CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 24 0000. ref SDS 22 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 2
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy.  The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 2 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 3 F25O
040915 -  ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 4 HH4I
040920 -  ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 5 YX8L  Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 5 MZ4N
040926 -  ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 6 TD5W
040930 -  ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 7 YL5N
040936 -  ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 8 6X7S
040942 -  ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 9 NT5N
040949 -  ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 10 KE4K
040954 -  ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 11
040958 - L54I
040960 -  ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 12 KE4K
040964 -  ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 13 PK9O
040967 -  ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 14 IZ7N
040973 -  ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 15 QQ6N
040978 -  ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 16 4W5F
040983 -  ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes.  He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice.  Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 -  ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 3 036C
041001 -  ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 4
041007 - 036C
041009 -  ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 21 036C  Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 21 MZ5H  Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 21 UN4M  Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 21 I33H  Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 21 UN5P
041023 -  ..
041024 - On 100603 0449 Millie submits record to medical team confirming
041025 - understandings, ref SDS 22 036C
041027 -  ..
041028 - On 100605 1817 Doctor Johnson responded to Millie's letter on 100603,
041029 - explaining Millie's medical right to choose level of pain getting
041030 - Hospice care, ref SDS 24 036C; does not address patient right to choose
041031 - life rather than death in Hospice. ref SDS 24 4R5J
041033 -  ..
041034 - On 100605 1838 Millie relates bad experience getting people to listen
041035 - that makes case management emotionally traumatic. ref SDS 0 036C
041036 -
041037 -
041038 -
041040 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Millie's letter to Doctor Johnson at Kaiser says...
041402 -
041403 -    1.  Subject: Re: Cancer 11th Relapse Work Plan - Hospice Started
041404 -        Date: Sat, 05 Jun 2010 18:53:28 -0700
041411 -         ..
041412 -    3.  Thanks very much for your letter today on pain v consciousness
041413 -        dilemma [reported in Millie's letter to medical team on 100603
041414 -        0449. ref SDS 22 IX8R and citing Millie's meeting with Liz the
041415 -        Hospice rep, also on 100602 0913. ref SDS 20 NN8F].  The past
041416 -        few days I have been more alert and active, I guess with
041417 -        effects of chemo wearing off.
041419 -         ..
041420 -    4.  Good news - my left arm keeps looking better with less IBC and
041421 -        lymphedema.  Wish I could say the same about the right chest,
041422 -        flowing from the wound in the breastbone.
041424 -         ..
041425 -    5.  As well, swelling from phlebitis has gone down in my legs,
041426 -        responding to treatment you prescribed on Tuesday.  Liz feels
041427 -        this will also reduce pressure on my right chest from IBC.
041429 -         ..
041430 -    6.  I was disappointed that Linda seemed unaware on Friday that I
041431 -        told Liz on Wednesday, I want to avoid more morphine [reported
041432 -        on 100604 1350, ref SDS 23 XL51].  Linda showed me Liz's notes
041433 -        on our 2-hour meeting Wednesday, handwritten on a 3 x 5 card.
041434 -        Had about 2 sentences, which I could not make out, and Linda
041435 -        seemed uncertain what was written. ref SDS 23 XL7M
041437 -         ..
041438 -    7.  This whole experience is emotional.  After Liz left, I was
041439 -        crying to Rod that I did not want to be a zombie like the past
041440 -        6 months in bed with side effects of chemo that didn't work.
041441 -        Confirmation was sent to the team through you on 100603 0449,
041442 -        ref SDS 22 IX8R, but nobody seems to listen.  During the
041443 -        meeting on Friday, I tried to tell Linda what was discussed
041444 -        with Liz.  However, verbal discussion goes off in different
041445 -        directions, sweeping people away with momentary feelings.
041446 -        Linda called you to get approval on increasing morphine, and
041447 -        she called and got support from Bob the pharmacist.  So, like
041448 -        entering Hospice, that's what I'm doing.  People don't realize
041449 -        that complicated problems are hard to discuss in meetings.
041450 -
041451 -            [On 100607 1243 Judy reported that searching the records
041452 -            does not show Millie has an Advance Directive on file at
041453 -            Kaiser; Judy will investigate and let Millie know if this
041454 -            work needs to be done again. ref SDS 27 AO6J
041456 -         ..
041457 -    8.  Good news is that I like Linda a lot.  She's fun, very
041458 -        energetic, and dedicated to patient care, a lot like Tara at
041459 -        UCSF.  As well, so far two morphine tablets started last night
041460 -        have been okay, since I have not needed Percocet today.
041461 -        Probably will need even more morphine later.  I was just hoping
041462 -        to get there gradually.
041464 -         ..
041465 -    9.  Did you get results of CA 15-3 for the lab on 100529 [cited as
041466 -        a big worry in Millie's letter to the medical team on 100601
041467 -        0136. ref SDS 17 1Q3P, requested in Millie's letter to Kaiser
041468 -        on 100603 0449, ref SDS 22 IX5R, and not submitted in Kaiser's
041469 -        letter earlier today on 100605 1817. ref SDS 24 036C
041470 -
041471 -            [On 100606 1604 Doctor Johnson reports Millie's cancer
041472 -            marker for lab on 100529 was CA 15-3 606, ref SDS 25 8H5I,
041473 -            considerably less than expected in Millie's letter on
041474 -            100601 0136. ref SDS 17 1Q3P
041476 -             ..
041477 -            [On 100606 1638 Millie thanks Doctor Johnson for submitting
041478 -            results of lab on 100529, showing less increase in cancer
041479 -            marker than exptected, even after 3 weeks without
041480 -            treatment, ref SDS 26 036C, and indicating there is still
041481 -            no internal involvement. ref SDS 26 PQ6V
041483 -         ..
041484 -   10.  Anyway, today was a good day, feeling the future will be smooth
041485 -        sailing, like the cruise last week...
041486 -
041487 -           
041489 -         ..
041490 -   11.  Hope all is well with you.
041491 -
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041500 -
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041502 -
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0416 -