CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 8 0000. ref SDS 7 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040508 -
040509 -
040510 -
040512 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Yesterday, the doctor left a message that tests show has pulmonary
040902 - emboli again. ref SDS 8 MI5I  The doctor gave instructions on getting
040903 - medicine for treatment, ref SDS 8 JK7J, and requested a letter
040904 - confirming that Millie carrying out the treatment. ref SDS 8 JK80  She
040905 - sent a letter to Kaiser confirming instructions are being followed.
040906 - ref SDS 8 V1DH  Millie went to Kaiser and got the medication.  In the
040907 - evening, she began self-injections of Lovenox to clear blood clots.
040908 - ref SDS 8 TN6G
040910 -  ..
040911 - Millie's letter yesterday to the doctor...
040912 -
040913 -    1.  Asked for the analyst's report on the CT test that found
040914 -        pulmonary emboli. ref SDS 8 JM42
040916 -  ..
040917 - Doctor says today, this is not yet available. ref SDS 0 J05V
040918 -
040919 -    2.  Asked if the doctor still needs the report on family genetics
040920 -        for pulmonary emboli. ref SDS 8 JM45
040922 -  ..
040923 - Doctor does not comment.
040925 -         ..
040926 -    3.  Requested additional details in medical chart on meeting for
040927 -        060929. ref SDS 8 JM59
040929 -  ..
040930 - Doctor resubmitted the reports again.
040931 -
040933 -  ..
040934 - Millie received a letter from the doctor saying...
040935 -
040938 -        Subject:  PE Treatment Plan
040939 -        Received: 10/3/06 1:59 PM
040941 -         ..
040942 -    2.  The CT scan report has not been transcibed as of yet.  The
040943 -        information below is all that I can copy as a document.  There
040944 -        is a print command that includes vitals.
040946 -  ..
040947 - Millie requested the report diagnosing pulmonary emboli, which the
040948 - doctor mentioned in a call yesterday, ref SDS 8 MI5I, and per above.
040949 - ref SDS 0 MI5I
040950 -
040951 -            [On 061006 Millie asks about CT test report again.
040952 -            ref SDS 9 QQ5P
040954 -  ..
040955 - Doctor's letter continues...
040956 -
040957 -    3.  This is a 70 year old woman with a history of inflammatory
040958 -        cancer of left breast who was initially diagnosed 03/04/02 who
040959 -        comes for re-evaluation.  She had recurrent disease noted
040960 -        initially in cervical LN's 03/03/04.  She has been treated on
040961 -        several salvage regimes. On Study with Avastin, she had a PE
040962 -        noted on CT 11/03/2004.  She was placed on aticoagulation
040963 -        therapy for one year.  Because of progression of disease, the
040964 -        patient was started on Taxotere/Xeloda 4/15/05.  She had a
040965 -        total of 8 cycles ending 9/16/05.  She had a palliative left
040966 -        mastectomy performed 10/21/05. Then her left chest lesions
040967 -        began expanding again.  The patient started Taxotere/Xeloda
040968 -        07/21/06, cycle #2 on 08/14/06 and cycle #3 on 09/08/06.  The
040969 -        patient is here for cycle #4.  She is having some chest
040970 -        heaviness again like the symptoms that she had with her PE.
040971 -        Her son apparently has a coagulapathy.
040973 -         ..
040974 -    4.  Current medications include:
040975 -        XELODA 500MG TABLETS
040976 -        DEXAMETHASONE 4MG TABLETS
040977 -        TIMOLOL MALEATE 0.5% EYE DR
040979 -         ..
040980 -    5.  PE:
040981 -        CVS: S1, S2 RR
040982 -        Chest wall: decreasing lesions on lower chest wall
040983 -        Lung: Clear to A & P
040984 -        Ext: decreased LUE edema
040986 -         ..
040987 -    6.  Lab:
040988 -        Bili, Tot Adult 0.6 mg/dL
040989 -        Creatinine 0.6 mg/dL
040990 -        ALT (SGPT) 22 U/L
040992 -         ..
040993 -    7.  WBC 5.2 K/uL
040994 -        RBC 3.71 M/uL
040995 -        Hemoglobin 12.1 g/dL
040996 -        Hematocrit 35.8 %
040997 -        MCV 97 fL
040998 -        RDW H 16.1 %
040999 -        Plt 249 K/uL
041001 -         ..
041002 -    8.  CA 15-3
041003 -        ----------
041004 -        51 H
041005 -        68 H
041006 -        73 H
041007 -        87 H
041008 -        71 H
041009 -        63 H
041010 -        59 H
041011 -        49 H
041012 -        44 H
041013 -        40 H
041014 -        36
041016 -         ..
041017 -    9.  Imaging:
041018 -        07/08/06 MRI BRAIN WO/W CONTRAST(STD)- negative
041020 -         ..
041021 -   10.  06/23/06 CHEST, TWO VIEWS
041023 -         ..
041024 -   11.  05/05/06 CT NECK, THORAX W CONTRAST
041026 -         ..
041027 -   12.  04/14/06 BASE SKULL TO MIDTHIGH PET
041029 -         ..
041030 -   13.  09/22/05 MAMMOGRAPHY SCREENING, BILAT
041032 -         ..
041033 -   14.  Imp:
041034 -        1. Metastatic breast cancer (IBC); chest wall recurrence
041035 -        2. LUE lymphedema; worsened since fall
041036 -        3. Hx of PE; R/O PE
041038 -         ..
041039 -   15.  Plan:
041040 -        1. Give cycle #4 of Xeloda/Taxotere today
041041 -        2. Proceed with cycle #5 on 10/20
041042 -        3. Obtain son's lab coagulopathy report
041043 -        4. Thin slice CT chest R/O PE (CT Appointments: 925-295-6868)
041044 -        5. Serial CA 15-3
041045 -        6. Monitor chest wall rash & CA 15-3 instead of PET
041046 -        7. Return to Lymphedema Clinic
041047 -        8. RTC 10/20/06
041048 -
041049 - *********************************
041051 -         ..
041054 -         ..
041055 -   17.  The patient is a 70 year old woman with a history of
041056 -        inflammatory cancer of left breast who was initially diagnosed
041057 -        03/04/02 who comes for re-evaluation.  She had recurrent
041058 -        disease noted initially in cervical LN's 03/03/04.  She has
041059 -        been treated on several salvage regimes (see previous notes).
041060 -        The patient was started on Taxotere/Xeloda 4/15/05.  She had a
041061 -        total of 8 cycles, the last was 9/16.  A palliative left
041062 -        mastectomy was planned and peripheral biopsies were performed
041063 -        10/12/05 in preparation for this that were all negative.  She
041064 -        had a left mastectomy performed 10/21/05.  She had a recent
041065 -        admission for a LLL pneumonia 06/07/06 06/09/06.  This has
041066 -        resolved.  Now her left chest lesions are expanding.  The
041067 -        patient started Taxotere/Xeloda 07/21/06 and had cycle #2 on
041068 -        08/14/06 because of decreased WBC. Her dizziness has resolved.
041069 -        The patient is here for FU.
041071 -         ..
041072 -   18.  Current medications include:
041073 -        XELODA 500MG TABLETS
041074 -        DEXAMETHASONE 4MG TABLETS
041075 -        TIMOLOL MALEATE 0.5% EYE DR
041077 -         ..
041078 -   19.  PE:
041079 -        CVS: S1, S2 RR
041080 -        Chest wall: decreasing lesions on chest wall
041081 -        Lung: Clear to A & P
041082 -        Ext: decreased LUE edema
041084 -         ..
041085 -   20.  Lab:
041086 -        WBC 8.4 K/uL
041087 -        RBC 4.08 M/uL
041088 -        Hemoglobin 13.2 g/dL
041089 -        Hematocrit 38.2 %
041090 -        MCV 94 fL
041091 -        RDW 14.3 %
041092 -        Plt 248 K/uL
041094 -         ..
041095 -   21.  CA 15-3
041096 -        ----------
041097 -        73 H
041098 -        87 H
041099 -        71 H
041100 -        63 H
041101 -        59 H
041102 -        49 H
041103 -        44 H
041104 -        40 H
041105 -        36
041107 -         ..
041108 -   22.  Imaging:
041109 -        07/08/06 MRI BRAIN WO/W CONTRAST(STD)- negative
041111 -         ..
041112 -   23.  06/23/06 CHEST, TWO VIEWS
041114 -         ..
041115 -   24.  05/05/06 CT NECK, THORAX W CONTRAST
041117 -         ..
041118 -   25.  04/14/06 BASE SKULL TO MIDTHIGH PET
041120 -         ..
041121 -   26.  09/22/05 MAMMOGRAPHY SCREENING, BILAT
041123 -         ..
041124 -   27.  Imp:
041125 -        1. Metastatic breast cancer (IBC); chest wall recurrence
041126 -        2. LUE lymphedema; continues to improve
041127 -        3. Dizziness resolved
041129 -         ..
041130 -   28.  Plan:
041131 -        1. Continue Xeloda/Taxotere; reschedule cycle #3 09/08/06
041132 -        2. Serial CA 15-3
041133 -        3. Monitor chest wall rash & CA 15-3 instead of PET
041134 -        4. RTC 09/29/06
041136 -         ..
041138 -
041140 -         ..
041141 -   30.  Vitals (Last Filed) BP Pulse Temp (Src) Resp Wt SaO2
041142 -        142/75 76 98.7 (Oral) 18 147 lbs (66.7kg) 98%
041144 -         ..
041145 -   31.  Instructions and Follow-Up
041146 -        Patient Instructions Plan:
041147 -        1. Continue Xeloda/Taxotere; reschedule cycle #3 09/08/06
041148 -        2. Serial CA 15-3
041149 -        3. Monito chest wall rash & CA 15-3 instead of PET
041150 -        4. RTC 09/29/06
041152 -         ..
041153 -   32.  Follow-up and Disposition Follow-up Disposition
041154 -        Inform Patient at Next Visit Return in about 5 weeks (around 9/29/2006) for
041155 -        Chemotherapy follow up.
041157 -         ..
041158 -   33.  Routing History Recorded
041160 -         ..
041161 -   34.  Future Appointments Date Time Visit Type Department Provider Length
041162 -        10/09/06 10:00 AM SPEC PROC SHA-OPH* >LENNON LANE VISUAL FIELD TESTING - SHA
041163 -        30
041164 -        10/10/06 8:45 AM PHYSICAL THERAPY SHA-PTDB >LENNON LANE ANDRE, MARY F (P.T.)
041165 -        60
041166 -        10/19/06 3:00 PM CHEMOTHERAPY WCR-CMO* >MAIN CAMPUS CHEMO CHAIR 5 - WCR 60
041167 -        10/20/06 2:20 PM TELEPHONE VISIT WCR-ONC1 >MAIN CAMPUS ONC PHARMACIST SCHEDULE
041168 -        1 -WCR 15
041169 -        10/20/06 2:30 PM CHEMOTHERAPY WCR-CMO* >MAIN CAMPUS CHEMO CHAIR 18 120
041170 -        10/20/06 4:40 PM OFFICE VISIT WCR-ONC2 >MAIN CAMPUS JOHNSON, ROBERT ALLSTON JR
041171 -        (M.D.) 20
041173 -         ..
041174 -   35.  Misc Information
041175 -        Contact Information Date & Time Provider Department Encounter # Center
041176 -        08/25/2006 2:40 PM ROBERT ALLSTON JOHNSON MD, MEDICAL DOCTOR Wcr-Onc2 >Main
041177 -        Campus 62392530 WCRA
041178 -
041188 -
041189 -
041190 -
041191 -
041192 -
041193 -
0412 -