CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 26 0000. ref SDS 22 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - Recent background is listed on 100301 0005. ref SDS 24 625I
040903 -  ..
040904 - On 100302 0830 Doctor Johnson made another examination and confirmed
040905 - diagnosis that Millie's cancer has progressed, and so he ended
040906 - treatment with Navelbine, and ordered treatment to start today with
040907 - Abraxane. ref SDS 25 FC34
040909 -  ..
040910 - Last week on 100303 CA 15-3 426 from blood test on 100301 showed
040911 - another 100 point rise over the past 2 weeks, while Millie was off
040912 - treatment for the bye-week.
040914 -  ..
040915 - This major rise of 200 in the cancer marker for the lab on 100301,
040916 - supports finding Millie's cancer mutated again causing Navelbine to
040917 - fail.  Strong evidence that Millie's cancer is progressing more
040918 - vigorously requires switching treatments, as presented in the letter
040919 - to the medical team on 100301. ref SDS 24 OO3X  Yesterday, during the
040920 - meeting at Kaiser on 100302 0830, Doctor Johnson decided to order
040921 - treatment with Abraxane as the first effort for Millie to recover from
040922 - her 10th relapse of cancer. ref SDS 25 FC34
040924 -  ..
040925 - On 100302 0830 Doctor Johnson ended Millie's treatment for shingles
040926 - with Acyclovir (Zovirax). ref SDS 25 FU5F  He advised that Abraxane
040927 - causes low blood counts, and low blood counts weakens the immune
040928 - system, making Millie more likely for shingles to recur. ref SDS 25
040929 - IC4N  On 100303 Anne confirmed that Abraxane chemotherapy causes low
040930 - blood counts. ref SDS 26 8U95
040932 -  ..
040933 - On 100309 1238 Millie notifies medical team that shingles seems not to
040934 - have recurred despite side effects of Abraxane that lower immunity by
040935 - degrading bone marrow that replenishes blood counts. ref SDS 29 ER95
040936 - Millie further reported that Kaiser's Knowledge Management system was
040937 - of -line and so could not access results of blood test. ref SDS 29
040938 - HL4V
040940 -  ..
040941 - On 100309 1643 Millie notifies medical team that blood counts from the
040942 - lab at Kaiser in the morning of 100309 show significant recovery above
040943 - requirements for getting chemotherapy treatment; since shingles has
040944 - not recurred, Millie is "good-to-go" for treatment on 100310 0730.
040945 - ref SDS 30 2O8W
040947 -  ..
040948 - On 100309 1643 Millie notifies medical team commending Doctor Johnson
040949 - for prescribing only 1 Neupogen treatment to recover from low blood
040950 - counts caused by Abraxane. ref SDS 30 2O9P
040951 -
040953 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Today starts 2nd treatment of the 1st cycle with Abraxane for Millie
041302 - to recover from the 10th relaspe of cancer, diagnosed on 100218 during
041303 - emergency meeting with Doctor Johnson. ref SDS 23 PP5Y
041305 -  ..
041306 - Nadine is Millie's nurse today.
041308 -  ..
041309 - Vitals are very good this morning.
041311 -  ..
041312 - Nadine submitted the report for Millie's blood test yesterday.  She
041313 - entered on the report in handwritting...
041314 -
041315 -                    ANC..... 4340
041317 -  ..
041318 - This translates to NEUTS 4.34, which is well above 1.5 required for
041319 - standard of care to safely provide chemotherapy treatment.
041321 -  ..
041322 - Nadine made examination and confirmed there is no evidence of shingles
041323 - recurrence on Millie's right forehead.
041325 -  ..
041326 - Since Millie passed the two criteria Doctor Johnson set during the
041327 - meeting at Kaiser on 090302 for Millie to get chemotherapy,
041328 - ref SDS 25 FC68, Nadine started Millie's treatment with Abraxane.
041330 -  ..
041331 - Millie reported side effects so far are extreme fatigue; until
041332 - yesterday, Millie spent most of the time in bed this past week.
041333 -
041335 -  ..
0414 -
0415 -
0416 - 0810
0417 -
041701 - Doctor Johnson visited with Millie to evaluate shingles recurrence,
041702 - reported in Millie's letter to the team on 100304 2251. ref SDS 27
041703 - OP6W  The doctor concurred with Millie's report the next day that
041704 - shingles seems to have subsided, shown in the record on 100305 0822.
041705 - ref SDS 28 0V6U  The doctor further concurred with Nadine's
041706 - examination earlier this morning that shingles has remained
041707 - controlled, per above. ref SDS 0 IO6P
041709 -  ..
041710 - The doctor did not prescribe treatment for shingles to have available
041711 - for timely recover in order to maintain treatment for cancer,
041712 - presented in Millie's letter on 100305 0822. ref SDS 28 0W3T
041713 -
041714 -            [On 100330 0830 Doctor Johnson examination at Kaiser finds
041715 -            no evidence of shingles recurrence, makes no assessment of
041716 -            the cause for increased pain on the forehead, head, neck,
041717 -            and across the upper back, ref SDS 33 FU5F; and, which was
041718 -            reported to the medical team the day before on 100329,
041719 -            ref SDS 32 WA8Y; the doctor does not extend prescription
041720 -            for Acyclovir (Zovirax) medication to be prepared for
041721 -            recovering from shingles recurrence, ref SDS 33 4E48, which
041722 -            Millie requested on 100305, ref SDS 28 0W3T, and in order
041723 -            to recover from shingles with enough time to maintain
041724 -            continuity of treatment to avoid death by recovering from
041725 -            cancer; instead, additional pain medication was prescribed
041726 -            with morphine. ref SDS 33 FB55
041728 -  ..
041729 - Doctor Johnson was very pleased Millie's blood counts recovered this
041730 - week with only 1 Neupogen treatment.
041732 -  ..
041733 - Since blood counts are strong today, and there is no evidence shingles
041734 - has recurred, Doctor Johnson approved Millie getting the 2nd treatment
041735 - with Abraxane chemotherapy today.
041737 -  ..
041738 - Millie thanked Doctor Johnson for visiting during treatment.  There
041739 - are many pending issues for the medical team, listed in the letter on
041740 - 100301.  The most urgent task pending since March of 2009 is to submit
041741 - a treatment plan with trade-offs for alternate oncology treatments
041742 - needed to recover from medical mistakes which UCSF made providing
041743 - radiation treatment on referral from Kaiser. ref SDS 24 PQYX
041745 -  ..
041746 - This morning, the doctor was hurried due a hectic schedule.
041748 -  ..
041749 - Doctor Johnson reminded Millie of his letter on 090205 explaining that
041750 - he checks Kaiser's internal proprietary email system more often than
041751 - regular email. ref SDS 1 278T  Therefore emergency communications get
041752 - faster attention using Kaiser's internal email system.  The doctor
041753 - sent another letter on 090406 1237, also reminding that emergency
041754 - communications get faster review that using public domain email
041755 - addresses for doctors at Kaiser. ref SDS 3 BY8J
041757 -             ..
041758 -            [On 100310 1350 Millie denied access to Kaiser's Knowledge
041759 -            Management proprietary, internal email system still
041760 -            off-line after primary care physician recommends using the
041761 -            Kaiser email system for emergency communications,
041762 -            ref SDS 31 GY4U
041764 -  ..
041765 - The record on 090205 presents analysis and case studies showing Millie
041766 - has bigger advantages communicating with the medical team using public
041767 - domain email addresses for doctors at Kaiser. ref SDS 1 YU4L  Millie's
041768 - care has been optimized by balancing bigger advantages of public
041769 - domain email compared to minimal benefits of slightly increased
041770 - confidentiality using Kaiser's email system, reported by Doctor
041771 - Johnson on 090213 1140. ref SDS 2 4W72  The doctor made the same point
041772 - again recently on 100302 0830. ref SDS 25 FC67
041774 -             ..
041775 -            [On 100310 1350 Millie explains again to the medical team
041776 -            that public domain email addresses for doctors at Kaiser
041777 -            are secure enough for confidentiality in Millie's case;
041778 -            regular email also leverages the power of knowledge through
041779 -            collaboration among the medical team by keeping "everybody
041780 -            on the same page," which enables Millie to survive 3 - 4
041781 -            times longer than patients using Kaiser's internal KM email
041782 -            system, which does not support collaboraton. ref SDS 31
041783 -            GY6P
041785 -  ..
041786 - On 100108 Millie notified the doctor that Kaiser denied access to a
041787 - "Securemail". ref SDS 14 MW4P
041789 -  ..
041790 - On 100301 Millie notified the medical team to use public domain email
041791 - addresses for doctors at Kaiser. ref SDS 24 OP4V
041793 -  ..
041794 - On 100309 Millie notified the medical team that Kaiser's Knowldge
041795 - Management system has been off-line for a week. ref SDS 29 HL4V
041796 -
041797 -
041798 -
041799 -
041800 -
041801 -
041802 -
041803 -
0419 -