CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 9 0000. ref SDS 8 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Today starts the 1st treatment of the 3rd cycle with Navelbine for
040902 - Millie to recover from the 9th relaspe of cancer.
040904 -  ..
040905 - Millie is resuming treatment after a 3-week pause ordered by Doctor
040906 - Johnson, on 100112 0830, ref SDS 11 G68H, while Millie was treated to
040907 - recover from a very severe case of shingles infection, reported
040908 - earlier on 100104 1115. ref SDS 10 0P9S
040910 -  ..
040911 - Barbara is Millie's nurse today.
040913 -  ..
040914 - Barbara initially asked if Doctor Johnson, Millie's primary care
040915 - physician, is aware that Millie's INR 5.8 for the lab at Kaiser
040916 - yesterday on 100202 0830. ref SDS 13 848J, is significantly elevated
040917 - above a safe level for Millie's patient profile diagnosed with
040918 - pulmonary embolism?
040920 -  ..
040921 - Millie related Laurie's call last night from a Kaiser Call Center, and
040922 - so presumably, her report has been presented to Doctor Johnson for
040923 - action this morning, reported on 100202 1927, ref SDS 14 KE5I
040925 -  ..
040926 - Additionally, late last night, Millie sent a letter notifying the
040927 - medical team that INR 5.8 is significantly elevated, and reporting
040928 - Laurie's call recommending adjusting Coumadin, reported on 100202
040929 - 2317. ref SDS 15 OH3Q  Therefore, Millie expects a call from Gloria,
040930 - her case manager for Coumadin treatments in Kaiser's Coagulation
040931 - Control Clinic, and that Gloria will pause Coumadin for a day or two,
040932 - as in past situations, and may change the dose of daily Coumadin to
040933 - account for changes to medications ordered by Doctor Johnson, which
040934 - was presented to the medical team last week, and asking for advice on
040935 - adjusting Coumadin in order to avoid problems from elevated INR,
040936 - reported on 100128 2249. ref SDS 12 FM4W
040938 -  ..
040939 - Barbara commended Millie for timely action giving the medical team
040940 - the opportunity to make adjustments that prevent compounding effects
040941 - of medication conflicts.
040943 -  ..
040944 - Barbara advised that she also noticed Millie's elevated CBC blood
040945 - counts, particularly WBC 9.9, and ANC 7.7, in the lab yesterday on
040946 - 100202, which are significantly above Millie's patient history norms.
040947 - ref SDS 13 NK7F
040949 -  ..
040950 - Barbara said that she canceled Millie's 2nd Neupogen treatment
040951 - scheduled on Friday, 100205, because Millie will only need 1
040952 - treatment this week, based on the lab yesterday.
040954 -  ..
040955 - Millie again requested a longer flush with saline following treatment
040956 - with Navelbine today, since this was helpful on 091230 to relieve
040957 - discomfort in the area around the Power Port. ref SDS 9 6Y8F
040959 -  ..
040960 - As a result, Barbara let the post treatment flush continue after the
040961 - guage on the container reached 1, and until it reached 2, which took
040962 - another 10 minutes.  Normally, the flush lasts about 2 mintues.
040963 -
040964 -
040965 -
040966 -
040967 -
040968 -
040969 -
040970 -
0410 -