CONTACTS
SUBJECTS
Medical Practices Surgery Oncology Chemotherapy Breast Cancer Pulmon
1503 -
1503 - ..
1504 - Summary/Objective
1505 -
150501 - Follow up ref SDS 25 0000.
150502 -
150503 - Millie's patient history yields chronology of cause and effect that
150504 - comprise case studies on aspects of medical practice generally, and on
150505 - diagnosing and treatment for cancer.
150507 - ..
150508 - Case studies in Millie's patient history....
150509 -
150510 - 1. CA 15-3 research on cancer biomarkers
150511 - for evaluating progression of
150512 - disease and response to
150513 - treatment........................... 030710, ref SDS 1 IA7H
150515 - ..
150516 - 2. Case studies purpose to discover
150517 - and refine "truth" that increases
150518 - the power of knowledge from energy
150519 - that connects order, structure,
150520 - and patterns of cause and
150521 - effect under the locality
150522 - principle........................... 040214, ref SDS 2 NU9L
150524 - ..
150525 - 3. Mistakes medical care, testing,
150526 - diagnosis, planning, treatment,
150527 - and monitoring...................... 040416, ref SDS 3 GN7J
150529 - ..
150530 - 4. Lessons learned health care......... 040517, ref SDS 4 PW8F
150532 - ..
150533 - 5. Cancer discovery left axilla........ 040517, ref SDS 4 OW3I
150535 - ..
150536 - 6. IBC discovery complex symptoms red rash
150537 - inflammation left breast mistaken for
150538 - other ailments, lumps under left arm
150539 - (axilla) and left supraclavicular
150540 - reported in test diagnositcs
150541 - overlooked for 18 months
150542 - by busy medical
150543 - team................................ 040517, ref SDS 4 S66O
150545 - ..
150546 - 7. Surgery considerations leading to
150547 - mastectomy and consequences of
150548 - decision............................ 041210, ref SDS 5 657F
150550 - ..
150551 - 8. Cancer cascades quickly out of control;
150552 - maintaining local control with quality of
150553 - life requires timely treatment for Millie's
150554 - patient profile stage IV very aggressive
150555 - disease narrow margin for delay
150556 - starting treatment in time to
150557 - be effective........................ 041230, ref SDS 6 P19O
150559 - ..
150560 - 9. Surgery criteria for approval
150561 - by patient to increase quality
150562 - of life............................. 050324, ref SDS 7 VL4O
150564 - ..
150565 - 10. Side effects chemotherapy treatment
150566 - with Taxotere and capecitabine
150567 - (Xeloda)............................ 050422, ref SDS 8 NT3I
150569 - ..
150570 - 11. Patient stress, emotional trauma
150571 - from family, friends, acquaintences
150572 - continually recommending web sites,
150573 - articles, television broadcasts
150574 - with cures for cancer, and getting
150575 - hurt feelings because patients cannot
150576 - spend 24 hours a day investigating
150577 - well meaning suggestions for relevance
150578 - to complex patient history, which
150579 - family, friends, acquaintences are
150580 - unwilling to review and correlate
150581 - for timely analysis, because good
150582 - management is a lot of hard
150583 - work................................ 050709, ref SDS 9 0001
150585 - ..
150586 - 12. Alternative treatments for cancer,
150587 - meditation, religion, positive
150588 - thinking, herbs, health diets,
150589 - exercise............................ 050712, ref SDS 10 4T7F
150591 - ..
150592 - 13. Patient history 2nd opinion
150593 - evaluate surgery options............ 050812, ref SDS 11 UF4J
150595 - ..
150596 - 14. Team care collaboration coordination
150597 - communication sharing information
150598 - resisted............................ 050923, ref SDS 12 N45O
150600 - ..
150601 - 15. Due diligence check list evaluating
150602 - scope, benefits and risks of
150603 - invasive surgery.................... 050923, ref SDS 12 O85O
150605 - ..
150606 - 16. Mastectomy surgery for local control
150607 - switched purpose to palliation
150608 - theory.............................. 051007, ref SDS 13 MW5O
150610 - ..
150611 - 17. Doctors, hospitals fail due diligence
150612 - review of surgery risks and benefits
150613 - despite express requirements to
150614 - perform specific steps for "Time Out"
150615 - analysis prior to performing
150616 - surgery............................. 051019, ref SDS 14 V55K
150618 - ..
150619 - 18. Surgery purpose and rationale for
150620 - mastectomy evolved from local control
150621 - to remove pockets of resistance to
150622 - systemic chemotherapy treatment, to
150623 - palliation.......................... 051027, ref SDS 15 F25H
150625 - ..
150626 - 19. Cancer discovery left
150627 - supraclavicular..................... 060217, ref SDS 16 8R6M
150629 - ..
150630 - 20. Read medical test findings - case
150631 - study doctors limited time prevents
150632 - reading findings to correlate
150633 - clinically for discovering symptomatic
150634 - trends that enable proactive case
150635 - management; there is only enough
150636 - time to read Impressions that
150637 - summarize the gist of
150638 - findings............................ 060428, ref SDS 17 VG5L
150640 - ..
150641 - 21. Lymphedema left arm swelled
150642 - measurements........................ 060509, ref SDS 18 HO7F
150644 - ..
150645 - 22. Mastectomy surgery scope, reduce
150646 - risk of relapse..................... 060711, ref SDS 19 9T46
150648 - ..
150649 - 23. Cancer terminology local, regional
150650 - distant metastatic disease applied
150651 - in Millie's patient
150652 - history............................. 060711, ref SDS 19 C56O
150654 - ..
150655 - 24. Cancer relapse from mutation review
150656 - risk of microscopic cancer cells not
150657 - treated with mastectomy
150658 - surgery............................. 060711, ref SDS 19 EG4F
150660 - ..
150661 - 25. Distant metastasis, and findings
150662 - of local, regional
150663 - disease............................. 060711, ref SDS 19 AG4I
150665 - ..
150666 - 26. Patient history 2nd opinion IBC
150667 - relapse, evaluate treatment
150668 - options............................. 060722, ref SDS 21 XQ7H
150670 - ..
150671 - 27. Wicked problems illustrated by
150672 - subtle symptoms of lethal, volatile
150673 - and rare issues, overlap and are
150674 - thereby masked, often hidden in
150675 - plain sight, by feel good management
150676 - that drives denial because diagnosis
150677 - of benign issues is fast and easy,
150678 - and cheap, and requires doing
150679 - nothing............................. 060722, ref SDS 20 346F
150681 - ..
150682 - 28. Pulmonary embolism Millie high risk
150683 - stage IV cancer and family genetics,
150684 - symptoms rise for 6 months on Avastin
150685 - drug trial, 2 CT tests negative;
150686 - symptoms diagnosed side effects
150687 - chemotherapy, Avastin drug company
150688 - reports death from pulmonary embolism,
150689 - symptoms increase, "wicked problem"
150690 - lethal symptoms PE difficult distinguish
150691 - from side effects of chemotherapy
150692 - that end after treatment ends; UCSF
150693 - 2nd opinion recommends Kaiser investigate,
150694 - CT test discovers PE, Kaiser policy treat
150695 - cancer patients with Coumadin for life;
150696 - after 2 months on treatment for PE patient
150697 - energy and activities restored; Millie
150698 - removed from treatment after 12 months;
150699 - symptoms rise over next 12 months; CT
150700 - test reports recurrence pulmonary
150701 - embolism; research 40% PE recurrence
150702 - die immediately; Millie lucky 60% who
150703 - survive; Kaiser reports CT test for
150704 - pulmonary embolism requires special
150705 - equipment and specific order;
150706 - patient resumes treatment
150707 - for life............................ 060722, ref SDS 20 6G6O
150709 - ..
150710 - 29. Side effects cancer treatment....... 060724, ref SDS 22 QX8K
150712 - ..
150713 - 30. Communication case study on meeting
150714 - productivity supports Kaiser's
150715 - reputation for doctor patient
150716 - parternship......................... 060809, ref SDS 23 K65G
150718 - ..
150719 - 31. Neutropenia patient routinely gets
150720 - chemotherapy treatment with low blood
150721 - counts when ANC (NEUTS) labs are below
150722 - 1500 (nominal minimal level for safe
150723 - chemotherapy) because patients require
150724 - maintaining a steady dose level of
150725 - chemotherapy in order for treatments
150726 - to be effective recovering from
150727 - cancer.............................. 060810, ref SDS 24 HV45
150729 - ..
150730 - 32. Doctor's orders changed prevents diagnosis,
150731 - prescription, treatment, evaluating
150732 - response contrary to requirements
150733 - for Kaiser to implement the
150734 - doctor's case management............ 061012, ref SDS 26 A55J
150735 - |
150736 - Comparisons failure to perform |
150737 - trend analysis ordered by doctor |
150738 - for CT test pulmonary |
150739 - embolism................................+
150740 - |
150741 - Doctor's orders ignored to assess |
150742 - patient history by comparison of |
150743 - medical tests...........................+
150744 - |
150745 - Failure to perform comparisons in |
150746 - medical tests ordered by the doctor |
150747 - to evaluate progression of |
150748 - disease................................./
150750 - ..
150751 - 33. Complexity patient history overwhelms, confuses
150752 - medical team from multiple forms of cancer
150753 - and multiple relapses compounded by multiple
150754 - medical problems of lymphedema, pulmonary
150755 - embolism, pneumonia, broken finger, Cellulitis;
150756 - diagnosis and treatment issues, scope, and
150757 - coordination requirements expand, rising
150758 - entropy requires proactive, comprehensive
150759 - management adding energy to maintain
150760 - order, and structure for understanding
150761 - patterns of cause and effect that
150762 - control future results
150763 - under the 2nd law of
150764 - thermodynamics...................... 061020, ref SDS 27 MO4K
150766 - ..
150767 - 34. Cancer treatment cascades into more
150768 - than 30 issues that overwhelm
150769 - medical management.................. 061020, ref SDS 27 PB3H
150771 - ..
150772 - 35. Computer paperless office for fast,
150773 - easy access to solve world problems
150774 - using artificial intelligence (AI)
150775 - Knowledge Management (KM), networks,
150776 - organizational memory with trails
150777 - of associations evolving goals
150778 - since 1945.......................... 061024, ref SDS 28 UN6L
150780 - ..
150781 - 36. Computer access fails with everything
150782 - on computer due to narrow focus,
150783 - infrequent use people forget commands,
150784 - don't have time, embarrassed to
150785 - ask for help........................ 061024, ref SDS 28 NU5O
150787 - ..
150788 - 37. Doctors cannot find information in Kaiser's
150789 - medical chart for patients required to
150790 - accurately guide care in time
150791 - to be effective..................... 061024, ref SDS 28 9W4O
150793 - ..
150794 - 38. Treatment prescribed for anemia
150795 - from a single test finding low blood
150796 - counts in 2006; conflicts with case
150797 - study on 3 year patient history of
150798 - consistent low counts and treatment
150799 - never prescribed.................... 061110, ref SDS 29 DT7O
150801 - ..
150802 - 39. Policy procedure applied with deference
150803 - to doctor's discretion treating
150804 - medical necessity in time
150805 - to be effective..................... 061201, ref SDS 30 N96O
150807 - ..
150808 - 40. Keflex antibiotics prescribed for
150809 - Cellulitis.......................... 061203, ref SDS 31 YT4M
150811 - ..
150812 - 41. Chemotherapy trials promoted for
150813 - expanding pool of drugs and increasing
150814 - theraputic benefits with reduced
150815 - side effects, but rarely result in
150816 - helping patients when trials are
150817 - completed........................... 061208, ref SDS 32 WI3J
150819 - ..
150820 - 42. Tumor Board considerations doctor
150821 - fails to support patient
150822 - requests............................ 061218, ref SDS 33 K36G
150824 - ..
150825 - 43. Double-agent couplets chemotherapy
150826 - routinely prescribed for Millie does
150827 - not support representation of preference
150828 - for prescribing single-agent treatment
150829 - to preserve options of declining
150830 - pool of drug
150831 - agents.............................. 061218, ref SDS 33 U16H
150833 - ..
150834 - 44. Heart specialist request examination
150835 - heart disorder "Cor Pulmonale" enlarged
150836 - right ventricle symptoms not relieved
150837 - by treatment difference from prior
150838 - presentation when pulmonary embolism
150839 - recovery occurred with a few weeks
150840 - treatment; Kaiser reluctant to make
150841 - referral for examination by heart
150842 - specialist.......................... 061228, ref SDS 34 JU9L
150844 - ..
150845 - 45. Emotional roller coaster suffered
150846 - by cancer patients.................. 070105, ref SDS 35 Y642
150848 - ..
150849 - 46. Crisis management discovers problems
150850 - only after prolonged exposure that
150851 - complicates treatment and reduces
150852 - chances of recovery................. 070105, ref SDS 35 FG6J
150854 - ..
150855 - 47. Collaboration coordination between
150856 - Kaiser and UCSF on referral for treatment
150857 - on clinical study shows prodigouos
150858 - efforts to expedite the work reduce
150859 - delay to only 1 month, with 3 blood
150860 - tests and 2 CT scans................ 070130, ref SDS 37 2X6L
150862 - ..
150863 - 48. Lymphedema and Cellulitis history
150864 - of symptoms, diagnosis, and
150865 - treatment........................... 070130, ref SDS 36 VX6F
150867 - ..
150868 - 49. Erratic changes IBC rash intensity
150869 - tracks changes in CA 15-3 cancer
150870 - marker.............................. 070130, ref SDS 36 SE9O
150871 - Study actually cites part of earlier
150872 - review on patient history in the
150873 - record on 040517. ref SDS 4 KR8O
150875 - ..
150876 - 50. Exercise improves fitness strengthens
150877 - immune system to resist cancer and
150878 - withstand aggressive chemotherapy to
150879 - recover from cancer; but chemotherapy
150880 - reduces energy, causes fatigue, weakness
150881 - shortness of breath, cough associated
150882 - with pulmonary embolism, which also
150883 - causes shortness of breath that impairs
150884 - exercise and reduces fitness, weakens
150885 - immune system to resist cancer; all
150886 - improve after chemotherapy treatment
150887 - ends, and and while on treatment
150888 - with Coumadin
150889 - (warfarin).......................... 070218, ref SDS 38 3M3J
150891 - ..
150892 - 51. Blood test diagnostic differences between
150893 - UCSF Kaiser collaborration clinical study
150894 - drug trial increases risk medical
150895 - mistakes requires coordination
150896 - plan to calculate common
150897 - results ............................ 070301, ref SDS 39 Q659
150899 - ..
150900 - 52. Communication coordination collaboration
150901 - stressful for patients care providers
150902 - ordering CT test evaluating PE and response
150903 - to treatment that guides next cycle of
150904 - care recovering from
150905 - cancer.............................. 070307, ref SDS 40 G56L
150907 - ..
150908 - 53. Collaboration communication fails to
150909 - expedite coordinate proactive management
150910 - to be prepared for productive meetings
150911 - people prefer conversation rather
150912 - than invest time for study to be
150913 - prepared to review comprehensive
150914 - list of side effects; cannot get
150915 - blood test reports, cannot order CT
150916 - test, Kaiser cannot follow doctor's
150917 - order for spiral CT to test for
150918 - pulmonary embolism, CT test report
150919 - fails to make comprisons for
150920 - context and reporting
150921 - trends.............................. 070329, ref SDS 41 S63K
150923 - ..
150924 - 54. Emotional roller coaster threatens
150925 - recovery from cancer when communication
150926 - fails to enable collaboration on
150927 - expediting the work................. 070329, ref SDS 41 Y642
150929 - ..
150930 - 55. Cat bites and other causes Cellulitis
150931 - fever, swollen, and inflammed
150932 - left arm............................ 070419, ref SDS 42 KG8G
150934 - ..
150935 - 56. Emergency treatment for temperature
150936 - over 100.5 implementing policy
150937 - procecures at Kaiser................ 070607, ref SDS 43 1N3X
150939 - ..
150940 - 57. Treatment conflicts place patient
150941 - at risk; problems avoided with doctor
150942 - patient partnership supported by
150943 - accurate diary...................... 070611, ref SDS 44 H64L
150945 - ..
150946 - 58. Clinical trial Kaiser referrals prescribed
150947 - by doctor standard of care for oncology
150948 - care; all costs paid by Kaiser to expand
150949 - pool of treatments for Millie's patient
150950 - profile the same as if profile the same
150951 - as if delivered without clinical
150952 - trial; no demand for 20%
150953 - coinsurance was ever
150954 - made by
150955 - Kaiser.............................. 070830, ref SDS 45 LQ5I
150957 - ..
150958 - 59. 2nd Opinion written reviews contribute
150959 - significantly to Millie's recovery
150960 - from continual relapse of
150961 - IBC................................. 080110, ref SDS 46 F47O
150963 - ..
150964 - 60. CT test with Power Port and Huber needle
150965 - schedule work to replace conventional
150966 - IV power injection contrast
150967 - media............................... 080502, ref SDS 47 VG5J
150969 - ..
150970 - 61. Interstitial disease in Millie's
150971 - patient history..................... 080723, ref SDS 48 7W6F
150973 - ..
150974 - 62. Biopsy test to expand cancer treatments
150975 - from changing triple negative status
150976 - to HER2 neu positive
150977 - ordered............................. 081016, ref SDS 50 J36R
150978 - pathology report on biopsy took
150979 - 50 tasks over 2
150980 - months.............................. 081016, ref SDS 50 W26G
150982 - ..
150983 - 63. Neutropenia Millie had 42 treatments
150984 - with Neupogen due to low blood counts
150985 - and so missed only 4 of 21 chemotherapy
150986 - treatments prescribed on cetuximab
150987 - and Carboplatin
150988 - protocol............................ 081023, ref SDS 51 OK67
150990 - ..
150991 - 64. CT scan tests for neck, chest, abdomen,
150992 - and pelvis, sometimes the head for
150993 - 7 years have always been consolidated
150994 - into a single
150995 - report.............................. 081113, ref SDS 53 HV4H
150996 - until separate reports were issued
150997 - for CT test on 081107 that were
150998 - distributed days apart initially
150999 - for chest, abdomen and
151000 - pelvis.............................. 081112, ref SDS 52 RU6R
151001 - and then for the only the
151002 - neck................................ 081113, ref SDS 53 RU6R
151004 - ..
151005 - 65. Dilemma cancer treatment balance Neupogen
151006 - treatments and pausing cancer treatments
151007 - to maintain blood counts so that Millie
151008 - can optimize recovery from 5th relapse of
151009 - IBC by maximizing sunitinib that shows high
151010 - effectiveness, and reduce chemotherapy
151011 - cyclophosphamide that may be resisted
151012 - by Millie's mutated cancer cells and
151013 - likely has severe side effects
151014 - that reduce blood
151015 - counts.............................. 081230, ref SDS 54 I87N
151017 - ..
151018 - 66. Drugs proposed by UCSF for treating Millie's
151019 - cancer as a chronic disease, and requested
151020 - by UCSF from the patient in order to
151021 - expedite prescribing Millie's next
151022 - treatment in time to recover
151023 - from 7th relapse of
151024 - cancer.............................. 090121, ref SDS 55 H95J
151026 - ..
151027 - 67. Disorder Medical Chart confuses doctors
151028 - and staff, growing complexity makes
151029 - accuracy difficult and
151030 - annoying............................ 090213, ref SDS 56 9L8O
151032 - ..
151033 - 68. Complexity patient history compounded by
151034 - medical success extending longevity
151035 - Knowledge Management dilemma 6th relapse
151036 - in 8 years of treatment for IBC overwhelms
151037 - case management; synergy doctor/patient
151038 - partnership enables medical team
151039 - to provide commprehensive
151040 - care................................ 090213, ref SDS 56 IG5O
151042 - ..
151043 - 69. 2nd opinions implemented by Kaiser
151044 - collaboration expands experience and
151045 - expertise for Millie's health care
151046 - to extend quality of
151047 - life................................ 090213, ref SDS 56 J58K
151048 - cancer mutates resists chemotherapy
151049 - after 7 relapses; Doctor Johnson prescribes
151050 - treating Millie's cancer as chronic disease;
151051 - asks Millie to ask UCSF for list of treatments
151052 - targeted to patient profile; UCSF lost their
151053 - list; asks Millie for help; Millie orders
151054 - 2nd opinion identifies 10 targeted treatments;
151055 - Millie requests standard of care comparing
151056 - trade-offs for list of prioritized
151057 - treatments.......................... 090213, ref SDS 56 PT3N
151059 - ..
151060 - 70. Life ending get affairs in order stage IV cancer
151061 - less than 1 year to live case study shows Kaiser
151062 - and UCSF have defied odds with Millie
151063 - in continuous treatment for 8
151064 - years............................... 090213, ref SDS 56 L19H
151066 - ..
151067 - 71. CA 15-3 cancer marker mapped with
151068 - treatment history................... 090323, ref SDS 57 J13O
151070 - ..
151071 - 72. Blood tests at Kaiser chronic delays
151072 - fail to enable effective labs
151073 - for referral care at
151074 - UCSF................................ 090325, ref SDS 58 KZ6N
151076 - ..
151077 - 73. Stage V treat Millie's cancer as a chronic
151078 - disease; Kaiser single-agent chemotherapy
151079 - treatments for breast cancer which Millie
151080 - has not yet received, like Gemzar and
151081 - Navelbine, are not appropriate for Millie's
151082 - complex patient profile which requires
151083 - targeted drugs to recover from
151084 - 8th relapse of Stage
151085 - IV cancer........................... 090325, ref SDS 58 L15M
151087 - ..
151088 - 74. Patients cannot "choose" to get any
151089 - treatment when they decide to do so;
151090 - doctors must prescribe care and
151091 - issue a signed chemotherapy
151092 - order authorizing
151093 - treatment........................... 090528, ref SDS 60 4T7L
151095 - ..
151096 - 75. Compare trade-offs based on best evidence
151097 - treatment effectiveness, side effects
151098 - (minimize suffering), requested by Millie;
151099 - and totally ignored by medical team contrary
151100 - to published guidance that doctor's have
151101 - fiducuary duty to provide standard
151102 - of care comparing treatment
151103 - choices............................. 090725, ref SDS 61 X66O
151105 - ..
151106 - 76. Millie and nurses suffer pain and emotional
151107 - trauma from IV needle punctures failing for
151108 - blood draws, infusion cancer treatments and
151109 - injecting CT test contrast medium because
151110 - repeated punctures cause scarring in veins
151111 - that prevents flow; doctor orders Power Port
151112 - new technology to avoid pain, save time
151113 - and money; implementation resisted
151114 - causing mistakes that increase
151115 - pain and suffering, costs and
151116 - time for performing
151117 - the work............................. 100113, ref SDS 62 9J6F
151119 - ..
151120 - 77. Millie very lucky inspirational looks good
151121 - surviving stage IV cancer for 9 years continual
151122 - treatment constitutes stage V cancer that requires
151123 - doctor patient partenrship treating cancer as a
151124 - chronic disease overcome mistakes and
151125 - resistance to good
151126 - management........................... 100419, ref SDS 63 3M5G
151128 - ..
151129 - 78. Millie submitted 44 written requests for treatment
151130 - "targeted" to cancer with PARP or equal to recover
151131 - from UCSF medical mistakes, and notifies that
151132 - chemotherapy is not effective for Millie's patient
151133 - profile, causes fatal infections, and severe pain
151134 - and suffering; violates Millie's human rights to life,
151135 - equal to woman's right to choose for unborn child;
151136 - failure to provide reasonable necessary care to recover
151137 - from medical mistakes denies Millie due process
151138 - for standard of care comparing trade-offs
151139 - on treatment results and costs in terms
151140 - of pain and suffering, time,
151141 - and money............................ 100622, ref SDS 64 LQ7G
151143 - ..
151144 - 79. Millie treated for urgent care at
151145 - Kaiser Minor Injury Clinic........... 121108, ref SDS 65 2L7O
151146 -
151147 -
151148 -
151149 -
151150 -
151151 -
151152 -
151153 -
1512 -