered lab to evaluate impact on immune system, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040976 - asked Millie to coordinate with Coagulation Control Clinic on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040977 - adjusting Coumadin. ref SDS 27 0P4S  Doctor Zhang arranged meeting with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040978 - opthalmology to test for damage to eyes. ref SDS 27 EY8F  Doctor Zhang                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040979 - recommended Millie meet with Doctor Johnson this week, rather than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040980 - wait for regularly scheduled meeting next week to review progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040981 - recovering from shingles. ref SDS 27 0P4Y                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040983 -  ..
040984 - On 100104 1216 Kaiser Oncology Chemotherapy Infusion Clinic did not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040985 - have enough time to spend 5 minutes accessing Millie's Power Port                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040986 - which was placed to facilitate blood draws, ref SDS 28 4P6K, in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040987 - case ordered by Doctor Zhang to evaluate requirements for treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040988 - shingles; Millie waited an hour and was fortunate that the lab                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040989 - technician was successful on the 1st try placing an IV to perform the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040990 - blood draw today. ref SDS 28 4Q40                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040992 -  ..
040993 - On 100104 1355 Millie meets Doctor Dossetor in Opthalmology at Kaiser                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040994 - Park Shadelands; examination findings no injury nor infection to eyes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040995 - from shingles. ref SDS 0 BW8I  Doctor prescribed Polysporin antibiotic                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040996 - to reduce pain and infection from bursting shingles blisters.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040997 - ref SDS 0 GH51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040998 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040999 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041001 -  ..
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041401 - Millie met with Doctor Dossetor the Kaiser Park Shadelands                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041402 - Opthalmology Clinic, per arrangements earlier today by Doctor Zhang in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041403 - Kaiser Adult Care. ref SDS 27 EY8F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041405 -  ..
041406 - Testing seems to show no injury to my eye so far.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041408 -  ..
041409 - The doctor prescribed an antibiotic Polysporin.  She explained that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041410 - Polysporin can be applied on the blisters to ease pain and to avoid                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041411 - infection, discussed by Doctor Zhan during the meeting this morning on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041412 - 100104 1115. ref SDS 27 0P4S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041414 -        [On 100104 2144 Millie notifies medical team of favorable                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041415 -        examination by Opthalmology. ref SDS 29 0P6P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041417 -  ..
041418 - She also provided eye drops - Ofloxacin ophthalmic solution 0.3% 5 ml,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041419 - manufactured by Falcon Pharmaceuticals.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041421 -  ..
041422 - Doctor Dossetor wants follow up review within 2 weeks.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041425 -  ..
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0417 - 1622                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041801 - Mona called and advised that Doctor Dossetor scheduled follow up                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041802 - examination on 100118 1100].                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041803 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041804 -        [On 100108 1057 Mona called and advised that Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041805 -        Dossetor advanced the date for follow up meeting from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041806 -        100119 to 100111 1100. ref SDS 33 Z35H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041808 -         ..
041809 -        [On 100111 1120 meeting with Doctor Dossetor finds shingles                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041810 -        blisters worse than today on 100104, with forehead bloody from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041811 -        sores bursting, ref SDS 35 ML5G; treatment with polysporin                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041812 -        antibiotic prevents infection. ref SDS 35 ML7I  Examination by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041813 -        Doctor Dossetor found no injury to Millie's right eye from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041814 -        shingles infection. ref SDS 35 ML7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041815 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041816 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041817 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041818 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041819 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041820 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041821 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0419 -