THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: May 16, 2005 09:16 AM Monday; Rod Welch

Millie called the doctor on side effects of Xeloda chemotherapy.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Tired Possible Side Effects Treatments Taxotere Xeloda Reported in D                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
Eyes Tearing Possible Side Effects Treatments Taxotere Xeloda Report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
Tingling Left Arm on Side Where Surgery was Performed on Lymph Nodes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
Nauseous Queasy Anxious Possible Side Effect Chemotherapy Treatments                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0906 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0906 -    ..
0907 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0908 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
090801 - Follow up ref SDS 16 0000. ref SDS 15 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
090802 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
090803 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
090804 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
090806 -  ..
0909 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0910 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0911 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0912 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
091201 - Millie talked to an advice nurse in the oncology department.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
091202 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091203 - Millie confirmed the report to Kaiser on 050514 that severity of side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091204 - effects have suddenly escalated. ref SDS 16 QC8M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
091206 -  ..
091207 - Millie explained that taking capecitabine (Xeloda) has turned out to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
091208 - be very difficult to tolerate.  She feels terrible, like the "walking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091209 - dead," beyond constant tearing of her eyes, and blistering of her feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
091210 - that led to recently stopping treatment on Saturday, 050514.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
091211 - ref SDS 16 RU9M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091213 -  ..
091214 - She said it would be better to just die than continue with this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091215 - treatment.  She might consider taking capecitabinve (Xeloda) on a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
091216 - reduced treatment level, but wants to take a break until meeting with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091217 - the doctor on 050520.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091218 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091219 -     [On 050520 dramatic improvement after 2 cycles of treatment with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
091220 -     Taxotere and capecitabine (Xeloda), ref SDS 17 025H, despite                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
091221 -     temporarily stopping treatments beginning on 050514 due to severe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091222 -     side effects, ref SDS 16 RU9M; on 050520 treatment dose for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091223 -     capecitabine (Xeloda) reduced to reduce side effects. ref SDS 17                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
091224 -     NT3I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
091226 -      ..
091227 -     [On 050729 side effects escalate, very difficult to tolerate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
091228 -     again, even with 25% reduced dose on 050520, ref SDS 18 DS5J,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
091229 -     doctor maintains strength of capecitabine (Xeldoa) for two (2)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
091230 -     more treatments to guard against another relapse. ref SDS 18 VP4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
091232 -      ..
091233 -     [On 050729 Vivian, the pharmacist, explained strategy to start                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
091234 -     patients with maximum strength of capecitabine (Xeloda), then                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
091235 -     experiment to reduce the dose down to a level patients can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
091236 -     tolerate. ref SDS 19 407N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
091238 -      ..
091239 -     [On 061201 1530 doctor proposes treatment with Navelbine or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
091240 -     Genzar; advises side effects similar to capeticabine. ref SDS 20                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
091241 -     JK6I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
091243 -  ..
091244 - The advice nurse renewed guidance for Millie to stop taking Xeloda                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
091245 - until further notice from the doctor.  The advice nurse said she will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091246 - notify the doctor of Millie's condition.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
091248 -  ..
091249 - Today, the blisters on Millie's feet seem less severe.  The feet are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
091250 - much less red (inflamed) after stopping treatments with capecitabine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
091251 - (Xeloda) on 050514. ref SDS 16 QC4E                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
091253 -  ..
091254 - Yesterday evening we put another coat of balm medication on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091255 - blistered feet, following up work on 050514. ref SDS 16 PQ3U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
091257 -  ..
091258 - This morning, Millie put more balm on her feet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091259 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091260 -     [On 050729 Vivian, the pharmacist, suggested using generous                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
091261 -     amounts of balm and wearing socks overnight while sleeping to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
091262 -     maximize treatment of blisters on the feet. ref SDS 19 S23H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091264 -  ..
091265 - We discussed opportunities for reducing the dosage of Xeloda from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091266 - current regimine of 2 pills twice a day for 2 weeks in order to reduce                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
091267 - side effects while maintaining treatment.  Possibilities include...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
091268 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091269 -            2 pills once a day, and 1 pill once a day.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
091270 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091271 -            1 pill twice a day.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
091273 -             ..
091274 -            1 pill twice a day for only 1 week.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
091276 -             ..
091277 -            2 pills every other day.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
091279 -             ..
091280 -            1 pill every other day.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
091281 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091282 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091283 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091284 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091285 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091286 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091287 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
091288 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0913 -