CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 3 0000, ref SDS 2 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie went to Kaiser in Martinez for weekly blood draw to test immune
040902 - system and cancer marker tp evaluate starting the 3rd cycle of
040903 - Navelbine, and how much Nupigen treatment is needed to maintain blood
040904 - counts.  Also testing INR which was too high for the last draw two
040905 - weeks ago, evaluating risk of pulmonary embolism.
040907 -  ..
040908 - Beth was the nurse today.
040910 -  ..
040911 - Blood counts for the test today show continuing elevated counts
040912 - across the board with...
040913 -
040914 -                                 Results  Units         Range
040915 -
040916 -       WBC COUNT                    9.9   K/uL      3.5    -   12.5
040917 -       RED BLOOD CELLS COUNT        4.06  M/uL      3.60   -    5.70
040918 -       HGB                         11.8   g/dL     11.5    -   15.0
040919 -       HEMATOCRIT                  37.7   %        34.0    -   46.0
040920 -       MCV                         93     fL       80      -  100
040921 -       RDW, RBC                    22.4   %        11.9    -   14.3
040922 -        ..
040923 -       PLATELETS COUNT            277     K/uL    140      -  400
040925 -        ..
040926 -       PT                          66.6   Sec       8.2    -   10.6
040927 -       PT INR                       5.8             2.0    -    3.0
040928 -
040929 -            [On 100202 0301 Laurie called and said Millie's elevated
040930 -            INR caused by medication conflicts; Gloria will call
040931 -            tomorrow and tell Millie to avoid Coumadin on Wednesday.
040932 -            ref SDS 4 K069
040934 -             ..
040935 -            [On 100203 1023 Gloria, Case Manager, Kaiser Coagulation
040936 -            Control Clinic in Martinez reported receiving Millie's
040937 -            letter on 100128 notifying medical team the the doctor
040938 -            added Nortriptyline to Millie's medications, and did not
040939 -            alert Millie this may affect Coumadin dose and INR blood
040940 -            counts, because Kaiser has gained enough experience using
040941 -            Nortriptyline to establish adjustments to Coumadin, and
040942 -            this can only be determined through trial and error.
040943 -            ref SDS 6 7X4M
040945 -             ..
040946 -            [On 100203 1148 Millie notified medical team that Gloria
040947 -            ordered a 2-day pause in Millie's Coumadin treatments to
040948 -            reduce risks of pulmonary embolism ref SDS 7 J53U
040950 -             ..
040951 -            [On 100203 1148 Millie notifies medical team that Gloria
040952 -            ordered an interim blood draw to test INR on Friday, and
040953 -            wanst the work performed at Kaiser in Walnut Creek, because
040954 -            that lab can issue same-day results, needed to adjust
040955 -            Coumadin on Friday, 100205, and the lab in Kaiser,
040956 -            Martinez, where Millie usually gets blood draws on
040957 -            Tuesdays, does not provide same-day results. ref SDS 7 J53X
040959 -             ..
040960 -            [On 100203 1410 Arlette called and advised she received
040961 -            Millie's letter notifying the medical team that Gloria
040962 -            ordered an interim blood draw to test INR on Friday,
040963 -            100205, and in order to make timely adjustment to Millie's
040964 -            Coumadin prescription on Friday to reduce the risk of
040965 -            pulmonary embolism. ref SDS 8 QJ85
040967 -             ..
040968 -            [On 100204 1325 Millie's letter to the medical team asks
040969 -            the primary care physician to enter in Millie's medical
040970 -            chart and notify the Chemotherapy Infusion Clinic that
040971 -            Millie's patient profile requires drawing blood from
040972 -            Millie's Power Port rather than use IV needle penetration
040973 -            balancing very low risks of Heprin contamination in the
040974 -            Power Port which has never occurred in Millie's case over 8
040975 -            years, against lymphedema recently diagnosed in the right
040976 -            arm which, has prevented IV needle penetrations in the left
040977 -            arm for 8 years. ref SDS 9 SB6S
040979 -             ..
040980 -            [On 100205 0938 Millie reports significant decline from INR
040981 -            5.8 to INR 3.2 for the lab ordered by Gloria, and asks for
040982 -            further guidance changing Coumadin medication to complete
040983 -            correction for INR to decline within 2.0 to 3.0.
040984 -            ref SDS 10 IS7Q
040986 -             ..
040987 -            [On 100205 1143 Gloria called Millie and sent a letter
040988 -            confirming instructions to resume Coumadin medication to
040989 -            prevent pulmonary embolism, ref SDS 11 QJ85, and adjusting
040990 -            the dose so that INR blood counts decline to a safe level.
040991 -            ref SDS 11 F28V
040993 -        ..
040994 -       NEUTROPHILS %,
040995 -       AUTOMATED COUNT             83     %        41      -   81
040997 -        ..
040998 -       LYMPHOCYTES %,
040999 -       AUTOMATED COUNT             10     %        13      -   46
041001 -        ..
041002 -       MONOS %, AUTO                5     %         4      -   12
041004 -        ..
041005 -       EOSINOPHILS %,
041006 -       AUTOMATED COUNT              3     %         0      -    4
041008 -        ..
041009 -       BASOPHILS %,
041010 -       AUTOMATED COUNT              0     %         0      -    1
041012 -        ..
041013 -       NEUTROPHILS, ABSOLUTE,
041014 -       AUTOMATED COUNT              8.1   K/uL      2.1    -    7.7
041015 -
041016 -            [On 100202 0301 Millie notified medical team about elevated
041017 -            blood counts, and asked about deferring Neupogen on Friday,
041018 -            100205, and perhaps on Thursday, 100204. ref SDS 5 OG6U
041020 -        ..
041021 -       PLATELETS,BLD,QL, MAN CT     ADEQUATE
041023 -        ..
041024 -       ANISOCYTOSIS                 1+
041025 -       MICROCYTES                   1+
041026 -       MACROCYTES                   1+
041027 -
041028 -
041029 -
041030 -
041031 -
0411 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - H1N1 Swine Flue Innoculation
050403 -
050404 - After getting the blood draw, Millie got the H1N1 swine flue shot.
050405 -
050406 -
050407 -
050408 -
050409 -
050410 -
050411 -
0505 -
0506 -