Click here to comment!
1...Consistently low pulse, does it reflect low blood pressure
CONTACTS
SUBJECTS
Treatment Cetuximab 4th Treatment 3rd Cycle Chemotherapy 10th Cycle
1103 -
1103 - ..
1104 - Summary/Objective
1105 -
110501 - Follow up ref SDS 40 0000. ref SDS 38 0000.
110502 -
110503 - Millie received the 4th treatment in the 3rd cycle of the cetuximab
110504 - clinical study. A blood test was done out of sequence to perform a
110505 - culture testing for infection on the port catheter. Energy continues
110506 - to recover well after treatment. Fatigue also may reflect
110507 - accumulating side effects of cetuximab shown by sleeping for several
110508 - hours following treatment. ref SDS 0 D48I
110509 -
110510 -
110511 -
110512 -
110514 - ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Clinic Examination Orientation Starting Treatment Cetuximab
110902 -
110903 - Follow up ref SDS 40 407N, ref SDS 38 407N.
110905 - ..
110906 - Agenda...
110907 -
110908 - 1. Breast examination........................ ref SDS 0 FO6H
110909 - 2. Infusion Clinic........................... ref SDS 0 1M6H
110910 - 3. Side effects.............................. ref SDS 0 QU8K
110911 -
110912 -
110913 -
110914 -
1110 -
SUBJECTS
Breast Examination Performed in Breast Care Clinic Prior to Treatmen
1903 -
190401 - ..
190402 - Breast Examination IBC Intensity Declines
190403 -
190404 - Follow up ref SDS 40 FO6H, ref SDS 38 FO6H.
190405 -
190406 - Breast examination performed in Breast Care clinic. ref SDS 41 025H
190407 -
190408 -
190409 -
1905 -
SUBJECTS
Emotional Health Not Reviewed Examination Breast Care Clinic Prior t
2603 -
260401 - ..
260402 - Emotional Roller Coaster Endemic Cancer Treatment and Coordination
260403 -
260404 - Follow up ref SDS 40 6A7J, ref SDS 38 6A7J.
260405 -
260406 - Emotional health reviewed during examination performed in Breast Care
260407 - clinic. ref SDS 41 Y642
260408 -
260409 -
260410 -
2605 -
SUBJECTS
Prognosis Reviewed Examination Breast Care Clinic Prior to Treatment
3203 -
320401 - ..
320402 - Cetuximab Prognosis IBC May Subside for 10 Months Before Progressing
320403 - Prognosis Disease May Subside 10 Months or More Before Progression
320404 - Progresssion of Disease May be Delayed for 10 Months or More
320405 -
320406 - Follow up ref SDS 40 6A9H, ref SDS 38 6A9H.
320407 -
320408 - Prognosis reviewed with medical team during examination in the Breast
320409 - Care Clinic. ref SDS 41 M645
320410 -
320411 -
320412 -
3205 -
SUBJECTS
Measurable Disease Not Reviewed No Examination Breast Care Clinic Pr
3803 -
380401 - ..
380402 - Measureable Disease Photographs IBC Rash Improving
380403 - IBC Rash Improved Measurable Disease Photographs Tape Measure
380404 -
380405 - Follow up ref SDS 40 6T6M, ref SDS 38 6T6M.
380406 -
380407 - Measurable disease will be reviewed with medical team during
380408 - examination in the Breast Care Clinic that will start the next
380409 - treatment cycle on 070426.
380410 -
380411 -
380412 -
380413 -
380414 -
3805 -
SUBJECTS
Side Effects Reviewed Examination in Breast Care Clinic Prior to Tre
4403 -
440401 - ..
440402 - Side Effects Medicated After Weekly Examinations
440403 -
440404 - Follow up ref SDS 40 FO66, ref SDS 38 FO66.
440405 -
440406 - Side Effects reviewed with medical team during examination in the
440407 - Breast Care Clinic. ref SDS 41 TQ6L
440408 -
440409 -
440410 -
440411 -
4405 -
SUBJECTS
Cetuximab 3rd Cycle 4th Treatment 12th Total Treatment Chemotherapy
5003 -
5004 - 0845
500501 - ..
500502 - Infusion Clinic for Cetuximab Treatent
500503 -
500504 - Follow up ref SDS 40 1M6H, ref SDS 38 1M6H.
500506 - ..
500507 - Millie received 12th overall and 4th treatment of 3rd cycle with
500508 - Cetuximab, starting from 070201, ref SDS 15 G68I, and the 19th
500509 - treatment for 3rd relapse of IBC, beginning on 060721. ref SDS 4 407N
500511 - ..
500512 - Catherine was the nurse today.
500514 - ..
500515 - Taxotere Capecitabine
500516 -
500517 - Follow up ref SDS 40 PR8Q, ref SDS 38 PR8Q.
500518 -
500519 - Relapse Treatments
500520 -
500521 - 1. Cycle 09 and 01 ................... 060721, ref SDS 4 407N
500522 - 2. Cycle 10 and 02 ................... 060814, ref SDS 7 LY6O
500523 - 3. Cycle 11 and 03 ................... 060908, ref SDS 8 407N
500524 - 4. Cycle 12 and 04 ................... 060929, ref SDS 9 407N
500525 - 5. Cycle 13 and 05 ................... 061020, ref SDS 10 407N
500526 - 6. Cycle 14 and 06 ................... 061110, ref SDS 11 407N
500527 - 7. Cycle 15 and 07 ................... 061201, ref SDS 12 407N
500529 - ..
500530 - Cetuxiab Clinical Study
500531 -
500532 - Follow up ref SDS 40 7T3H, ref SDS 38 7T3H.
500533 -
500534 - Total Cetuximab
500535 - 8. Cycle 01 and 08 and 01 01.......... 070201, ref SDS 15 SG8I
500536 - 9. Cycle 01 and 08 and 02 02.......... 070208, ref SDS 17 SG8I
500537 - 10. Cycle 01 and 08 and 03 03.......... 070215, ref SDS 18 SG8I
500538 - 11. Cycle 01 and 08 and 04 04.......... 070222, ref SDS 21 SG8I
500539 - 12. Cycle 02 and 09 and 01 05.......... 070301, ref SDS 24 SG8I
500540 - 13. Cycle 02 and 09 and 02 06.......... 070308, ref SDS 27 7T3H
500541 - 14. Cycle 02 and 09 and 03 07.......... 070315, ref SDS 29 7T3H
500542 - 15. Cycle 02 and 09 and 04 08.......... 070322, ref SDS 30 7T3H
500543 - 16. Cycle 03 and 10 and 01 09.......... 070329, ref SDS 35 7T3H
500544 - 17. Cycle 03 and 10 and 02 10.......... 070405, ref SDS 38 7T3H
500545 - 18. Cycle 03 and 10 and 03 11.......... 070412, ref SDS 40 7T3H
500546 - 19. Cycle 03 and 10 and 04 12.......... 070419, ref SDS 0 7T3H
500548 - ..
500549 - Nurses Notes...
500560 - ..
500561 - Why is the visit number constant in Nurse's Notes, and yet seems to
500562 - vary in the schedule received from Nola last week? ref SDS 29 159O
500564 - ..
500565 - UCSF Log Time...
500566 -
500567 - Blood
500568 - Test Infusion
500569 -
500570 - In....... 0930
500571 - Out...... 1230
500572 - Visit.... Min 3.0 Hours Total 3 Hours
500574 - ..
500575 - Pain Assessment...
500576 -
500577 - x
500578 - 0123456789 10
500579 -
500580 - <923k
500581 - Administration Site: Right Port Catheter
500582 - Needle Size: 20 G 1"
500583 - Blood Return Good: Yes
500585 - ..
500586 - Remind patient to call MD if temp > 101 F, Shaking Chills
500587 -
500588 - This protocol differs from Kaiser requirements, reported on
500589 - 041202. ref SDS 1 IX9N
500590 -
500591 -
500592 -
500593 -
5006 -
SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A
6703 -
6704 - 0840
670501 - ..
670502 - Side Effects Minimal...
670503 -
670504 - Follow up ref SDS 40 QU8K, ref SDS 38 QU8K.
670506 - ..
670507 - Nurse's notes report side effects...
670509 - ..
670510 - 1. Rash acne-like
670511 -
670512 - Follow up ref SDS 40 SK9O
670513 -
670514 - Minimal facial rash continues from 070208 around the nose
670515 - and chin. ref SDS 17 QU8K Millie reported slight increased
670516 - rash on the chin, which is not noticable today, except by
670517 - careful examination. Treatment very effective with
670518 - medication prescribed on 070222. ref SDS 21 FO66
670519 -
670521 - ..
670522 - 2. Dry skin face, chest arm
670523 -
670524 - Follow up ref SDS 40 JS6M
670525 -
670526 - Background on notice and treatments prescribed reported on
670527 - 070322. ref SDS 30 JS6M Medical team commented during
670528 - examination on 070329, how well Millie looks. ref SDS 33
670529 - N49K The next day on 070330, the primary care physician at
670530 - Kaiser commented similarly, during follow up examination.
670531 - ref SDS 37 N49K This indicates UCSF examinations by
670532 - Catherine in the Infusion Clinic, and by Brigid in the
670533 - Breast Care Center has been timely, thorough, and effective
670534 - prescribing Curel on 070301, ref SDS 23 5V73, and later
670535 - Aquaphor on 070322. ref SDS 30 JS6M
670536 -
670538 - ..
670539 - 3. Inflammation Possible Infection Port Catheter
670540 -
670541 - Doctor Rugo noticed this morning during examination in the
670542 - Breast Care Center that there is a slight inflammation at
670543 - the needle penetration for the port catheter. There is
670544 - also a large blemish, perhaps .5" diameter about .75" above
670545 - the port catheter. ref SDS 41 S640
670547 - ..
670548 - The doctor ordered a culture with a blood test this
670549 - morning, per below, ref SDS 0 R54J, to evaluate these new
670550 - conditions, which may be side effects of cetuximab.
670551 -
670553 - ..
670554 - 4. Inflammation rash right chest
670555 -
670556 - Follow up ref SDS 40 KU3L
670557 -
670558 - Examination of right chest observes various blemishes.
670559 - Nurses's Notes report no rash above the port, continuing
670560 - observations the last several weeks reported on 070329.
670561 - ref SDS 35 KU3L Patient reports no interim recurrent rash
670562 - at this location.
670563 -
670565 - ..
670566 - 5. Rash right arm
670567 -
670568 - Follow up ref SDS 40 LI4M
670569 -
670570 - Catherine does not comment on this issue in Nurse's Notes
670571 - today. Examination by the medical team on 070329 found no
670572 - evidence of disease in the right arm. ref SDS 33 H15M
670573 -
670575 - ..
670576 - 6. Restless legs side effect Benedryl Resolved
670577 -
670578 - Follow up ref SDS 40 F77K
670579 -
670580 - This was resolved on 070329 by Brigid changing the
670581 - chemotherapy order to reduce the dose of Benadryl
670582 - pre-treatment. ref SDS 33 MF4N
670583 -
670585 - ..
670586 - 7. Sleeping difficulty subsided
670587 -
670588 - Follow up ref SDS 40 NG3I
670589 -
670590 - This problem has subsided as worry and doubt have been
670591 - reduced by continuing favorable reports showing response to
670592 - treatment, discussed with the medical team during
670593 - examination on 070329. ref SDS 33 Y642
670594 -
670596 - ..
670597 - 8. Lymphedema Cellulitis Complications
670598 - Inflammation Erratic Upper Left Arm
670599 -
670600 - Follow up ref SDS 40 SU6L
670601 -
670602 - Lymphedema continues relatively controlled with major
670603 - swelling in the left arm measured this morning at 11.5, and
670604 - shown by the study on 060509. ref SDS 2 HO7F There is no
670605 - evident association with cetuximab treatments. Proximate
670606 - cause was left breast mastectomy with removal of lymph
670607 - nodes in the left axillary, complicated by exercise to
670608 - strengthen the immune system for resisting cancer, and by
670609 - cat bites that flow from engaging pets for qualify of life,
670610 - reported in the case study on 070130. ref SDS 14 VX6F
670612 - ..
670613 - Increased intensity of rash on the upper left arm was
670614 - reported on 070330 during examination at Kaiser by primary
670615 - care physician. ref SDS 37 N19J
670617 - ..
670618 - These changes were diagnosed without biopsy as
670619 - complications of lymphedema causing Cellulitis with
670620 - elevated temperature, and possibly triggered by patient's
670621 - increased exercise that overtaxed the system. ref SDS 37
670622 - 7C7F Keflex antibiotics was prescribed, ref SDS 37 474O;
670623 - about 3 hours later self-examination showed increased
670624 - inflammation had subsided, and so Keflex treatment was not
670625 - performed. ref SDS 37 KZ6L
670627 - ..
670628 - Today, there is no evidence of increased inflammation rash
670629 - intensity of the upper left arm, as seen during examination
670630 - by the medical team in the Breast Care Center on the 2nd
670631 - floor prior to treatment.
670633 - ..
670634 - Causes of erratic inflammation were considered during
670635 - examination in the Breast Care Center, ref SDS 41 S57H,
670636 - to assess possibilities...
670637 -
670638 - 1. IBC progression...................... ref SDS 41 527G
670639 - 2. Cellulitis complications lymphedema.. ref SDS 41 4Y93
670640 - 3. Cetuximab side effects inflammation.. ref SDS 41 F57K
670641 - 4. Cat bite............................. ref SDS 41 P67J
670642 -
670644 - ..
670645 - 9. Tired, fatigued - pulmonary emoblism
670646 -
670647 - Follow up ref SDS 40 FG3N
670648 -
670649 - Fatigue, shortness of breath and other symptoms of
670650 - pulmonary embolism were presented during meeting on 070130,
670651 - ref SDS 14 CV5L, citing case study listed on 060722.
670652 - ref SDS 5 ZV41
670654 - ..
670655 - Energy that seemed to be declining leading up to treatment
670656 - on 070301, ref SDS 24 CA4K, has continued to rise back to
670657 - normal, as reported last week on 070322. ref SDS 30 CA4K
670658 - Millie continues working out in the gym, and has started
670659 - hiking the trail at Lafayette Reservoir again, as reported
670660 - to the medical team during examination on 070329.
670661 - ref SDS 33 E44L An active life that brings strength and
670662 - stamina is reflected in Millie's improved vitals, shown
670663 - today, per below. ref SDS 0 AW4L Increased exercise in
670664 - the morning on 070330 may have triggered symptoms of
670665 - Cellulitis diagnosed during examination later in the
670666 - afternoon on 070330. ref SDS 37 7C7F
670668 - ..
670669 - Millie has been taking naps 2 - 3 hours after treatments
670670 - the past month, beginning on 070405. ref SDS 38 BB7G May
670671 - indicate accumulating effects of cetuximab that make
670672 - patients tired, listed as side effect in Consent documents
670673 - reviewed on 070116. ref SDS 13 O64M
670674 -
670676 - ..
670677 - 10. Heavy chest - shortness of breathing
670678 -
670679 - Follow up ref SDS 40 UL6L
670680 -
670681 - Patient history was reported to UCSF on 070130. ref SDS 14
670682 - RT6I
670684 - ..
670685 - Condition seems improved, tracking continuing higher
670686 - energy, per above. ref SDS 38 CA4K
670687 -
670689 - ..
670690 - 11. Cough - clearing throat
670691 -
670692 - Follow up ref SDS 40 8N4G
670693 -
670694 - This condition occassionally increases noticably with
670695 - episodes of mild, contined cough and clearing throat, as
670696 - reported to the doctor on 070130. ref SDS 14 RT6I
670697 -
670699 - ..
670700 - 12. Dry hands and feet
670701 -
670702 - Follow up ref SDS 40 UM32
670704 - ..
670705 - Dry hands and feet seem much improved since ending
670706 - treatment with Taxotere and capecitiabine on 061201.
670707 -
670709 - ..
670710 - 13. Eyes tearing
670711 -
670712 - Follow up ref SDS 40 HM9G
670713 -
670714 - This seems improved since ending treatment with Taxoter
670715 - and capecitabine on 061201.
670716 -
670718 - ..
670719 - 14. Nausea and vomitting
670720 -
670721 - Follow up ref SDS 40 D19M
670723 - ..
670724 - Problems with Taxotere and capecitabine reported on 061110,
670725 - ref SDS 11 D19M, did not occur this past week after
670726 - treatment with cetuximab. As a result, there was no
670727 - pre-treatment with Decadron today, per below. ref SDS 30
670728 - G57I
670730 - ..
670731 - 15. Sores in mouth
670732 -
670733 - Follow up ref SDS 40 KW4R
670734 -
670735 - None yet, cleaning mouth carefully to avoid problem.
670736 -
670737 -
670738 -
670739 -
6708 -
SUBJECTS
Schedule Treatment Weekly Thursday 0800 4 Week Cycles Clinical Study
7303 -
730401 - ..
730402 - Schedule Weekly Treatments Continue on Thursdays
730403 -
730404 - Follow up ref SDS 40 QK6L, ref SDS 38 QK6L.
730406 - ..
730407 - Millie's next treatment is scheduled for 070426 0830, reported by Nola
730408 - on 070315. ref SDS 29 159O
730410 - ..
730411 - The schedule was modifed by the medical team last week on 070412,
730412 - switching Millie's meeting with the doctor from next week to today.
730413 - ref SDS 40 FO6H This change does not affect the schedule for
730414 - treatment next week.
730415 -
730416 -
730417 -
730418 -
7305 -
SUBJECTS
Blood Tests Culture Evaluate Infection Port Catheter Counts Normal C
7903 -
7904 - 0922
790501 - ..
790502 - Blood Test Counts Normal Full Dose Cetuximab Ordered
790503 -
790504 - Follow up ref SDS 35 Q659, ref SDS 27 Q659.
790505 -
790506 - Millie had a blood draw this morning in the Infusion Clinic after
790507 - meeting with the medical team for examination. The test was ordered
790508 - by the doctor to perform a blood culture for assessing a prominent
790509 - blemish near and above the port catheter, as reported earlier this
790510 - morning. ref SDS 41 L55J
790512 - ..
790513 - This was a limited test CBC with DIFF & PLT CT only.
790514 -
790516 - ..
7906 -
7907 -
7908 - 1117
7909 -
790901 - During treatment, Catherine submitted results of the test.
790903 - ..
790917 - ..
790918 - Log#: 070419 09:30
790919 - <----------------------- U C S F -----------------------> <------------- Kaiser -------------->
790920 - Type Results Units Normal ACRO Type Units Normal
790922 - ..
790923 - CBC with DIFF & PLT CT CBCD
790924 - ..
790925 - WBC COUNT 4.6 x10E9/L 3.4 - 10 WBC WBC x10-3 K/uL 3.4 - 10.0
790926 - RBC COUNT 4.33 x10E12/L 4 - 5.2 RBC RBC x10-6 M/uL 3.60 - 5.70
790927 - HEMOGLOBIN 13.6 g/dL 12 - 15.5 HGB Hemoglobin g/dL 11.5 - 15.0
790928 - HEMATOCRIT 39.5 PERCENT 36 - 46 HCT Hematocrit % 34.0 - 46.0
790929 - MCV 91 fL 80 - 100 MCV MCV fL 80.0 - 100.0
790930 - MCH 31.5 pg 26 - 34 MCH
790931 - MCHC 34.5 g/dL 31 - 36 MCHC
790932 - PLATELETS 204 x10E9/L 140 - 450 PLT Plt x10-3 K/uL 140 - 400
790933 - ..
790934 - (NEUTS x 1000 = ANC for Kaiser)
790935 - NEUTS 1.87 x10E9/L 1.8 - 6.8 N-A ANC 1500
790936 - Neutrophils Not Reported Neutrophils % 50 - 70
790938 - ..
790939 - LYMPHS 2.07 x10E9/L 0.9 - 2.9 L-A Lymphocytes % 20 - 50
790940 - MONOS 0.40 x10E9/L 0.1 - 0.6 M-A Monocyte % 0 - 11
790941 - EOS 0.17 x10E9/L 0 - 0.4 E-A Esoinophils % 1 - 5
790942 - BASOS 0.07 x10E9/L 0 - 0.1 B-A Basophil % 0 - 2
790943 - 0 - 5
790944 -
790945 -
7910 -
SUBJECTS
Absolute Neutrophils Count ANC 1870 Above 1800 UCSF Requirement for
8603 -
860401 - ..
860402 - ANC 1870 Above 1800 Criteria for Blood Counts to Approve Treatment
860403 -
860404 - Follow up ref SDS 35 P560, ref SDS 24 P560.
860405 -
860406 - Background on differences representing ANC in Kaiser and UCSF blood
860407 - testing is reported on 070301. ref SDS 24 U37I
860409 - ..
860410 - ANC reported as "NUETS" in the UCSF blood test reported as 1.87, per
860411 - above. ref SDS 0 QY6H This is equivalent to 1810 in Kaiser's scheme.
860413 - ..
860414 - ANC continues rising...
860415 -
860416 - 6972................................ 060814, ref SDS 7 P560
860417 - 6390................................ 060908, ref SDS 8 P560
860418 - 5200................................ 060929, ref SDS 9 P560
860419 - 3869................................ 061020, ref SDS 10 P560
860420 - 2880................................ 061110, ref SDS 11 P560
860421 - 2888................................ 061201, ref SDS 12 P560
860422 - 1760................................ 070201, ref SDS 15 P560
860423 - 1230................................ 070301, ref SDS 24 P560
860424 - 1510................................ 070308, ref SDS 23 P560
860425 - 1810................................ 070329, ref SDS 35 P560
860426 - 1870................................ 070419, ref SDS 0 P560
860428 - ..
860429 - Blood counts for ANC rising shows strengthening immune system that
860430 - reverses prior trend over the past 6 months, which threatened to delay
860431 - or impede schedule of weekly treatments, especially if the doctor
860432 - added carboplatin to increase effectiveness of treatments, as reported
860433 - last month on 070301. ref SDS 24 AZ4G ANC rising over the past 2
860434 - months validates UCSF treatment plan.
860435 -
860436 -
860437 -
860438 -
860439 -
8605 -
SUBJECTS
Port Catheter IV Connection Prepare for Drip Treatment 1 Try Require
9303 -
9304 - 0926
930501 - ..
930502 - Preparation for Treatment Required One (1) Attempt to Connect Port
930503 -
930504 - Follow up ref SDS 40 EB7J, ref SDS 38 EB7J.
930506 - ..
930507 - The nurse connected the IV tubes to the port....
930509 - ..
930510 - Interlink System Vented Paclitaxel set
930512 - ..
930513 - Like last week and earlier on 070301, there were no problems getting
930514 - blood to flow from the port, ref SDS 24 EB7J, as occurred on 070222,
930515 - ref SDS 20 DC5W, and earlier on 070201. ref SDS 15 DC5W
930517 - ..
930518 - The nurse flushed the port with saline.
930520 - ..
930521 - As noted, during examination in the Breast Care Center the doctor
930522 - noticed inflammation at the port catheter penetration, and another
930523 - slightly above. ref SDS 41 S640 The doctor ordered a blood test for a
930524 - culture to investigate infection, per above. ref SDS 0 R54J
930525 -
930526 -
930527 -
930528 -
930529 -
9306 -
SUBJECTS
Blood Draws None Today 7 Vials Clinical Study Research Cetuximab Dru
A003 -
A00401 - ..
A00402 - Blood Draws 7 Vials for Clinical Study Research
A00403 -
A00404 - Follow up ref SDS 40 O56V, ref SDS 38 O56V.
A00405 -
A00406 - Blood draws for the clinical study occur only to start a new cycle; so
A00407 - there were no blood draws today during the 2nd treatment of cycle 3.
A00408 -
A00409 -
A00410 -
A00411 -
A00412 -
A005 -
SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A
A603 -
A604 - 0930
A60501 - ..
A60502 - Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
A60503 -
A60504 - Follow up ref SDS 40 DC7J, ref SDS 38 DC7J.
A60505 -
A60506 - Benadryl (diphenhydramine) started. 50 MG....... ref SDS 30 IJ41
A60507 -
A60508 - Purpose reported on 060721. ref SDS 3 DC7J
A60510 - ..
A60511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
A60512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 38
A60513 - IJ41
A60515 - ..
A60516 - Nurse Notes report NS back up flush 250 cc.
A60517 -
A60518 -
A60520 - ..
A606 -
A607 -
A608 - 0950
A609 -
A60901 - Benedryl completed equipment beeps.
A60903 - ..
A60904 - Millie reported that decreasing the dose of Benadryl pre-treatment to
A60905 - 25 mg completely eliminated previous problems of "restless legs," per
A60906 - above. ref SDS 35 F77K
A60907 -
A60908 -
A60910 - ..
A610 -
A611 -
A612 -
A613 -
A61301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 30 FM4M
A61302 -
A61303 - On 070208 Decadron was not given because Millie did not experience
A61304 - side effects of nausea and vomitting after treatment with cetuximab on
A61305 - 070201. ref SDS 17 G57I Since this favorable condition continues, per
A61306 - above, ref SDS 30 D19M, Decadron was not given again today.
A61307 -
A61309 - ..
A614 -
A615 -
A616 -
A61601 - Decadron completed -- not reported.
A61602 -
A61603 -
A61604 -
A61605 -
A617 -
SUBJECTS
Cetuximab 3rd Cycle 4th Treeatment Clinical Study Drug Trial Treatme
AF03 -
AF04 - 1000
AF0501 - ..
AF0502 - Cetuximab Full Dose Blood Counts on Targets Treatment 1 Hour
AF0503 -
AF0504 - Follow up ref SDS 40 4N5M, ref SDS 38 4N5M.
AF0506 - ..
AF0507 - Cetuximab started.
AF0508 -
AF0509 - Verify chemotherapy order for 070208.
AF0511 - ..
AF0512 - Chemotherapy order calls for cetuximab to start 30 - 60 minutes after
AF0513 - Beyadryl pre-tretment. ref SDS 30 IJ41
AF0515 - ..
AF0516 - Chemotherapy Orders...
AF0517 -
AF0523 - Auth# Stor BCC LOC
AF0524 - Visit: 12575738 DOS 20070201
AF0526 - ..
AF0527 - Date: 20070201
AF0529 - ..
AF0530 - Study Order for CC#05752: Phase II Trial of Cetuximab alone and
AF0531 - in combination with Carboplatin in ER-negative, PR-negative,
AF0532 - HER2-negative Nonoverexpressing Metastatic Breast Cancers
AF0534 - ..
AF0535 - Dates to be given: 070201
AF0536 - Arm 1:Cetuximab alone
AF0538 - ..
AF0539 - Diagnosis: breast cancer
AF0541 - ..
AF0542 - ICD-9 codes: 174.9
AF0543 - Allergies NKDA
AF0545 - ..
AF0546 - Pre-medications 30 - 60 minutes prior to cetuximab infusion
AF0548 - ..
AF0549 - 4. Diphenhydramine 25 mg IV or [illegible writing]
AF0550 -
AF0551 - Benadryl........... ref SDS 30 DC7J
AF0552 -
AF0553 - Earlier this morning, Brigid changed the Chemotherapy Order
AF0554 - reducing Diphenhydramine (Benadryl) from 50 mg to 25 mg in order
AF0555 - to reduce side effects of "restless legs," per above.
AF0556 - ref SDS 35 F77K
AF0558 - ..
AF0559 - This was effective, reported above. ref SDS 35 7R6H
AF0561 - ..
AF0562 - 5. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
AF0563 -
AF0564 - Further premed TBD [barely legible handwriting??]
AF0566 - ..
AF0567 - Medication: (plan to give weekly ********STUDY SUPPLY**********
AF0569 - ..
AF0570 - 6. Cetuximab (Erbitux) (loading dose)
AF0571 -
AF0572 - 400 mg/m [squared] = 684 mg IV over 120 minutes for
AF0573 - first dose x 1
AF0574 -
AF0575 - dose on dcte 20070201 Maximum infusion rate is 5 ml/minute
AF0576 - (concentration 2 mg/ml)
AF0578 - ..
AF0579 - 7. Cetuximab (Erbitux) (maintenance dose)
AF0580 -
AF0581 - 250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
AF0582 - ____mg) IV over 60 or ____ minutes.
AF0583 -
AF0584 - Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
AF0585 - Infuse once weekly for 8 weeks. First dose to be given on date
AF0586 - 20070201.
AF0588 - ..
AF0589 - Cetuximab is administered undiluted through a low protien
AF0590 - binding 0.22 micro in-line filter. Use NS solution to flush the
AF0591 - line at the end of the infusion.
AF0593 - ..
AF0594 - ARM 2: Administer carboplatin of vital signs are unremarkable
AF0595 - one hour after cetuximab infusion.
AF0597 - ..
AF0598 - Vital signs at baseline, upon cetuximab completion and one hour
AF0599 - after cetuximab.
AF0600 -
AF0601 - ****please note start and stop times****
AF0603 - ..
AF0604 - Laboratory work:
AF0605 -
AF0606 - See carboplatin orders
AF0608 - ..
AF0609 - x Notify MD for dose modifications if patient has severe
AF0610 - acne in form rash
AF0611 -
AF0612 - CBC with differential and platletes every 4 weeks
AF0613 - Creatinine and magnesium every 4 weeks
AF0614 - BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
AF0615 - weeks. If levels are outside of normal laboratory values
AF0616 - notify Brigid NP (MD/RN) at 415 443 4730
AF0618 - ..
AF0619 - x Physician has discussed risks/benefits of therapy with the
AF0620 - patient. Signed consent obtained.
AF0621 -
AF0622 -
AF0623 - Yes 5. O2 by nasal cannula at 2 liters/min prn for chest
AF0624 - pain or SOB
AF0626 - ..
AF0627 - Yes 6. Diphenhydramine 50 mg IV prn x1 for urticaria
AF0628 - [barely legible], pruritis SOB
AF0630 - ..
AF0631 - Yes 7. Hydrocortizone 100 mg IV prn x1 for urticaria
AF0632 - [barely legible], pruritis SOB
AF0634 - ..
AF0635 - Yes 8. Albuterol inhaler 2-4 puffs prn SOB or chest
AF0636 - tightness
AF0638 - ..
AF0639 - Yes 9. Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
AF0640 - anaphylaxis
AF0642 - ..
AF0643 - Breast CC05752 Cetuximab doc 20061024
AF0644 - Approved 20060615
AF0646 - ..
AF0647 - Physician signature [Hope Rugo]
AF0649 - ..
AF0650 - Provider# 35313
AF0652 - ..
AF0653 - Date: 20010131
AF0654 -
AF0656 - ..
AF07 -
AF08 -
AF09 - 1115
AF10 -
AF1001 - Cetuximab treatment completed.
AF1002 -
AF1003 - Millie had a 1 hour rest and observation period, required by the
AF1004 - protocol. ref SDS 30 G679
AF1005 -
AF1006 -
AF1007 -
AF1009 - ..
AF11 -
AF12 -
AF13 - 1225
AF14 -
AF1401 - Nurse disconnected the IV tubes.
AF1403 - ..
AF1404 - She inserted Herceptin to flush the port.
AF1406 - ..
AF1407 - She then removed the needle from the port, and swabbed the needle
AF1408 - wound, and placed a temporary bandage.
AF1409 -
AF1410 -
AF1411 -
AF1412 -
AF1413 -
AF15 -
SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme
AL03 -
AL04 - 0930
AL0501 - ..
AL0502 - Vitals Show Patient Stable
AL0503 -
AL0504 - Follow up ref SDS 40 AW4L, ref SDS 38 AW4L.
AL0505 -
AL0506 - Blood
AL0507 - Date Time Pressure Pulse Temprtr Weight So2
AL0509 - ..
AL0510 - 070419 1230..... 133 79 57 36.3c 98
AL0511 - 070419 1130..... 141 78 56 37.6c **1 99
AL0512 - 070419 0930..... 153 80 53 36.1c 100
AL0513 - 070412 1120..... 114 65 53 36.6c 96
AL0514 - 070412 1020..... 130 66 57 36.8c 99
AL0515 - 070412 0900..... 116 69 65 36.8c 97
AL0516 - 070405 1130..... 133 75 55 36.2c 97
AL0517 -
AL0518 - Consistently low pulse, does it reflect low blood pressure
AL0519 - side effect of cetuximab, or improved fitness from working
AL0520 - out that benefits emotional stress and immune system?
AL0522 - ..
AL0523 - 070405 1030..... 114 69 57 36.4c 99
AL0524 - 070405 0900..... 128 78 54 36.5c 100
AL0525 - 070329 1140..... 125 74 53 36.8c 98
AL0526 - 070329 1045..... 125 72 53 c 100
AL0527 - 070329 0900..... 141 76 60 36.6c 99
AL0528 - 070322 1055..... 118 71 55 37.0c 97
AL0529 - 070322 1015..... 120 69 57 37.1c 98
AL0530 - 070322 0900..... 130 70 56 36.0c 98
AL0531 - 070315 1300..... 119 75 58 36.2c 98
AL0532 - 070315 1150..... 137 73 52 36.5c 99
AL0533 - 070315 0945..... 143 85 60 36.4c 97
AL0534 - 070308 1100..... 144 87 70 36.0c 98
AL0535 - 070301 1645..... 125 62 90 * 36.4c
AL0536 - 070301 1505..... 112 69 86 * 36.6c 98
AL0537 - 070222 1145..... 115 73 58 36.3c 147 98
AL0538 - 070222 1045..... 100 60 56 36.6c 147 98
AL0539 - 070222 0930..... 117 63 68 36.2c 147 97
AL0540 - 070215 1200..... 106 66 61 37.0c 147 97
AL0541 - 070215 1055..... 96 61 64 37.0c 147 94
AL0542 - 070215 0930..... 100 64 66 36.7c 147 98
AL0543 - 070208 0920..... 143 70 59 36.5c 147 98
AL0544 - 070201 1330..... 136 74 66 148 94
AL0545 - 070201 1220..... 110 65 62 36.3c 148 96
AL0546 - 070201 1000..... 132 80 65 36.9c 148 99
AL0547 - 061201 1534..... 123 76 76 97.5 150
AL0548 - 061110 1534..... 136 83 73 97.0 150 98
AL0549 - 061020 1534..... 140 79 67 99.8 151 97
AL0550 - 060929 1452..... 141 78 66 98.3 149
AL0551 - 060908 1335..... 139 79 73 98.1 149
AL0552 - 060814 1610..... 139 80 59 98.2 151
AL0553 - 060722 1440..... 142 74 67 98.1 149
AL0554 - 060711.......... 172 87 54 97.5 147
AL0555 - 060623.......... 141 87 71 98.0 147
AL0556 - 060428.......... 129 73 80 99.4 149
AL0557 - 060217.......... 153 81 61 98.6 150
AL0558 - 050916.......... 120 80 80 98.5
AL0559 -
AL0560 - * Need vitals taken twice to verify atypical diagnostics.
AL0561 - **1 Nurses Notes seem to show 97.6 which is impossible, so.....
AL0562 -
AL0563 -
AL0564 -
AL06 -
SUBJECTS
Energy Normal Stable Alert Drive Home After Treatment Tired Sleep 2
AY03 -
AY04 - 1120
AY0501 - ..
AY0502 - Energy Normal Stable After Treatment Cetuximab Support Drugs
AY0503 -
AY0504 - Follow up ref SDS 40 F54N, ref SDS 38 F54N.
AY0506 - ..
AY0507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
AY0508 - clinical study drug trial. ref SDS 6 YP4I
AY0510 - ..
AY0511 - Millie was alert after treatment again today, and not wobbly nor
AY0512 - disoriented. She was able to drive home without side effects of
AY0513 - treatment.
AY0515 - ..
AY0516 - After arriving home about 1320, Millie took a nap from about 1320
AY0517 - until about 1600. Could relate to side effects from cetuximab
AY0518 - treatments that cause fatigue, reported on 070116. ref SDS 13 O64M
AY0519 -
AY0520 -
AY0521 -
AY0522 -
AY0523 -
AY0524 -
AY0525 -
AY06 -