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 13 0000. ref SDS 12 0000.
090902 -
090903 - Anne is the nurse today.
090905 -  ..
090906 - Millie had blood drawn at the Chemotherapy clinic again yesterday, on
090907 - Memorial Day, so they could use the port catheter.
090908 -
090909 -
090911 -  ..
0910 -
0911 -
0912 - 1211
0913 -
091301 - Anne brought a big bag with the equipment and treatments for Millie.
091302 - She said they have everything ready today except the Avastin, which
091303 - she will order after starting the Taxol.
091305 -  ..
091306 - Blood counts are a little low again today. (report is shown below.
091307 - ref SDS 0 0N7Q, and so the dose of Taxol is lowered again today, see
091308 - also below showing chemotherapy dose has been continuously lowered.
091309 - ref SDS 0 Q659)
091311 -  ..
091312 - Breakout on Millie's forehead reported on 040527, which Rosalie called
091313 - a "rash," ref SDS 13 BG41, seems to be further reduced today.
091315 -  ..
091316 - Millie feels that the lumps in her neck have gotten smaller, even
091317 - disappeared because they are hard to detect now.
091318 -
091319 -    This may suggest favorable response to chemotherapy using Taxol and
091320 -    Avastin, so that surgery and radiation, considered in the Tumor
091321 -    Board report received on 040517, may not be needed. ref SDS 11 F78G
091323 -  ..
091324 - There have been no further episodes of difficult breathing and
091325 - coughing reported on 040517. ref SDS 11 RZ4I
091326 -
091327 -        [On 040607 extended coughing to clear a scratchy throat for
091328 -        about 18 hours resulting in soar throat, reported in connection
091329 -        with hiking and following a meal.  Aspirin seems to have
091330 -        helped. ref SDS 14 0001
091331 -
091332 -
091333 -
091334 -
091335 -
0914 -

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

1305 -
130601 -  ..
130602 - Blood Counts Down a Little Dose Chemotherapy Taxol Adjusted Lower
130603 -
130604 - Follow up ref SDS 13 Q659, ref SDS 12 Q659.
130605 -
130606 - Millie asked about results of the blood test taken yesterday?
130608 -  ..
130609 - Mary said a critical count is down a little today, and so the dose of
130610 - taxol has been adjusted, per Rosalie, as was done last week.  Anne
130611 - checked the record and advised that the dose today continues a
130612 - reduction that was actually started with the treatment on 040427.
130613 - ref SDS 8 6W5L
130614 -
130615 -        Low dose of chemotherapy may conflict with protocol for
130616 -        treating inflammatory breast cancer (IBC); one account calls
130617 -        for "high dose" of chemotherapy to treat IBC. ref SDS 11 JK94
130619 -  ..
130620 - Mary later submitted the report showing...
130621 -
130622 -    Patient   Provider  Category   View      FR Date   To Date
130628 -     ..
130629 -    Procedure              Results             Reference Range
130631 -     ..
130632 -    Log#: 510415200774      040531 15:22 Outpa WCR Req: RA Johnson, MD
130633 -
130634 -                  ** Walnut Creek Medical Center **
130636 -     ..
130637 -    @CBC
130638 -    WBC x 10-3               3.8 K/uL           3.5   -     12.5
130639 -    RBC x 10-6    L         3.20 M/uL           3.60  -      5.10
130640 -    Hemoglobin    L         10.1 g/dL          11.5   -     15.0
130641 -    Hematocrit    L         30.0 %             34.0   -     46.0
130642 -    MCV                       94 fL            80.0   -    100.0
130643 -    RDW                     14.3 %             11.9   -     14.3
130644 -    Plt x10-3                202 K/uL         140     -    400
130645 -     ..
130646 -    Neutrophils   L           37 %             50     -     70
130647 -    Lymphocytes               47 %             20     -     50
130648 -    Monocyte                   5 %              0     -     11
130649 -    Eosinophil    H            9 %              0     -      4
130650 -    Basophil                   2 %              0     -      2
130651 -    Manual Diff?         NOT REQ
130652 -    ANC                     1406                      >   1500
130654 -     ..
130655 -    @MDIF
130656 -    Diff Method         Auto Dif
130658 -     ..
130659 -    LAB.RES <Shift F9> For complete Lab Results    WCRM9H  040601 1216
130660 -
130661 -
130663 -  ..
130664 - Urinalisys
130665 -
130666 -    Patient   Provider  Category   View      FR Date   To Date
130667 -    03573704                       Results   040517    040601
130668 -
130669 -    Patient             Personal Physician:  Robert A. Johnson, MD
130670 -    Buck, Mildred     68/F Lab Results Summary     Page 1 of 3
130672 -     ..
130673 -    Procedure              Results             Reference Range
130675 -     ..
130676 -    Log#: 510415200775      040531 15:22 Outpa WCR Req: RA Johnson, MD
130677 -
130678 -                  ** Walnut Creek Medical Center **
130680 -     ..
130681 -    Urinalysis
130683 -     ..
130684 -    Culture Per?           Not Ind
130685 -    Microscopic?           Not Ind
130686 -    pH                     5.0                 4.5     -    8.0
130687 -    Sp. Gravity            1.015               1.001   -    1.035
130688 -    Glucose                Negative            Negative
130689 -    Blood                  Negative            Negative
130690 -    Nitirtes               Negative            Negative
130691 -    Ketones                Negative            Negative
130692 -    Leuk Esterase          Negative            Negative
130693 -    Protein                Negative            Negative
130694 -    Bilirubin              Negative            Negative
130695 -    Urobilinogen           < 1 EU/dL           =< 2.0
130696 -    Urine Source           Clean
130698 -     ..
130699 -    LAB.RES <Shift F9> For complete Lab Results    WCRM9H  040601 1216
130700 -
130701 -
130702 -
130703 -
1308 -

SUBJECTS
CA 15-3 78 Smaller Rise than 10 Points Reported on 040318

1403 -
140401 -  ..
140402 - CA 15-3 Rises from 70 to 78, Reduction from 10 Point Rise on 040318
140403 -
140404 - Follow up ref SDS 11 087J.
140406 -     ..
140407 -    Log#: 510413801998      040517 13:15 Outpa WCR Req: RA Johnson, MD
140408 -
140409 -             ** TPMG Regional Lab, Berkeley   **
140411 -  ..
140412 - Received results of CA 15-3 from blood test which was not available on
140413 - 040518, ref SDS 12 0N5Q, nor included with test results submitted by
140414 - Kaiser on 040525. ref SDS 13 Q659 and ref SDS 13 PE5O
140416 -  ..
140417 - CA 15-3 rises from 70 to 78, a slightly reduced rate of increase from
140418 - the 10 point increase in the prior test from 60 to 70, reported on
140419 - 040318. ref SDS 1 SM6M
140420 -
140421 -
140422 -
140423 -
140424 -
140425 -
140426 -
140427 -
1405 -

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

1705 -
1706 - 1214
170701 -  ..
170702 - Preparation for Treatment Required One (3) Attempt to Connect Port
170703 -
170704 - Follow up ref SDS 13 EB7J, ref SDS 12 EB7J.
170705 -
170706 - Anne brought compazine pill for nausea.
170707 -
170708 - Anne was effective connecting the port to the equipment that links to
170709 - the infusion tubing.
170711 -  ..
170712 - Benedril started.
170713 -
170714 -
170715 -
170716 -
170718 -  ..
1708 -
1709 -
1710 - 1227
1711 -
171101 - Benedril completed.
171102 -
171103 - Anne starts tagimint and dexatron are administered prior to Taxol for
171104 - prevention of allergic reaction.
171105 -
171106 -
171108 -  ..
1712 -
1713 -
1714 - 1239
1715 -
171501 - Alarm sounds indicating tagiment and dexatron is complete, ready for
171502 - Taxol treatment.
171504 -  ..
171505 - Anne comes by and turns off the machine.
171506 -
171507 -
171508 -
171509 -
171510 -
1716 -

SUBJECTS
Taxol Treatment Delayed 30 Minutes Because Lab Has Not Prepared Trea

1803 -
1804 - 1245
180501 -  ..
180502 - Taxol Dosage Reduced Today Due to Lowered Blood Counts
180503 -
180504 - Follow up ref SDS 13 4N5M, ref SDS 12 4N5M.
180505 -
180506 - Taxol is started.
180508 -  ..
180509 - Dosage was reduced today, per Rosalie, above, ref SDS 13 BG9Q, because
180510 - blood count was well below the lower limit. ref SDS 13 8W7S
180511 -
180512 -        How does lower dosage align with research on 040517 showing
180513 -        that one treatment for inflammatory breast cancer is high
180514 -        dosage of chemotherapy? ref SDS 11 JK94
180516 -  ..
180517 - Millie is hooked up for continuous blood pressure tests, as on prior
180518 - treatments; however, system only ran once today, rather than every 15
180519 - minutes as was done on prior treatments.
180521 -  ..
180522 - Anne took Millie's temperature.  Said it does not need to be taken
180523 - every 15 minutes.
180524 -
180525 -    Pulse................ 56
180526 -
180528 -  ..
1806 -
1807 -
1808 - 1304
1809 -
180901 - Anne takes blood pressure and temperature again.
180902 -
180903 -    Notices blood pressure is up a little, and pulse is down to 49,
180904 -    perhaps due to benedril.
180906 -     ..
180907 -    Anne advises she adds saline to treatment of Taxol.
180908 -
180909 -
180911 -  ..
1810 -
1811 -
1812 - 1324
1813 -
181301 - Anne takes blood pressure and temperature again.
181302 -
181303 -    Pulse back up to 56.
181305 -     ..
181306 -    Anne shuts down saline additive to treatment now that pulse has
181307 -    returned to normal.
181308 -
181309 -
181311 -  ..
1814 -
1815 -
1816 - 1338
1817 -
181701 - Anne takes blood pressure and temperature again.
181702 -
181703 -    Blood pressure:  139 83
181705 -     ..
181706 -    Pulse........... 56
181707 -
181708 -
181709 -
181711 -  ..
1818 -
1819 -
1820 - 1446
1821 -
182101 - Taxol completed.
182102 -
182103 -
182104 -
182105 -
182106 -
1822 -

SUBJECTS
Avastin Treatment Without Blood Pressure Testing

1903 -
1904 - 1354
190501 -  ..
190502 - Avastin Treatment Without Blood Pressure Testing
190503 -
190504 - Follow up ref SDS 13 PV4H, ref SDS 12 PV4H.
190505 -
190506 - New nurse.
190507 -
190508 - Avastin started.  Nurse asks how many times Millie has had Avastin.
190510 -  ..
190511 - Millie is pretty much asleep, and cannot recall.
190513 -  ..
190514 - Nurse advised that this is the 4th treatment, per record on 040518.
190515 - ref SDS 12 GQ4F
190516 -
190518 -  ..
1906 -
1907 -
1908 - 1358
1909 -
190901 - Nurse, Tony, takes blood pressure and temperature again.
190902 -
190903 -    Blood pressure:  147 81
190905 -     ..
190906 -    Pulse........... 53
190907 -
190909 -  ..
1910 -
1911 -
1912 - 1424
1913 -
191301 - Avastin treatment ends.
191302 -
191303 - New nurse, Kathy Kendal, asks Millie if that is it for her today.  She
191304 - asked if she is supposed to get more chemotherapy.  Millie said no.
191306 -  ..
191307 - Nurse Tony comes by, and since Kathy is already demobilizing the
191308 - equipment, she completes the work.
191310 -  ..
191311 - Kathy removes connection to port catheter.
191313 -  ..
191314 - Extra taping was needed because of bleeding from the port catheter.
191316 -  ..
191317 - Kathy advised that bleeding like today is not an issue that needs
191318 - treatment to avoid blood clots that might clog the port, raised as a
191319 - concern in connection with a dual port, reviewed with Rosalie on
191320 - 040402. ref SDS 2 6C6I
191322 -  ..
191323 - Kathy said that some minor bleeding, like today, helps keep the port
191324 - catheter clear.
191325 -
191326 -
191327 -
191328 -
191329 -
191330 -
191331 -
1914 -

SUBJECTS
Tired Wobbly on Feet after Treatment In Asleep by 1900

2003 -
2004 - 1621
200501 -  ..
200502 - Tired and Wobbly Today After Treatments
200503 -
200504 - Follow up ref SDS 13 F54N, ref SDS 12 F54N.
200505 -
200506 - After treatment, Millie was more tired today, even than last week.
200507 -
200508 - We got home earlier today, about 1510.
200510 -  ..
200511 - We got home about 1505.
200513 -  ..
200514 - Millie ate a few crackers with some swiss cheese and drank some
200515 - bottled water from the regrigerator.  She watched television for about
200516 - 5 minutes, then laid down.  She was asleep in about 3 minutes, with a
200517 - blanket to avoid a chill, even though room temperature was about 77.
200519 -  ..
200520 - She slept for about an hour or so.
200521 -
200522 -
200523 -
200524 -
200525 -
200526 -
200527 -
2006 -