CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 30 0000. ref SDS 29 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 100203, Millie resumed treatment after a 3-week pause ordered by
040902 - Doctor Johnson, on 100112 0830, ref SDS 23 G68H, while Millie was
040903 - treated to recover from a very severe case of shingles infection,
040904 - reported earlier on 100104 1115. ref SDS 21 0P9S
040906 -  ..
040907 - On 100217 0730 Millie got the 3rd treatment of the 3rd cycle with
040908 - Navelbine for Millie to recover from the 9th relaspe of cancer.
040910 -  ..
040911 - On 100218 1000 Millie got Neupogen treatment at Kaiser to maintain
040912 - blood counts essential for getting Navelbine chemotherapy treatment
040913 - for cancer. ref SDS 0 ER95   After getting Neupogen, Millie has
040914 - emergency meeting with Doctor Johnson; shingles recurrence diagnosed,
040915 - treatment resumed. ref SDS 0 PP5Y  Doctor Johnson diagnosed
040916 - progression of cancer after 3 week delay treating cancer with
040917 - chemotherapy, while Millie was treated for shingles. ref SDS 0 MD4H
040918 - Millie very discouraged about delays treating her cancer with
040919 - chemotherapy rather than providing targeted treatment that works
040920 - concurrently with treating shingles. ref SDS 0 XE6I
040921 -
040923 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Florida was Millie's nurse today for the Neupogen injection.
041302 -
041303 -
041305 -  ..
0414 -
0415 -
0416 - 1010
0417 -
041701 - Received call from Arlette, returning the call yesterday requesting
041702 - immediate examination of shingles recurrence, and spread of IBC rash,
041703 - indicatin 10th relapse of cancer.
041705 -  ..
041706 - Arlette advised that Doctor Johnson wants to see Millie today for
041707 - emergency examination.
041709 -  ..
041710 - Explained that Millie is already on-site in the Oncology Chemotherapy
041711 - Clinic, getting a Neupogen treatment, per above. ref SDS 0 ER95
041713 -  ..
041714 - Arellete will go and see if Millie is still on-site.
041715 -
041717 -  ..
0418 -
0419 -
0420 - 1045
0421 -
042101 - Millie called.
042102 -
042103 - Arlette found Millie in the Chemotherapy Clinic, and arranged an
042104 - immediate meeting with Doctor Johnson in the Oncology Department after
042105 - Mil's treatment, per request above for exigent medical review today of
042106 - rising symptoms. ref SDS 0 00W1
042108 -  ..
042109 - Doctor Johnson found in examination that shingles has resumed, based
042110 - on noticable swelling of the "bump" in the middle of Millie's
042111 - forehead.
042113 -  ..
042114 - The doctor found further significant progression of Millie's cancer
042115 - observing new IBC rash that has become more intense across the right
042116 - breast and upper right chest.  Progression of cancer aligns with rise
042117 - of cancer marker CA 15-3 328 for the test on 100216, and was caused by
042118 - pausing treatment with chemotherapy, ordered during the meeting at
042119 - Kaiser on 100112, and in order to prevent fatal infection from
042120 - shingles, because Kaiser and UCSF have not yet switched from
042121 - chemotherapy to "targeted" treatment for Millie to recover from UCSF
042122 - medical mistakes, and which can be given to recover from cancer
042123 - concurrently with treatment for shingles. ref SDS 23 G68H
042125 -  ..
042126 - Case study on 090323, shows Millie's cancer marker has increased
042127 - significantly in the past 4 weeks from CA 15-3 212 on 100111, to CA
042128 - 15-3 328 for the lab on 100216. ref SDS 4 J13O
042130 -  ..
042131 - The doctor diagnosed Millie's 10th relapse of cancer, and 9th relapse
042132 - of IBC.
042134 -  ..
042135 - Doctor Johnson ordered treatment for shingles to resume, but only
042136 - with Acyclovir (Zovirax) 800 MG tablets.
042138 -  ..
042139 - Doctor Johnson decided that extensive progression of IBC rash on
042140 - Millie's chest, right breast, and wrapping from her left flank onto
042141 - her back, reflecting rise of cancer marker CA 15-3 328, requires
042142 - immediately ending Navelbine, and switching to chemotherapy with
042143 - Abraxane, when Millie starts a new cycle scheduled next Wednesday on
042144 - 100303.
042146 -  ..
042147 - On 091112, the doctor planned Abraxane for treatment after Navelbine,
042148 - because Doctor Rugo has not notified Kaiser that UCSF is ready to
042149 - start PARP, planned in the meeting at UCSF on 090616. ref SDS 14 KB4F,
042150 - and reviewed recently by Doctor Johnson on 100112, showing PARP is
042151 - targeted to cancer, and to Millie's patient profile of triple negative
042152 - status, ref SDS 23 1D4G, and so gives Millie a better chance
042153 - recovering from UCSF medical mistakes that have spread cancer, and
042154 - will not cause pain and suffering that is caused by chemotherapy.
042156 -             ..
042157 -            [On 100219 1453 Zan the pharmacist called and reported more
042158 -            chemotherapy will not be effective for Millie to recover
042159 -            from cancer, ref SDS 31 LY5F; and chemotherapy has severe
042160 -            risks of fatal infection, ref SDS 31 LY5O; Zan sent a
042161 -            letter confirming severe side effects. ref SDS 31 LP3U
042163 -             ..
042164 -            [On 100228 1322 Doctor Johnson's letter transmitting
042165 -            results of CT test ordered today (100218, ref SDS 0 M25I),
042166 -            and the doctor summarized findings that Millie's cancer is
042167 -            progressing mostly in the skin, since the report reported
042168 -            no adenopathy internally. ref SDS 32 4Q54
042170 -             ..
042171 -            [On 100301 0005 Millie's letter to the medical team submits
042172 -            agenda for meeting on 100302 to review starting another
042173 -            cycle of treatment for IBC, and progress recovering from
042174 -            shingles, and reports possible improvement in cancer, with
042175 -            new IBC lesions that were bleeding, now drying up on the
042176 -            left chest, and left arm. ref SDS 33 ON6V
042178 -             ..
042179 -            [On 100301 0005 Millie requested trade-offs between
042180 -            abraxane and other treatments targeted to the profile of
042181 -            Millie's cancer. ref SDS 33 OO7T
042183 -             ..
042184 -            [On 100301 0005 since CT test reports finding no
042185 -            adenopathy, this indicates Navelbine has been effective,
042186 -            and so if cancer marker declines or is stable, then since
042187 -            IBC rash seems to have improved, consideration should be
042188 -            given to continuing Navelbine. ref SDS 33 OO5U
042190 -             ..
042191 -            [On 100301 0005 Millie reported to medical team that Zan,
042192 -            Manager Kaiser Oncology Pharmacy, called to verify Millie
042193 -            agreed to treatment for 10th relapse of cancer with
042194 -            Abraxane that has severe side effects. ref SDS 33 OO5X
042196 -             ..
042197 -            [On 100302 0830 Doctor Johnson examination at Kaiser found
042198 -            expanding IBC rash, ref SDS 34 FB9Y, palpation found no
042199 -            swelled LNs, which aligns with the CT test on 100218 that
042200 -            reported no adenopathy in either supraclavicular nor axilla
042201 -            regions, ref SDS 34 EM4K; as a result of observable spread
042202 -            of cancer, the doctor ordered changing Millie's treatment
042203 -            from Navelbine to Abraxane to recover from the 10th relapse
042204 -            of cancer. ref SDS 34 FB67
042206 -             ..
042207 -            [On 100303 0730 Millie at Kaiser for 1st treatment of 1st
042208 -            cycle with Abraxane to recover from 10th relapse of cancer.
042209 -            ref SDS 35 625I
042211 -             ..
042212 -            [On 100303 0730 Millie's nurse, Anne, in the Kaiser
042213 -            Oncology Chemotherapy Infusion Clinic said that Abraxane is
042214 -            very expensive, because it is a new drug that extends
042215 -            capabilities of Taxol, and is only prescribed for patients,
042216 -            like Millie, who have received multiple treatments due to
042217 -            cancer mutating.  Millie's patient profile shows she is
042218 -            getting treatment for her 10th relapse, reported in the
042219 -            record on 090213 1140. ref SDS 3 AC6G
042221 -             ..
042222 -            [On 100330 0830 examination at Kaiser by Doctor Johnson,
042223 -            primary care physician, and starting 2nd cycle of Abraxane
042224 -            chemotherapy, Millie shows response to 1st cycle of
042225 -            treatment, ref SDS 36 FB9Y, including "drying up" of IBC
042226 -            nodules. ref SDS 36 HR9K
042228 -             ..
042229 -            [On 100501 1037 Millie notified medical team about Kaiser's
042230 -            new strategy to use targeted treatments instead of
042231 -            chemotherapy, ref SDS 38 F25O, for Millie to recover from
042232 -            11th relapse of cancer that seems stable to improved on
042233 -            left side, but worsening on the right side. ref SDS 38 U46S
042234 -            Millie asked to switch treatments based on examination and
042235 -            rising cancer marker CA 15-3 424. ref SDS 38 U44V  She is
042236 -            concerned about cancer cascading out of control without
042237 -            treatment for several weeks, and asks about oral treatments
042238 -            that can be taken while traveling? ref SDS 38 U44Y
042240 -             ..
042241 -            [On 100501 2017 Doctor Rugo reports plans to collaborate
042242 -            with Doctor Johnson at Kaiser on work plan for Millie to
042243 -            recover from 11th relapse of cancer caused by UCSF medical
042244 -            mistakes. ref SDS 39 HH4I
042246 -             ..
042247 -            [On 100503 1945 Kaiser notifies Millie to get remaining 2
042248 -            treatments with Abraxane chemotherapy that seems to be
042249 -            failing, and then after 3 more weeks without treatment,
042250 -            following a trip abroad, the doctor will discuss "next
042251 -            steps." ref SDS 40 YL5N
042253 -             ..
042254 -            [On 100503 2338 Millie reports to medical team that she
042255 -            will implement the Kaiser's guidance to delay changing
042256 -            treatments, and takes Kaiser's letter on 010503, as
042257 -            assurance that recovery will be equal to changing treatment
042258 -            immediately on 100505. ref SDS 41 6X7S
042260 -             ..
042261 -            [On 010505 0730 Millie received the 2nd treatment at Kaiser
042262 -            for the 3rd cycle of Abraxane chemotherapy, as ordered by
042263 -            Doctor Johnson. ref SDS 42 KE4K
042265 -             ..
042266 -            [On 100511 0900 cancer marker CA 15-3 520 increased another
042267 -            100 points, seemingly on an accelerating rise, which
042268 -            threatens to cascade out of control. ref SDS 43 L54I
042270 -             ..
042271 -            [On 100512 0730 Millie received 3rd treatment for 3rd cycle
042272 -            of Abraxane. ref SDS 44 KE4K
042274 -             ..
042275 -            [On 100601 0830 Doctor Johnson diagnosed Phlebitis, which
042276 -            can be fatal causing blood clots; he ordered treatment with
042277 -            Relafen for 2 weeks, ref SDS 45 OP4G; this is the 2nd major
042278 -            infection from treating Millie with chemotherapy that
042279 -            conflicts with patient profile, reported on 090601 0818.
042280 -            ref SDS 7 FR8L
042282 -             ..
042283 -            [On 100601 0830 Doctor Johnson advised that Kaiser has no
042284 -            treatments for Millie to recover from UCSF medical
042285 -            mistakes; therefore, she can get relief from rising pain
042286 -            caused by chemotherapy side effects, and progression of
042287 -            cancer only by entering Hospice; so Millie chose Hospice.
042288 -            ref SDS 45 P59L
042290 -  ..
042291 - Millie reported again rising pain across her left chest and wrapping
042292 - toward her back, as related to Anne, while getting treatment yesterday
042293 - on 100217 0730. ref SDS 30 698L
042295 -  ..
042296 - Doctor Johnson indicated he was not notified by the Oncology
042297 - Chemotherapy Infusion Clinic that Millie has been suffering rising
042298 - pain on her left chest and wrapping toward her back.
042300 -  ..
042301 - The doctor ordered a CT test to evaluate pain in Millie's chest and
042302 - back.
042304 -  ..
042305 - Millie explained being very discouraged by medical afflications piling
042306 - up, and side effects of chemotherapy make life torture.  Getting
042307 - shingles on 100104, has been a horribly painful, and frightening
042308 - experience, that seems worse than death. ref SDS 21 PS49  Now today,
042309 - Doctor Johnson saying she needs still more treatment for shingles and
042310 - she cannot get treatment for cancer, per above, ref SDS 0 0Y6O, makes
042311 - her feel trapped with no way out.  She feels delay getting treatment
042312 - for cancer that is both effective and enables quality of life, like
042313 - cetuximab did in 2007 and 2008, has been physically and emotionally
042314 - overwhelming.  Seeing her cancer get worse despite trying her best to
042315 - be a good partner getting chemotherapy, shows Doctor Johnson was
042316 - correct advising on 090515, that chemo is the wrong treatment for her
042317 - patient profile, and that he would get in trouble from a quality care
042318 - audit for prescribing chemotherapy. ref SDS 6 658J
042320 -  ..
042321 - Previously, the doctor warned on 080829, that Millie's cancer has
042322 - mutated to resist chemotherapy, so he planned for UCSF to treat
042323 - Millie's cancer as a chronic disease with agents "targeted" to destroy
042324 - only her cancer cells, and thereby avoid pain and suffering from
042325 - horrible side effects of chemotherapy, shown in case study on 090213
042326 - 1140. ref SDS 3 PT3N
042328 -  ..
042329 - Millie asked today why Kaiser can't order treatment with PARP instead
042330 - of chemotherapy, which Doctor Johnson explained last month is targeted
042331 - to Millie's patient profile?  At that time, Doctor Johnson advised
042332 - that PARP would be more effective than chemotherapy for Millie to
042333 - recover from UCSF medical mistakes, and would not require pausing
042334 - treatment for cancer until after Millie recovers from shingles.
042335 - ref SDS 23 N586
042337 -  ..
042338 - Doctor Johnson said he has called and called for Doctor Rugo, but she
042339 - has not had time to return his calls.
042341 -  ..
042342 - Millie related today that the past 2 months taking 2 oxycodone pills
042343 - several times a day to control pain in her head from shingles, and in
042344 - her body from chemotherapy, and from Neupogen required for
042345 - chemotherapy, which she got earlier today, per above. ref SDS 0 ER95
042346 - Being constantly drugged lowers energy, spending most of the time in
042347 - bed.  This is not a life - she might as well be dead.
042349 -  ..
042350 - Doctor Johnson reminded Millie that she has a lot to live for.  She is
042351 - generally very healthy, and looks wonderful.  The doctor noted that
042352 - new "targeted" drugs are coming along to control Millie's cancer for a
042353 - long time, and without horrific side effects of chemotherapy.  He
042354 - feels that since Millie's cancer is primarily in her skin, this is a
042355 - local problem that can be treated effectively with the right agents.
042356 -
042357 -        [On 100228 1322 CT test results received, ref SDS 32 AK5H, from
042358 -        Doctor Johnson for the test ordered today (100218, ref SDS 0
042359 -        ES3U); doctor's transmittal letter summarized findings that
042360 -        Millie's cancer is progressing mostly in the skin, since the
042361 -        report found no adenopathy internally. ref SDS 32 4Q54
042363 -         ..
042364 -        [On 100301 1023 Millie's letter to the medical team cited
042365 -        Doctor Johnson's report that results of the CT test today show
042366 -        the only medical problem to solve is cancer in the skin.
042367 -        ref SDS 33 ON6S
042369 -         ..
042370 -        [On 100302 0830 during meeting at Kaiser discussed Doctor
042371 -        Johnson's analysis in his letter on 100301, reporting resutls
042372 -        for the CT test today finding that the only problem for the
042373 -        medical team to solve in Millie's case in cancer in the skin.
042374 -        ref SDS 34 FB90
042376 -  ..
042377 - During a meeting at Kaiser a few weeks ago on 100112, Doctor Johnson
042378 - reviewed an article in Cure, an oncology periodical.  The article
042379 - reported new "targeted" drugs for cancer.  PARP was highlighted as the
042380 - most promising.  The doctor indicated PARP is particularly "targeted"
042381 - to Millie's patient profile being "triple negative," reported on
042382 - 100112 0830. ref SDS 23 N586
042384 -  ..
042385 - Millie is concerned that Doctor Johnson had a lot of problems for 6
042386 - months getting Doctor Rugo to schedule treatment with PARP, planned in
042387 - the meeting at UCSF on 090616. ref SDS 9 KD6L  Doctor Rugo didn't have
042388 - time to call nor send a letter by email, which she had done many times
042389 - before, e.g., on 090130, ref SDS 2 TZ6H, and again on 090514 0830.
042390 - ref SDS 5 DI63  Doctor Johnson didn't have time to follow up, e.g., on
042391 - 090909, ref SDS 10 3R9G, and on 091027, 091027 0830, ref SDS 13 0M3H,
042392 - Then, a few weeks ago, Doctor Rugo's assistant suddenly sent a letter
042393 - saying UCSF would not treat Millie with PARP, as UCSF and Kaiser
042394 - agreed on 090616, would be done for Millie to recover from UCSF
042395 - medical mistakes, because Millie had previously been treated with
042396 - Carboplatin in 2008. ref SDS 22 FM5I  Since UCSF applied doctor
042397 - discretion for medical necessity to treat Millie with Sunitinib and
042398 - cyclophosphamide in 2008, despite Millie's prior treatment in 2002 and
042399 - 2005 with cyclophosphamide, there seems no justification to withhold
042400 - life-saving care in 2010, with PARP to recover from UCSF medical
042401 - mistakes.
042403 -  ..
042404 - Doctor Johnson said he will try to find time for contacting Doctor
042405 - Rugo on a work plan, so that Millie's treatment with PARP is not
042406 - delayed too long for her to recover from UCSF medical mistakes.
042407 -
042408 -        [On 100427 0830 Doctor Johnson reported Millie's cancer has
042409 -        mutated to resist chemotherapy, and so she needs a new
042410 -        strategy to treat her cancer as a chronic disease with
042411 -        therapy targeted to her patient profile. ref SDS 37 SJ6N
042413 -  ..
042414 - After meeting with Doctor Johnson, Millie went to the pharmacy and
042415 - received additional treatment for shingles prescribed by Doctor
042416 - Johnson today.
042417 -
042419 -  ..
0425 -
0426 -
0427 - 1230
0428 -
042801 - Millie went to the CT Department for the test ordered by Doctor
042802 - Johnson, per above. ref SDS 0 M25I
042804 -  ..
042805 - The CT Department was unable to provide care for Millie's patient
042806 - profile that requires injecting contrast medium through Millie's Power
042807 - Port.
042809 -  ..
042810 - Cassandra was the technician for Millie's test today.
042812 -  ..
042813 - She advised that the CT Department is formulating a protocol for using
042814 - Power Ports to inject contrast medium.
042816 -  ..
042817 - Millie was elated that the Kaiser CT Department has finally
042818 - implemented recommendations submitted previously in a letter to the
042819 - medical team on 090922 0028, ref SDS 12 NW8X, proposing that Kaiser
042820 - develop a protocol to solve problems using Power Ports for CT testing
042821 - on 090919 0742, ref SDS 11 MI9Q
042823 -  ..
042824 - Improvments in the CT Department to support Power Port technology
042825 - aligns with changes upgrading the Emergency Room Department also
042826 - reported on 090919 0742. ref SDS 11 QZ45
042828 -  ..
042829 - Cassandra clarified that this protocol is not yet implemented, since
042830 - it requires department technicians to get training for certification,
042831 - as related by Ike during the meeting at Kaiser on 080711. ref SDS 1
042832 - JQ55
042834 -  ..
042835 - Cassandra proposed that rather than inconvenience the CT Department
042836 - nor the Interventional Radiology Department, that Millie take a chance
042837 - on a CT Department technician to try once making an IV needle
042838 - penetration for injecting contrast medium.  Cassandra said that if
042839 - this fails, then the Department will coordinate with Interventional
042840 - Radiology to perform the work using Millie's Power Port that aligns
042841 - with Millie's patient profile.
042843 -  ..
042844 - Since the last 2 needle penetrations were effective in the lab getting
042845 - blood draws, because of mistakes in the Oncology Chemotherapy Infusion
042846 - Clinic, Millie agreed to trying the needle penetration today for
042847 - injecting contrast medium.  She feels that recent experience may
042848 - indicate that her veins have healed so that needle penetrations can be
042849 - done normally.
042851 -  ..
042852 - Cassandra was successful with the first try making an IV needle
042853 - penetration, and the rest of the test went smoothly.
042854 -
042856 -  ..
0429 -
0430 -
0431 - 1353
0432 -
043201 - Millie arrived home.
043202 -
043203 -
043204 -
043205 -
043206 -
043207 -
043208 -
0433 -