CONTACTS 

SUBJECTS
Orientation Rosalie to Begin Treatments Chemotherapy Taxol Side Effe

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 4 0000, ref SDS 3 0000.
040502 -
040503 - Drove to Kaiser and Met with Rosalie.  She did not mention having
040504 - received Millie's letter on 040415. ref SDS 2 J77L
040506 -  ..
040507 - She submitted more documents and reviewed the protocol, including side
040508 - effects again, supplementing review with Rosalie on 040402.
040509 - ref SDS 1 BK8M
040511 -  ..
040512 - Millie provided a urine sample, which is required for participation
040513 - the Avastin study.
040515 -  ..
040516 - Millie asked how many other patients at the Kaiser Walnut Creek
040517 - hospital are being treated with Avastin?
040519 -  ..
040520 - Rosalie seemed to say 10 - 12.
040521 -
040522 -
040523 -
040524 -
040525 -
0406 -

SUBJECTS
Chemotherapy Taxol Avastin Bevacizamub VEGF Treatments Begin Today

0503 -
0504 - 1210
050501 -  ..
050502 - Cancer Treatments and Avastin Trial Protocol Begins
050503 -
050504 - Rosalie took Millie into the chemo treatment area and introduced
050505 - Vicki, who administers the drugs.
050507 -  ..
050508 - The treatment center was bursting with activity, much busier than we
050509 - remembered from treatments in 2002.  There were no empty chairs, and
050510 - the nurses were in constant motion tending to patients.
050512 -  ..
050513 - Vickie took two vials of blood samples from Millie's right arm.
050515 -  ..
050516 - Millie complimented Vicki on finding a vein quickly and with minimal
050517 - discomfort.  This has been an issue previously.
050519 -  ..
050520 - Vicki noted from Millie's chart that a port catheter was installed
050521 - yesterday in Martinez. ref SDS 4 0001  She commented that on prior
050522 - assignments with other hospitals the port has been used immediately.
050523 - Kaiser has a policy of waiting a week, which therefore required Vicki
050524 - to place a needle for an IV into a vein in Millie's right hand.
050525 -
050526 -
050528 -  ..
0506 -
0507 -
0508 - 1226
0509 -
050901 - Vicki started Millie on an intravenous medication that is a
050902 - preparation for Taxol. She explained the pre-treatment drugs help
050903 - avoid allergic reaction to the chemotherapy drugs, including Avastin.
050904 -
050905 -     [On 040517 Doctor Johnson explains patient's difficulty breathing
050906 -     and extended cough for several hours may be reaction to allergy.
050907 -     ref SDS 6 035L
050909 -      ..
050910 -     [On 040601 the record of treatment on 040601 reports there have
050911 -     been no further episodes of difficulty breathing and coughing, as
050912 -     reported on 040517. ref SDS 7 X44L
050914 -  ..
050915 - This pre-treatment medication will take about 20 - 30 minutes, then
050916 - there will be another preparation medication, Benadryl, for another 10
050917 - minutes or so.  After that Taxol will be administered for about 90
050918 - minutes on this first treatment.  Subsequent treatments will speed the
050919 - rate of administering the medication, based on experience showing
050920 - tolerance for Taxol.
050922 -  ..
050923 - After Taxol, Bevacizumab (Avastin) will be administered.
050924 -
050925 -
050927 -  ..
0510 -
0511 -
0512 - 1405
0513 -
051301 - Stephanie Aguliar stopped and visited with Millie for about 5 minutes
051302 - or so, following up the visit in Doctor Johnson's office when we met
051303 - on 040416. ref SDS 3 2T65  Stephanie explained that part of her job is
051304 - to prepare the fluid samples for submission to the lab.  This entails
051305 - "spinning" the blood to separate the serum, and the it is the serum
051306 - that goes to the lab.
051308 -  ..
051309 - Rosalie also stopped by once or twice to say hello, and asked Millie
051310 - if everything is going okay.
051312 -  ..
051313 - Rosalie walked through the treatment area several times to visit other
051314 - patients and nurses.
051316 -  ..
051317 - Doctor Johnson also said hello to Millie, but did not stop and talk.
051318 -
051319 -
051320 -
051322 -  ..
0514 -
0515 -
0516 - 1430
0517 -
051701 - Vicki switched from Taxol to Bevacizumab (Avastin - VEGF)
051702 -
051703 - This is the second part of the treatment which is the trial protocol.
051704 -
051705 -
051707 -  ..
0518 -
0519 -
0520 - 1530
0521 -
052101 - Bevecizumab completed.  Vicki was on a break, so another nurse,
052102 - connected a "flushing" solution to the IV.  She said this would take
052103 - about 5 minutes.
052105 -  ..
052106 - After about 15 minutes, we asked another nurse about progress.
052108 -  ..
052109 - The nurse inspected the equipment and said that the treatment was
052110 - concluded.  She removed the IV, and Millie and reviewed documentation
052111 - to ensure Millie has the schedule of coming meetings.
052112 -
052113 -
052114 -
052116 -  ..
0522 -
0523 -
0524 - 1600
0525 -
052501 - Left the hospital and arrived home OA 1635.
052502 -
052503 - Millie seemed a little tired, went to bed early about 2000.
052504 -
052505 -
052506 -
052507 -
052508 -
052509 -
052510 -
0526 -