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: June 6, 2010 04:04 PM Sunday; Rod Welch

Doctor Johnson notifies Millie cancer marker CA 15-3 moderate rise.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 26 0000. ref SDS 25 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 Kaiser's new
040912 - strategy to treat Millie's cancer with "targeted therapy." ref SDS 3
040913 - F25O  Millie requests Kaiser immediately switch from Abraxane
040914 - chemotherapy that has failed, and implement Doctor Rugo's plan at UCSF
040915 - on 090616, to treat Millie with PARP that is "targeted" to Millie's
040916 - rare patient profile of "triple negative" and avoids pain and
040917 - suffering from chemotherapy side effects, and for the purpose of
040918 - recovering from UCSF medical mistakes. ref SDS 3 U47P and ref SDS 3
040919 - U49V
040921 -  ..
040922 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040923 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040924 - of cancer caused by UCSF medical mistakes. ref SDS 4 HH4I
040926 -  ..
040927 - On 100502 2143 Kaiser confirms that some patients respond well to new
040928 - "targeted" therapies. ref SDS 5 YX8L  Kaiser contends that all of the
040929 - strategies for "targeted" therapies have been executed for Millie,
040930 - which seems conflicting with the record in this case. ref SDS 5 MZ4N
040932 -  ..
040933 - On 100503 1522 Millie notifies medical team that time of the essence
040934 - to get the next treatment going. ref SDS 6 TD5W
040936 -  ..
040937 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040938 - with Abraxane chemotherapy that seems to be failing, and then after 3
040939 - more weeks without treatment, following a trip abroad, the doctor will
040940 - discuss "next steps." ref SDS 7 YL5N
040942 -  ..
040943 - On 100503 2338 Millie reports to medical team that she will implement
040944 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040945 - letter on 010503, as assurance that recovery will be equal to changing
040946 - treatment immediately on 100505. ref SDS 8 6X7S
040948 -  ..
040949 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040950 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040951 - communicate with Doctor Johnson, or had already done so, to coordinate
040952 - with Kaiser on planning Millie's next treatment to recover from the
040953 - 11th relapse of cancer. ref SDS 9 NT5N
040955 -  ..
040956 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040957 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040958 - ref SDS 10 KE4K
040960 -  ..
040961 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040962 - seemingly on an accelerating rise, which threatens to cascade out of
040963 - control, because Abraxane chemotherapy is not effective. ref SDS 11
040964 - L54I
040966 -  ..
040967 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040968 - Abraxane. ref SDS 12 KE4K
040970 -  ..
040971 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 13 PK9O
040973 -  ..
040974 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040975 - Department for standard of care to recover from 11th relapse of cancer
040976 - caused by medical mistakes getting radiation treatments at UCSF on
040977 - referral from Kaiser. ref SDS 14 IZ7N
040979 -  ..
040980 - On 100528 0322 Millie requests support from Medicare to separate
040981 - recovery for medical mistakes getting radiation from UCSF, from health
040982 - care benefits limited by Medicare insurance coverage. ref SDS 15 QQ6N
040984 -  ..
040985 - On 100528 1031 called Medicare they have formed a team to review
040986 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040987 - response to Millie's claim. ref SDS 16 4W5F
040989 -  ..
040990 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040991 - collaborate with UCSF on treatment for Millie to recover from UCSF
040992 - medical mistakes.  He discussed treating Millie with MPA, but this was
040993 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040994 - ended the treatment due to fears about blood clot side effects, which
040995 - were believed to cause breathing problems Millie had, though later
040996 - breathing problems were discovered to be caused by defective radiation
040997 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040998 - for Millie, the only way Millie can get relief from pain caused by
040999 - cancer that is progressing without treatment is get treatment in
041000 - Hospice.  Since Hospice is the only choice of care offered today,
041001 - Millie accepted this.
041003 -  ..
041004 - On 100601 1531 Sharon called to schedule starting Hospice medical
041005 - services beginning tomorrow between 0900 - 1000. ref SDS 3 036C
041007 -  ..
041008 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041009 - Sharon's report yesterday, that if Kaiser performs on the insurance
041010 - agreement to provide standard of care for Millie's patient profile,
041011 - than Millie can elect to recover from 11th relapse of cancer, rather
041012 - than continue with Hospice support for dying peacefully. ref SDS 4
041013 - 036C
041015 -  ..
041016 - On 100602 1046 Diane received notice from Medicare to file claim for
041017 - Millie to get treatment for recovering from UCSF medical mistakes; she
041018 - is preparing a statement of claim. ref SDS 22 036C  Advised Diane to
041019 - use Millie's statement of claim submitted to Kaiser on 100527.
041020 - ref SDS 22 MZ5H  Eileen called later and reported that Kaiser denied
041021 - Millie's claim on the grounds that Medicare does not authorize payment
041022 - for treatment to recover from cancer, after a patient starts Hospice.
041023 - ref SDS 22 UN4M  Requested that Eileen read he claim and then make a
041024 - good faith determiantion. ref SDS 22 I33H  Eileen called back after
041025 - reading the claim and advised the denial of claim has been withdrawn,
041026 - and the matter is referred to Claims Resolution Department.
041027 - ref SDS 22 UN5P
041029 -  ..
041030 - On 100603 0449 Millie submits record to medical team confirming
041031 - understandings, ref SDS 23 036C
041033 -  ..
041034 - On 100605 1817 Doctor Johnson responded to Millie's letter on 100603,
041035 - explaining Millie's medical right to choose level of pain getting
041036 - Hospice care, ref SDS 25 036C; does not address patient right to choose
041037 - life rather than death in Hospice. ref SDS 25 4R5J
041039 -  ..
041040 - On 100605 1838 Millie relates bad experience getting people to listen
041041 - that makes case management emotionally traumatic. ref SDS 26 036C
041043 -  ..
041044 - On 100606 1604 Doctor Johnson submits results of Millie's lab test on
041045 - 100529 shows CA 15-3 606, must less than expected. ref SDS 0 036C
041046 -
041047 -
041048 -
041049 -
041051 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Doctor Johnson submits Millie's cancer marker for lab on 100529...
041402 -
041403 -    1.  Subject: Re: Cancer 11th Relapse Work Plan - Hospice Started
041404 -        Date: Sun, 6 Jun 2010 15:07:02 -0700
041405 -        From: Robert.A.Johnson@kp.org
041406 -        To: milliebuck@pacbell.net
041408 -         ..
041409 -    2.  Glad you are settling in to Hospice.  Here is your latest flow
041410 -        sheet [requested in Millie's letter yesterday on 100605 1838,
041411 -        ref SDS 26 CG8V, for the lab test on 100529 0930. ref SDS 17
041412 -        L54I
041413 -
041414 -          DATE   TIME  |    CA 15-3
041415 -        ---------------+-----------
041416 -        05/29/10 09:24 |      606 H
041417 -        05/11/10 10:43 |      520 H
041418 -        04/26/10 10:48 |      424 H
041419 -        04/13/10 10:37 |      367 H
041420 -        03/29/10 08:45 |      384 H
041421 -        03/16/10 10:28 |      369 H
041422 -        03/01/10 13:37 |      426 H
041423 -        02/16/10 10:58 |      328 H
041424 -        02/02/10 10:15 |      275 H
041425 -        01/11/10 10:47 |      212 H
041426 -
041427 -           [On 100606 1638 Millie thanks Doctor Johnson for submitting
041428 -           results of lab on 100529, showing less increase in cancer
041429 -           marker than exptected, even after 3 weeks without
041430 -           treatment, ref SDS 27 036C, and indicating there is still
041431 -           no internal involvement. ref SDS 27 PQ6V
041433 -            ..
041434 -           [On 100702 1424 Millie received a letter in the mail dated
041435 -           100624, from Doctor Johnson transmitting Kaiser's lab
041436 -           report for Millie's blood test on 100622.  The doctor
041437 -           provides no analysis, nor comment of any kind except he
041438 -           circuled in ink "CA 15-3 1116." ref SDS 28 NC3F
041439 -
041455 -
041456 -
041457 -
041458 -
041459 -
041460 -
041461 -
041462 -
041463 -
041464 -
041465 -
041466 -
041467 -
0415 -