CONTACTS 

SUBJECTS
Chemotherapy Taxol Avastin Bevacizamub VEGF Treatments Begin Today 2
Blood Tests Cause Big Welt on Right Forearm Difficulty Finding Vein
Difficulty Finding Vein Blood Tests Cause Big Welt on Right Forearm
Port Catheter Not Used Blood Tests Difficulty Finding Vein Cause Big
Blood Tests Cause Big Welt on Right Forearm Difficulty Finding Vein

0907 -
0907 -    ..
0908 - Summary/Objective
0909 -
090901 - Follow up ref SDS 11 0000. ref SDS 9 0000.
090902 -
090903 - Mary is the nurse again.
090905 -  ..
090906 - Yesterday, Millie had blood drawn at the Chemotherapy clinic so they
090907 - could use the port catheter to avoid prior problems Kaiser has had
090908 - problems drawing blood from Millie, reported last week. ref SDS 11
090909 - J46N  At that time, she met with Rosalie and they scheduled a meeting
090910 - for next Monday on Memorial Day, 040531, which is a holiday, to draw
090911 - blood again for treatment the following day on 040601.
090912 -
090913 -
090915 -  ..
0910 -
0911 -
0912 - 1224
0913 -
091301 - Rosalie visited with Millie.
091302 -
091303 - Blood counts are a little low today. (report is shown below.
091304 - ref SDS 0 8W7S  The dose of Taxol is lowered slightly, per below.
091305 - ref SDS 0 4N5M
091307 -  ..
091308 - Millie explained that a breakout on her forhead, that looks like acne,
091309 - began occurring a few weeks ago, but now seems to have subsided.
091310 - There are still numerous red marks, but prominent blisters have
091311 - quieted at this time.
091313 -  ..
091314 - Rosaile said this fits expectations for side effects classified as a
091315 - "rash," listed in the consent, ref OF 1 CE7T, reviewed on 040402.
091316 - ref SDS 1 V77O
091317 -
091318 -     [On 040601 "rash" on forehead seems less pronounced. ref SDS 12
091319 -     BG41
091320 -
091321 -
091322 -
091323 -
0914 -

SUBJECTS
Default Null Subject Account for Blank Record
Rosalie Confirms Planning to Change Treatment Schedule Requests Remi

1204 -
120501 -  ..
120502 - Schedule Treatments to Maintain Doctor Patient Continuity
120503 -
120504 - Millie reviewed discussions with Doctor Johnson on 040517 about
120505 - modifying the schedule for chemotherapy treatments to fit his
120506 - schedule. ref SDS 10 X188
120508 -  ..
120509 - Rosalie advised that Doctor Johnson asked her to Move Millie's
120510 - treatments from Tuesday to Friday, so that he can see her on Thursday
120511 - or Friday, when he is scheduled to be working in the clinic, and
120512 - prior to Millie's treatments, in accordance with the trial protocol.
120514 -  ..
120515 - Rosalie asked Millie to notify her again about adjusting the schedule,
120516 - near the date when the change is too occur, which will be prior to
120517 - starting the next cycle of treatments.
120518 -
120519 -    An issue arises about whether the change should advance the
120520 -    treatment date to the prior Friday, which will be on 040611; or,
120521 -    extend the start of the next cycle to the following Friday, which
120522 -    will be 040618?
120523 -
120524 -
120525 -
120526 -
120527 -
120528 -
120529 -
1206 -

SUBJECTS
Blood Tests White Cell Count Good 2nd Cycle 1st Treatment Chemothera
Urine Tests No Evident Problems
Blood Test Results Pass for Treatment

1605 -
160601 -  ..
160602 - Blood and Other Tests Within Target Range
160603 -
160604 - Follow up ref SDS 11 Q659.
160605 -
160606 - Millie asked about results of the blood test taken yesterday?
160608 -  ..
160609 - Mary said a critical count is down a little today, and so the dose of
160610 - taxol has been adjusted, per Rosalie, above, ref SDS 0 BG9Q,
160612 -  ..
160613 - Mary later submitted the report showing...
160614 -
160615 -    Patient   Provider  Category   View      FR Date   To Date
160621 -     ..
160622 -    Procedure              Results             Reference Range
160624 -     ..
160625 -    Log#: 510414502532      040524 15:00 Outpa WCR Req: RA Johnson, MD
160626 -
160627 -                  ** Walnut Creek Medical Center **
160629 -     ..
160630 -    @CBC
160631 -    WBC x 10-3               3.8 K/uL           3.5   -     12.5
160632 -    RBC x 10-6              3.77 M/uL           3.60  -      5.10
160633 -    Hemoglobin              12.2 g/dL          11.5   -     15.0
160634 -    Hematocrit              34.9 %             34.0   -     46.0
160635 -    MCV                       93 fL            80.0   -    100.0
160636 -    RDW                     13.5 %             11.9   -     14.3
160637 -    Plt x10-3                230 K/uL         140     -    400
160638 -     ..
160639 -    Neutrophils   L           39 %             50     -     70
160640 -    Lymphocytes               44 %             20     -     50
160641 -    Monocyte                   6 %              0     -     11
160642 -    Eosinophil    H            9 %              0     -      4
160643 -    Basophil                   2 %              0     -      2
160644 -    Manual Diff?         NOT REQ
160646 -     ..
160647 -    LAB.RES <Shift F9> For complete Lab Results    WCRM9H  040525 1311
160648 -
160649 -
160650 -
160651 -
160652 -
160653 -
160654 -
1607 -

SUBJECTS
Prepare for Treatment Connect Equipment for Port Catheter
Tagiment Dexatron Administered to Prevent Alergic Reaction to Taxol
Port Catheter Required 3 Tried to Connect Infusion Equipment Prepare

1905 -
1906 - 1217
190701 -  ..
190702 - Preparation for Treatment Required Three (3) Attempts to Connect Port
190703 -
190704 - Follow up ref SDS 11 EB7J.
190705 -
190706 - Mary was effective today connecting the port to the equipment that
190707 - links to the infusion tubing.  On prior treatments, this was
190708 - accomplished on the first try, without any pain or incident.
190710 -  ..
190711 - Benedril started.
190713 -  ..
190714 - Talked to Kathy briefly, after she attended a patient in an adjacent
190715 - chair.  Kathy said there is a shortage of qualified nurses to support
190716 - chemotherapy clinic work, and this contributes to congestion, backup
190717 - on availability of chairs, and nurses suffer stress from having to
190718 - remember a great many critical details for a number of different
190719 - patients.
190721 -  ..
190722 - We have noticed Kathy seems to be very helpful filling in for nurses,
190723 - as needed.  In fact all of the nurses have a strong ethic of team work
190724 - in helping each other, which reflects good leadership in the
190725 - department.
190726 -
190727 -
190728 -
190729 -
190730 -
190732 -  ..
1908 -
1909 -
1910 - 1241
1911 -
191101 - Benedril completed.
191102 -
191103 - Mary starts tagimint and dexatron are administered prior to Taxol for
191104 - prevention of allergic reaction.
191105 -
191107 -  ..
191108 - Millie asked about compazine pill for nausea, as was done last
191109 - week?
191111 -  ..
191112 - Mary said she forgot about compazine, but will bring the pill later.
191113 -
191115 -  ..
1912 -
1913 -
1914 - 1248
1915 -
191501 - Mary brings companzine pill, and some water.
191502 -
191503 -
191504 -
191506 -  ..
1916 -
1917 -
1918 - 1255
1919 -
191901 - Alarm sounds indicating tagiment and dexatron is complete, ready for
191902 - Taxol treatment.
191903 -
191905 -  ..
1920 -
1921 -
1922 - 1303
1923 -
192301 - Mary comes by and turns off the machine.
192302 -
192304 -  ..
1924 -
1925 -
1926 - 1311
1927 -
192701 - Mary submits schedule for next 4 weeeks, and submits requisition for
192702 - blood test next week.
192704 -  ..
192705 - Millie asks again for copy of blood test.
192706 -
192707 -      Need results of CA 15-3 from test last week, which was available
192708 -      on 040516. ref SDS 11 0N5X
192709 -
192710 -        [On 040601 received CA 15-3 results, up to 78. ref SDS 12 UH7H
192711 -
192712 -
192713 -
192714 -
192715 -
192716 -
192717 -
192718 -
1928 -

SUBJECTS
Taxol Delayed 30 Minutes Because Lab Has Not Prepared Treatment

2003 -
2004 - 1315
200501 -  ..
200502 - Taxol Dosage Reduced Today Due to Lowered Blood Counts
200503 -
200504 - Follow up ref SDS 11 4N5M.
200505 -
200506 - Taxol is started.
200508 -  ..
200509 - Dosage was reduced today, per Rosalie, above, ref SDS 0 BG9Q, because
200510 - blood count was well below the lower limit. ref SDS 0 8W7S  Equally,
200511 - when blood counts rise to a level for full dose of treatment, Millie's
200512 - chemotherapy will be increased to normal.
200513 -
200514 -        How does lower dosage align with research on 040517 showing
200515 -        that one treatment for inflammatory breast cancer is "high"
200516 -        dosage of chemotherapy? ref SDS 10 JK94
200518 -           ..
200519 -          [On 040614 primary care physician explains low blood counts
200520 -          occur because chemotherapy treatments and age both reduce
200521 -          rate that bone marrow creates blood. ref SDS 13 6T7F
200523 -           ..
200524 -          [On 040615 blood counts rise, Kaiser increases dose to normal
200525 -          for chemotherapy in order to optimize recovery from cancer.
200526 -          ref SDS 14 Q659
200528 -           ..
200529 -          [On 080418 Millie getting treatment at UCSF on referral from
200530 -          Kaiser; doctor proposes discussing lowering dose of
200531 -          chemotherapy Carboplatin according to blood counts.
200532 -          ref SDS 15 598J
200534 -           ..
200535 -          [On 080423 Millie proposes lowering and increasing
200536 -          chemotherapy treatments at UCSF as occurred at Kaiser in
200537 -          order to optimize treatment for cancer. ref SDS 16 OY7S
200539 -           ..
200540 -          [On 080423 UCSF notifies Milllie that when dose of
200541 -          Carboplatin is reduced due to low blood counts, treatment
200542 -          cannot later be increased when blood counts improve.
200543 -          ref SDS 16 I49N
200545 -           ..
200546 -          [On 080423 Millie notifies UCSF to maintain higher dose to
200547 -          optimize recovery, and to treat low blood counts with
200548 -          Neupogen and skipping treatments. ref SDS 16 TY6Y
200549 -
200551 -  ..
200552 - Millie is hooked up for continuous blood pressure tests, as on prior
200553 - treatments; however, system only ran once today, rather than every 15
200554 - minutes as was done on prior treatments.
200556 -  ..
200557 - Today they are not taking Millie's temperature every 15 minutes.
200558 -
200559 -
200560 -
200561 -
200563 -  ..
2006 -
2007 -
2008 - 1418
2009 -
200901 - Taxol completed.
200902 -
200903 - Treatment ends.
200905 -  ..
200906 - Nurse removes connection to port catheter.
200907 -
200908 -
200909 -
200910 -
200911 -
200912 -
2010 -

SUBJECTS
Avastin Treatment Without Blood Pressure Testing

2103 -
210401 -  ..
210402 - Avastin Treatment Without Blood Pressure Testing
210403 -
210404 - Follow up ref SDS 11 PV4H.
210405 -
210406 - No Avastin today.
210407 -
210408 -
210409 -
210410 -
2105 -

SUBJECTS
Tired Wobbly on Feet after Treatment In Asleep by 1900

2203 -
2204 - 1621
220501 -  ..
220502 - Tired and Wobbly Today After Treatments
220503 -
220504 - Follow up ref SDS 11 F54N, ref SDS 9 F54N.
220505 -
220506 - Millie seemed a little more tired today, and so we decided not to go
220507 - shopping for a new wig in Walnut Creek, which she investigated
220508 - yesterday when she came to the hospital to have blood drawn for
220509 - testing to support the treatments today.
220511 -  ..
220512 - However, after we left the parking garage, Millie felt a little
220513 - better, and so we visited the Wig Shop on Cypress, a few blocks from
220514 - the hospital.  Millie tried on several wigs and finally settled on one
220515 - that she liked.   This took about 30 minutes or so, and was a good
220516 - excursion.
220518 -  ..
220519 - Made the purchase.
220521 -  ..
220522 - We got home about 1540; traffic was again pretty light for this time
220523 - in the afternoon.
220525 -  ..
220526 - Millie made some tea, and then watched television in the living room.
220528 -  ..
220529 - She slept for about an hour or so.
220530 -
220531 -
220532 -
220533 -
220534 -
220535 -
220536 -
2206 -