CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 39 0000. ref SDS 36 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - Recent background is listed on 100301 0005. ref SDS 26 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 27 FC34
040909 -  ..
040910 - On 100302 0830 Doctor Johnson ended Millie's treatment for shingles
040911 - with Acyclovir (Zovirax). ref SDS 27 FU5F  He advised that Abraxane
040912 - causes low blood counts, and low blood counts weaken the immune
040913 - system, making Millie more likely for shingles to recur. ref SDS 27
040914 - IC4N
040916 -  ..
040917 - On 100303 CA 15-3 426 from blood test on 100301 showed another 100
040918 - point rise over the past 2 weeks, while Millie was off treatment for
040919 - the bye-week.
040921 -  ..
040922 - On 100303 Anne confirmed that Abraxane chemotherapy causes low
040923 - blood counts. ref SDS 28 8U95
040925 -  ..
040926 - On 100309 1238 Millie notifies medical team that shingles seems not to
040927 - have recurred despite side effects of Abraxane that lower immunity by
040928 - degrading bone marrow that replenishes blood counts. ref SDS 31 ER95
040929 - Millie further reported that Kaiser's Knowledge Management system was
040930 - of -line and so could not access results of blood test. ref SDS 31
040931 - HL4V
040933 -  ..
040934 - On 100309 1643 Millie notifies medical team that blood counts from the
040935 - lab at Kaiser in the morning of 100309 show significant recovery above
040936 - requirements for getting chemotherapy treatment; since shingles has
040937 - not recurred, Millie is "good-to-go" for treatment on 100310 0730.
040938 - ref SDS 32 2O8W
040940 -  ..
040941 - On 100309 1643 Millie notifies medical team commending Doctor Johnson
040942 - for prescribing only 1 Neupogen treatment to recover from low blood
040943 - counts caused by Abraxane. ref SDS 32 2O9P
040945 -  ..
040946 - On 100310 0730 Millie received the 2nd treatment for the first cycle
040947 - of Abraxane. ref SDS 33 KE4K  Doctor Johnson visited Millie and
040948 - approved treatment based on bood blood counts and no signs of shingles
040949 - recurrence. ref SDS 33 OR3H   The doctor repeated prior notice that
040950 - Kaiser's internal proprietary email system is faster for emergency
040951 - communications. ref SDS 33 OR71
040953 -  ..
040954 - On 100310 1350 Millie notified the medical team that 2nd treatment
040955 - with Abraxane was completed at Kaiser, ref SDS 34 ER95, Millie
040956 - reported that Kaiser's internal proprietary email system has been out
040957 - of service for a week. ref SDS 34 GY4U  Millie further explained that
040958 - faster emergency communications using Kaiser's internal proprietary
040959 - email system is less beneficial than using commercial public domain
040960 - email addresses for doctors at Kaiser that enable timely coordination
040961 - and collaboration among the medical team, which is more advantages to
040962 - survival than improving emergency communications, which rarely occur
040963 - in Millie's case. ref SDS 34 GY6P
040965 -  ..
040966 - On 100317 0730 Millie received the 3rd treatment that completes the
040967 - 1st cycle with Abraxane to recover from the 10th relapse of cancer.
040968 - At this time, Millie is experiencing rising pain from progressing IBC,
040969 - and rising lymphedema, most noticably in the right arm, which has been
040970 - free of disease for 10 years. ref SDS 36 KE4K
040972 -  ..
040973 - On 100330 0830 Doctor Johnson approved Millie to start the 2nd cycle
040974 - of Abraxane to recover from the 10th relapse of cancer. ref SDS 0 KE4K
040976 -  ..
040977 - On 100331 0730 Millie had the 1st treatment for the 2nd cycle of
040978 - Abraxane. ref SDS 0 KE4K
040979 -
040980 -
040982 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Today starts 1st treatment of the 2nd 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 25 PP5Y
041305 -  ..
041306 - Barbara is Millie's nurse today.
041308 -  ..
041309 - Swelling in both arms again requires taking vitals in the leg, rather
041310 - than the right arm, previously reported in Millie's letter to the
041311 - medical team on 100204 1325, ref SDS 22 SB8U, reflecting observations
041312 - by Anne in the Chemotherapy Clinic on 100317 0730, ref SDS 36 QR4X,
041313 - and noted in Millie's letter to the team on 100329 2322. ref SDS 38
041314 - WA8P, and observed by Doctor Johnson during examination at Kaiser on
041315 - 100330 0830. ref SDS 39 C54N
041317 -  ..
041318 - Vitals are very good this morning.
041320 -  ..
041321 - The lab reported Millie has good blood counts from the test on 100329
041322 - 0830. ref SDS 37 AS5H, and so yesterday, Doctor Johnson approved
041323 - Millie to start the 2nd cycle with Abraxane chemotherapy today,
041324 - reported during the meeting at Kaiser on 100330 0830. ref SDS 39 FB9Y
041326 -  ..
041327 - Barbara submitted the report for Millie's blood test yesterday, which
041328 - shows...
041329 -
041330 -                    ANC..... 3200
041332 -  ..
041333 - This translates to NEUTS 3.20, which is well above 1.5 required for
041334 - standard of care to safely provide chemotherapy treatment.
041336 -  ..
041337 - Cancer marker CA 15-3 384 reported for the lab on Monday, 100329,
041338 - increased from 369 during the 2 weeks, since Millie's last treatment
041339 - ending the 1st cycle with Abraxane on 100317. ref SDS 36 KE4K  This
041340 - slight increase in the cancer marker after the 1st cycle of Abraxane
041341 - chemotherapy aligns with the pattern of recent chemotherapy regimins
041342 - with Gemzar and Navelbine, first declining, then registering a slight
041343 - increase, and then dropping signficantly, shown in case study on
041344 - 090323 1352. ref SDS 3 J13O
041346 -  ..
041347 - Barbara made examination and confirmed there is no evidence of
041348 - shingles recurrence on Millie's right forehead, confirming findings
041349 - during meeting with Doctor Johnson yesterday on
041350 -
041351 -        ********************************************
041352 -        ********************************************
041354 -  ..
041355 - Since Millie passed the two criteria Doctor Johnson set during the
041356 - meeting at Kaiser on 100302 for Millie to get chemotherapy, i.e., good
041357 - blood counts and no evidence of shingles, ref SDS 27 FC68, Barbara
041358 - started Millie's treatment with Abraxane.
041360 -  ..
041361 - Millie reported side effects of Abraxane and Neupogen so far are
041362 - extreme fatigue; although this week her energy has been up.  On
041363 - Saturday, Millie hiked for nearly 3 miles, and on Monday, Millie
041364 - hiked about 3.2 miles.  Yesterday, however, was not a good day.
041365 -
041366 -        *********************************************
041367 -        *********************************************
041369 -  ..
041370 - Visited with Cisi about scheduling Millie's treatments at 0730, which
041371 - is the usual time.  Cisi didn't know why Millie was suddenly and
041372 - without notice scheduled for treatment at 0800 today, after a year
041373 - getting treatment at 0730.
041375 -  ..
041376 - Cisi was concerned that customers cannot visit her at the clinic desk.
041377 - She feels this presents a security threat because information about
041378 - customers is laying open on the desk.  It was not clear that more
041379 - information about customers is open on Cisi's desk than on 4 or 6
041380 - other desks and computes which are open for all customers to observe
041381 - in the treatment clinic area.  This admonition, therefore, seems like
041382 - a refusal of the Charge Nurse to support the customer.
041384 -  ..
041385 - Cisi advised that Millie's nurse can schedule the work.
041387 -  ..
041388 - Talked with Barbara.  She said nurses can request schedule dates, but
041389 - others set the priorities.  She looked at Millie's schedule, and said
041390 - she will try to correct the schedule to continue past practice of
041391 - giving treatment at 0730.
041393 -  ..
041394 - Later saw Cisi in the hallway on the way back from Doctor Johnson's
041395 - office.  Cisi was again emotionally concerned about hospital security.
041396 - She planned to notify security police to prevent seeing the doctor for
041397 - 2 minutes, while Millie was treated in the clinic.
041399 -  ..
041400 - A few weeks ago, Cisi complained about compromising hospital security
041401 - from working in the conference room in the morning at 0730 before
041402 - everybody else starts work, reported on 100317 0730. ref SDS 36 AV5H
041404 -  ..
041405 - Cisi said today that Brigid presented a negative report on calling to
041406 - convey Cisi's fear about compromising hospital security working in the
041407 - Oncology Conference room for a few minutes, while Millie gets
041408 - chemotherapy treatment.
041410 -  ..
041411 - As a result, today, even though the conference room remained empty,
041412 - Cisi objected to visiting the doctor for a few minutes.
041413 -
041414 -
041415 -
041416 -
041417 -
041418 -
041419 -
041420 -
041421 -
0415 -