THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: April 7, 2010 07:30 AM Wednesday; Rod Welch

Millie 2nd treatment 2nd cycle Abraxane at Kaiser recover 10th relaspe

1...Summary/Objective


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SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 40 0000. ref SDS 39 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
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 40 KE4K
040976 -  ..
040977 - On 100331 0730 Millie had the 1st treatment for the 2nd cycle of
040978 - Abraxane. ref SDS 42 KE4K
040980 -  ..
040981 - On 100406 0830 Millie had a blood draw at the Kaiser Clinic in
040982 - Martinez. ref SDS 43 AS5H
040984 -  ..
040985 - On 100407 0730 Millie had the 2nd treatment for the 2nd cycle of
040986 - Abraxane. ref SDS 0 KE4K
040987 -
040988 -
040990 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Today starts 2nd 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 - Anne 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 good this morning.   Millie's blood pressure has creeped
041319 - up above 140 90
041321 -  ..
041322 - The lab reported Millie has good blood counts from the test yesterday
041323 - on 100406 0830. 100406 0830, ref SDS 43 NK7F approved Millie to start
041324 - the 2nd treatment for the 2nd cycle with Abraxane chemotherapy today,
041325 - prescribed during the meeting at Kaiser on 100330 0830. ref SDS 39
041326 - FB9Y
041327 -
041328 -
041329 -
041330 -
041331 -
041332 -
0414 -