CONTACTS 

SUBJECTS
Cellulitus Improved Letter to Kaiser Asking About Treatment with Ant

1303 -
1303 -    ..
1304 - Summary/Objective
1305 -
130501 - Follow up ref SDS 22 0000. ref SDS 18 0000.
130502 -
130503 - This morning Cellulitus seems better even without treatment.
130504 - ref SDS 0 MF9H  Millie sent a letter notifying the doctor she may not
130505 - need another prescription of antibiotics. ref SDS 0 V45L  IBC seems to
130506 - be traveling across the chest and infecting the right breast.
130507 - ref SDS 0 I93X  Millie asks the doctor about progress investigating
130508 - drug trials, including UCSF proposals. ref SDS 0 I944  Later in the
130509 - morning, Cellulitus was much improved, and the rise of rash on the
130510 - left chest, including creeping onto the right breast subsided,
130511 - suggesting there is cellulitus in the left breast as well as IBC.
130512 - ref SDS 0 PQ7U
130513 -
130514 -            [On 061205 Cellulitus seems a bit worse in the evening; so,
130515 -            Millie will start taking antibiotics treatments.
130516 -            ref SDS 23 P760
130517 -
130518 -
130519 -
130520 -
130521 -
130523 -  ..
1306 -
1307 -
1308 - Progress
1309 -
130901 - Cellulitus seems better this morning, slighlty less inflammed.
130902 - Millie still does not have a temperature.
130903 -
130905 -  ..
130906 - IBC Expands Across from Left to the Right Breast
130907 -
130908 - Millie noticed that IBC rash has spread across her sternum and begun
130909 - to invade the right breast, at least that is how it looks.  There is a
130910 - small portion of inflammation about .5" or less in diameter now
130911 - evident on the inner part of the right breast, and connected to the
130912 - rash on the left chest area.
130914 -  ..
130915 - This seems like a major change for the worse from examination on
130916 - Friday, 061201, ref SDS 21 025H, reflecting scenario #2 developed on
130917 - 060808.
130918 -
130919 -            [On 061208 1200 examination at Kaiser confirms spread of
130920 -            IBC to right breast. ref SDS 24 AX6G
130922 -  ..
130923 - This could be a complication of Cellulitus, and reacting to the cat
130924 - bite, as discussed in the record yesterday. ref SDS 22 MF9H
130925 -
130926 -            [...below, this afternoon IBC rash seems much improved on
130927 -            the left chest, and gone from right breast. ref SDS 0 FF4L
130929 -             ..
130930 -            [...below, letter to doctor reports remarkable improvement
130931 -            in IBC inflammation. ref SDS 0 2P8U
130933 -             ..
130934 -            [On 061205 IBC inflammation on left chest seems worse
130935 -            again, and has appeared again slightly on the right breast,
130936 -            possiby Cellulitus rather than IBC. ref SDS 23 P76F
130938 -             ..
130939 -            [On 070222 examination at UCSF indicates rash on upper left
130940 -            arm likely expanding IBC. ref SDS 30 B64F
130942 -  ..
130943 - Millie submitted ref DIT 1 0001 to the primary care physician at
130944 - Kaiser, and the following letter last night, ref DIP 2 0001, to the
130945 - primary care physician notifying Kaiser that...
130946 -
130947 -    1.  I got through the night okay.  The left arm still has a solid
130948 -        red rash (inflammation). [per report yesterday, 061203, citing
130949 -        cat bite possibly causing complications. ref SDS 22 MF9H]  I
130950 -        think it is reduced this morning.  Temperature has been okay.
130951 -        ref DIT 1 0001
130953 -         ..
130954 -    2.  Therefore, maybe I don't need antibiotic treatment.  If you
130955 -        decide to go ahead with treatment today, I would like to get
130956 -        some extra pills in order to address this type of problem if it
130957 -        occurs again. ref DIT 1 I932
130958 -
130959 -            [...below, the doctor prescribes antibiotics. ref SDS 0
130960 -            ZS5N
130962 -         ..
130963 -    3.  It looks like IBC rash on my left chest has traveled across the
130964 -        sternum and begun to invade the right breast.  At this time it
130965 -        is very slight, but evident.  Maybe that is driving CA 15-3.
130966 -        ref DIT 1 I93X
130967 -
130968 -            [...below, the doctor does not comment on this development.
130969 -            ref SDS 0 S13N
130971 -             ..
130972 -            [On 061208 1200 examination at Kaiser confirms spread of
130973 -            IBC to right breast. ref SDS 24 AX6G
130975 -             ..
130976 -            [On 070130 IBC progression spreads to stomach and wrapping
130977 -            toward back, examination at UCSF. ref SDS 27 M68J
130979 -             ..
130980 -            [On 070222 examination at UCSF indicates rash on upper left
130981 -            arm likely expanding IBC. ref SDS 30 B64F
130983 -             ..
130984 -            [On 091112 0930 IBC has now spread significantly onto
130985 -            Millie's right side for the first time in 8 years of
130986 -            treatment, and caused by cancer untreated in the breastbone
130987 -            for 6 months, due to medical mistakes getting radiation
130988 -            treatments at UCSF on referral from Kaiser. ref SDS 31 8G6O
130990 -         ..
130991 -    4.  Has Kaiser given any further thought to drug trials in my case?
130992 -        On 060711 you asked Rosalie to look into this.  Has she issued
130993 -        a report?  What about UCSF's letter on 060821 received during
130994 -        the meeting on 060929?  Have you had a chance to collaborate on
130995 -        efficacy of drug trials Doctor Benz cited in his letter to
130996 -        Kaiser? ref DIT 1 I944
130998 -             ..
130999 -            [...below, the doctor does not comment on drug trials for
131000 -            Millie. ref SDS 0 P64H
131002 -             ..
131003 -            [...below, Millie asks again for Kaiser's research on drug
131004 -            trials. ref SDS 0 2P9T
131006 -             ..
131007 -            [...below, later today the doctor responded in a letter
131008 -            saying "no problem," but the reference is unclear.
131009 -            ref SDS 0 OQ7L
131011 -         ..
131012 -    5.  Please let me know about treatment for cellulitus in my left
131013 -        arm. ref DIT 1 I952
131014 -
131015 -            [...below, the doctor prescribes antibiotics. ref SDS 0
131016 -            S14J
131017 -
131019 -  ..
1311 -
1312 -
1313 - 0940
1314 -
131401 - Millie received a letter saying the doctor cannot respond, because the
131402 - doctor is out of the office.
131404 -  ..
131405 - Considered submitting follow up to Arlette, who has been helpful in
131406 - the past coordinating communciations when the primary care physician
131407 - has been out of the office.
131409 -  ..
131410 - Decided against this because do not want to over tax Arlette's
131411 - excellent efforts for Millie.
131413 -  ..
131414 - Millie feels very badly from side effects of chemotherapy beginning on
131415 - Friday with Taxotere, and continuing with capecitabine (Xeloda) for
131416 - the next several weeks.
131418 -  ..
131419 - She feels side effects are harder to bear now than earlier in the
131420 - treatment, beginning on 060721.
131421 -
131422 -
131423 -
131425 -  ..
1315 -
1316 -
1317 - 1001
1318 -
131801 - Cellulitus Inflammation Improved
131802 - Inflammation Right Breast Recedes Indicating Cellulitus Not IBC
131803 -
131804 - Examination indicates Cellulitus in left arm is much better.
131805 -
131806 -            [On 061205 Cellulitus seems a bit worse in the evening; so,
131807 -            Millie will start taking antibiotics treatments.
131808 -            ref SDS 23 P760
131810 -  ..
131811 - Coloration in the right breast has receded, and even the left breast
131812 - area looks much better.
131814 -  ..
131815 - Possibly, there has been a compound problem on the left breast of
131816 - cellulitus with IBC, caused in part by the cat bite, per analysis
131817 - above. ref SDS 0 5N5M, and citing analysis yesterday. ref SDS 22 GE5O
131818 - This occurred previously on 041202 when Millie was treated with an
131819 - antibiotic for cellulitus, and this increased inflammation on the left
131820 - breast, spreading toward the neck. ref SDS 2 415Y
131822 -  ..
131823 - IBC has proven to wax and wane, noted by Doctor Benz in his opinion on
131824 - 061018 received and reported on 061117. ref SDS 1 OS6W
131825 -
131826 -
131828 -  ..
1319 -
1320 -
1321 - 1610
1322 -
132201 - Received ref DRT 1 0001 from the primary care physician saying...
132203 -         ..
132204 -    1.  [Responding to your letter this morning notifying of Cellulitus
132205 -        recurrence, possibly due to cat bite... ref SDS 0 V45L]
132207 -         ..
132208 -    2.  I sent a prescription for Keflex, with a renewal, to Shadelands
132209 -        Pharmacy.  I hope you continue to do well.
132211 -  ..
132212 - Prescribing antibiotics for Cellulitus, responds to Millie's letter
132213 - this morning notifying of recurrence, possibly related to cat bite a
132214 - few weeks ago. ref SDS 0 V45L
132215 -
132216 -            [On 070214 Millie notifies primary care physician rash
132217 -            observed during examination on 070202, ref SDS 28 JP6F,
132218 -            continues on left arm, requests refill prescription
132219 -            antibiotic treatment for cellulitus, Keflex. ref SDS 29
132220 -            R66P
132222 -  ..
132223 - The doctor does not comment on new developments of IBC spreading from
132224 - the left chest slightly across the sternum to the right breast, per
132225 - above. ref SDS 0 I93X
132227 -  ..
132228 - For some reason, the doctor does not report Kaiser's work on finding
132229 - drug trials for Millie, which Mil requested in her letter this
132230 - morning, per above. ref SDS 0 I944
132231 -
132233 -  ..
1323 -
1324 -
1325 - 1623
1326 -
132601 - Millie submitted ref DIT 1 0001 reporting evident improvement noticed
132602 - earlier today, per above. ref SDS 0 PQ7U
132603 -
132604 -    1.  Thanks very much for the prescription renewal, set out in your
132605 -        letter earlier today.  I will go and get the pills, and hold
132606 -        them in reserve.
132608 -         ..
132609 -    2.  Good news.
132611 -         ..
132612 -    3.  My arm is nearly free of inflammation, and swelling is also
132613 -        down, all without treatment.
132614 -
132615 -            [On 061205 Cellulitus seems a bit worse in the evening; so,
132616 -            Millie will start taking antibiotics treatments.
132617 -            ref SDS 23 P760
132619 -         ..
132620 -    4.  Additionally, my left chest looks remarkably improved from
132621 -        examination this past Friday.  The rash that spread today
132622 -        slightly onto the right breast is gone. ref SDS 0 PQ7U  This
132623 -        suggests Cellulitus may be a complication in the left breast
132624 -        area, possibly related to loss of lymphatics with surgery last
132625 -        year.  I would not expect IBC rash to come and go so easily.
132626 -
132627 -            [On 061205 IBC inflammation on left chest seems worse
132628 -            again, and has appeared again slightly on the right breast,
132629 -            possiby Cellulitus rather than IBC. ref SDS 23 P76F
132631 -         ..
132632 -    5.  In my prior letter today, I asked about progress reviewing drug
132633 -        trials in connection with changing treatments. ref SDS 0 I944
132634 -        Sudden improvement this afternoon may make the matter moot for
132635 -        awhile, especially if CA 15-3 drops to align with reduced IBC
132636 -        rash.  In any case, I would like to see the work up on drug
132637 -        trials, and review of UCSF 2nd opinion proposal.
132638 -
132639 -            [...below, later today the doctor responded in a letter
132640 -            saying "no problem," but the reference is unclear.
132641 -            ref SDS 0 S23J
132643 -             ..
132644 -            [On 061208 Millie reviewed UCSF 2nd opinion on drug trial
132645 -            opportunities with primary care physician during meeting at
132646 -            Kaiser, ref SDS 24 VT7F, Kaiser requested assistance to
132647 -            facilitate review. ref SDS 24 P256
132649 -             ..
132650 -            [On 061218 Kaiser assisted in finding UCSF 2nd opinion, and
132651 -            proposals for treating Millie on clinical study drug
132652 -            trials. ref SDS 25 086H
132654 -             ..
132655 -            [On 061228 Kaiser performing due diligence investigating
132656 -            drug trials for treating Millie. ref SDS 26 086H
132657 -
132658 -
132659 -
132660 -
132662 -  ..
1327 -
1328 -
1329 - 1642
1330 -
133001 - Millie drove to Kaiser Park Shadelands in Walnut Creek and purchased
133002 - the antibiotics prescribed by the doctor.
133004 -  ..
133005 - Since Cellulitus seems to be clearing up, Millie decided not to take
133006 - antibiotics, and evaluate the condition tomorrow monring for taking
133007 - the medication.
133008 -
133009 -
133010 -
133012 -  ..
1331 -
1332 -
1333 - 2249
1334 -
133401 - Millie received ref DRT 2 0001 from the doctor resonding to the letter
133402 - she sent, ref DIT 2 0001, submitted earlier today, per above.
133403 - ref SDS 0 JK3N
133405 -  ..
133406 - Doctor says...
133407 -
133408 -    1.  [Responding to your letter this afternoon reporting improvement
133409 -        in IBC and Cellulitus inflammation, ref SDS 0 2P7X, and asking
133410 -        about Kasier's progress reviewing drug trials for Millie, and
133411 -        evaluating UCSF proposals, ref SDS 0 2P9T...]
133413 -         ..
133414 -    2.  No problem. ref DRT 2 0001
133416 -  ..
133417 - The doctor's comment seems unclear.  Could mean the doctor plans to
133418 - submit Kaiser's research on drug trials for Millie's patient profile,
133419 - requested in Millie's 2nd letter, ref SDS 0 2P9T,
133420 -
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133422 -
133423 -
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133427 -
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1335 -