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1...Catherine advised that when problems drawing blood from a port
CONTACTS
SUBJECTS
Cetuximab 5th Cycle 2nd Treatment 18th Total Treatment Chemotherapy
0903 -
0903 - ..
0904 - Summary/Objective
0905 -
090501 - Follow up ref SDS 76 0000. ref SDS 73 0000.
090502 -
090503 - Millie received the 2nd treatment of the 5th cycle, making 18 total
090504 - treatments with cetuximab chemotherapy on clinical study at UCSF.
090505 - ref SDS 0 7T3H Side effects remain mild. ref SDS 0 QU8K
090506 -
090507 -
090509 - ..
0906 -
0907 -
0908 - Progress
0909 -
090901 - Infusion Clinic for Cetuximab Treatent
090902 -
090903 - Follow up ref SDS 76 1M6H, ref SDS 73 1M6H.
090905 - ..
090906 - Agenda...
090907 -
090908 - 1. Side effects.............................. ref SDS 0 QU8K
090909 - 2. Treatment cetuximab....................... ref SDS 0 4N5M
090910 - 3. Vitals.................................... ref SDS 0 AW4L
090911 - 4. Energy after treatment.................... ref SDS 0 F54N
090913 - ..
090914 - Millie received 18th overall and 2nd treatment of 5th cycle with
090915 - cetuximab, starting from 070201, ref SDS 38 G68I, and the 25th
090916 - treatment for 3rd relapse of IBC, beginning on 060721. ref SDS 17 407N
090918 - ..
090919 - Catherine was the nurse today.
090921 - ..
090922 - Taxotere Capecitabine
090923 -
090924 - Follow up ref SDS 76 PR8Q, ref SDS 73 PR8Q.
090925 -
090926 - Relapse Treatments
090927 -
090928 - 1. Cycle 09 and 01 ................... 060721, ref SDS 17 407N
090929 - 2. Cycle 10 and 02 ................... 060814, ref SDS 21 LY6O
090930 - 3. Cycle 11 and 03 ................... 060908, ref SDS 22 407N
090931 - 4. Cycle 12 and 04 ................... 060929, ref SDS 23 407N
090932 - 5. Cycle 13 and 05 ................... 061020, ref SDS 29 407N
090933 - 6. Cycle 14 and 06 ................... 061110, ref SDS 31 407N
090934 - 7. Cycle 15 and 07 ................... 061201, ref SDS 32 407N
090936 - ..
090937 - Cetuxiab Clinical Study
090938 -
090939 - Follow up ref SDS 76 7T3H, ref SDS 73 7T3H.
090940 -
090941 - Total Cetuximab
090942 - 8. Cycle 01 and 08 and 01 01.......... 070201, ref SDS 38 SG8I
090943 - 9. Cycle 01 and 08 and 02 02.......... 070208, ref SDS 40 SG8I
090944 - 10. Cycle 01 and 08 and 03 03.......... 070215, ref SDS 41 SG8I
090945 - 11. Cycle 01 and 08 and 04 04.......... 070222, ref SDS 43 SG8I
090946 - 12. Cycle 02 and 09 and 01 05.......... 070301, ref SDS 46 SG8I
090947 - 13. Cycle 02 and 09 and 02 06.......... 070308, ref SDS 48 7T3H
090948 - 14. Cycle 02 and 09 and 03 07.......... 070315, ref SDS 52 7T3H
090949 - 15. Cycle 02 and 09 and 04 08.......... 070322, ref SDS 53 7T3H
090950 - 16. Cycle 03 and 10 and 01 09.......... 070329, ref SDS 56 7T3H
090951 - 17. Cycle 03 and 10 and 02 10.......... 070405, ref SDS 59 7T3H
090952 - 18. Cycle 03 and 10 and 03 11.......... 070412, ref SDS 61 7T3H
090953 - 19. Cycle 03 and 10 and 04 12.......... 070419, ref SDS 63 7T3H
090954 - 20. Cycle 04 and 11 and 01 13.......... 070426, ref SDS 66 7T3H
090955 - 21. Cycle 04 and 11 and 02 14.......... 070503, ref SDS 68 7T3H
090956 - 22. Cycle 04 and 11 and 03 15.......... 070510, ref SDS 70 7T3H
090957 - 23. Cycle 04 and 11 and 04 16.......... 070517, ref SDS 73 7T3H
090958 - 24. Cycle 05 and 12 and 01 17.......... 070524, ref SDS 76 7T3H
090959 - 25. Cycle 05 and 12 and 02 18.......... 070531, ref SDS 0 7T3H
090961 - ..
090962 - Nurses Notes...
090973 - ..
090974 - Why is the visit number constant in Nurse's Notes, and yet seems to
090975 - vary in the schedule received from Nola on 070315? ref SDS 52 159O
090977 - ..
090978 - UCSF Log Time...
090979 -
090980 - Blood
090981 - Test Infusion
090982 -
090983 - In....... 0820
090984 - Out...... 1120
090985 - Visit.... Min 3.0 Hours Total 2.5 Hours reported
090987 - ..
090988 - Pain Assessment...
090989 -
090990 - x
090991 - 0123456789 10
090992 -
090993 - <923k
090994 - Administration Site: Right Port Catheter
090995 - Needle Size: 20 G 1"
090996 - Blood Return Good: Yes
090998 - ..
090999 - Remind patient to call MD if temp > 101 F, Shaking Chills
091000 -
091001 - This protocol differs from Kaiser requirements, reported on
091002 - 041202. ref SDS 11 IX9N
091003 -
091004 -
091005 -
091006 -
0911 -
SUBJECTS
Side Effects Infusion Clinic UCSF Consultation Treatment Cetuximab A
3403 -
3404 - 0940
340501 - ..
340502 - Side Effects Minimal...
340503 -
340504 - Follow up ref SDS 76 QU8K, ref SDS 73 QU8K.
340506 - ..
340507 - Nurse's notes report side effects...
340509 - ..
340510 - 1. Rash acne-like
340511 -
340512 - Follow up ref SDS 76 958F, ref SDS 73 958F.
340513 -
340514 - Very mild facial rash barely visible continues the same
340515 - from 070208 around the nose and chin. ref SDS 40 QU8K
340516 - Antibiotic treatment effective prescribed on 070222.
340517 - ref SDS 42 FO66
340518 -
340520 - ..
340521 - 2. Dry skin face, chest arm
340522 -
340523 - Follow up ref SDS 76 JS6M, ref SDS 73 JS6M.
340524 -
340525 - Background reported on 070503. ref SDS 63 JS6M Condition
340526 - continues controlled getting positive results with Curel
340527 - treatment prescribe on 070301, ref SDS 44 5V73, and later
340528 - Aquaphor on 070322. ref SDS 53 JS6M
340529 -
340531 - ..
340532 - 3. Dizziness Symptoms Enlarged Right Ventricle Cor Pulmonale
340533 -
340534 - Follow up ref SDS 76 Y14O.
340535 -
340536 - Recurrance of slight dizziness getting out of bed was
340537 - reported to the medical team starting last week on 070524.
340538 - ref SDS 75 PT4K Dizziness is a symptom of Cor Pulmonale,
340539 - which Kaiser diagnosed in Millie's case in a CT test report
340540 - on 060930, and reviewed on 061012. ref SDS 27 LG9L On
340541 - 070525 dizziness recurrence was presented to primary care
340542 - physician at Kaiser. ref SDS 77 PT4K This seems very mild
340543 - and even less than last week. There is no evident
340544 - connection to cetuximab treatments at UCSF.
340545 -
340547 - ..
340548 - 4. Lymphedema Cellulitis Complications None Evident
340549 - Inflammation Erratic Upper Left Arm Side Effects Cetuximab
340550 -
340551 - Follow up ref SDS 76 SU6L, ref SDS 73 SU6L.
340552 -
340553 - Lymphedema continues relatively controlled with swelling in
340554 - the left arm reduced to near normal today at 10.50, cited
340555 - in the study on 060509. ref SDS 14 HO7F There are no
340556 - evident signs of Cellulitis.
340558 - ..
340559 - Changing intensity of rash on the upper left arm seems
340560 - reduced in recent weeks, reported on 070503, ref SDS 68
340561 - 8B8I, and previously by the medical team on 070426,
340562 - ref SDS 65 115F, and following the report at Kaiser on
340563 - 070330. ref SDS 58 N19J Causes of erratic inflammation,
340564 - including side effects of cetuximab treatments are listed
340565 - in the record for treatment on 070426. ref SDS 66 8B8Y
340566 -
340568 - ..
340569 - 5. Tired, fatigued - pulmonary emoblism
340570 -
340571 - Follow up ref SDS 76 FG3N, ref SDS 73 FG3N.
340572 -
340573 - Fatigue, shortness of breath and other symptoms of
340574 - pulmonary embolism were presented during meeting on 070130,
340575 - ref SDS 36 CV5L, citing case study listed on 060722.
340576 - ref SDS 18 ZV41 These are also side effects of cetuximab
340577 - treatments, reported on 070116. ref SDS 35 O64M Planning
340578 - was discussed this morning with the medical team for thin
340579 - slice spiral CT test to assess pulmonary embolism and Cor
340580 - Pulmonale (enlarged right ventricle), per above.
340581 - ref SDS 70 VP4H
340583 - ..
340584 - Energy and exercise remain active, reported on 070503.
340585 - ref SDS 68 CA4K
340587 - ..
340588 - Naps continue 2 - 3 hours after treatments, since beginning
340589 - on 070405. ref SDS 59 BB7G May indicate accumulating
340590 - effects of cetuximab that make patients tired, listed as
340591 - side effect in Consent documents reviewed on 070116.
340592 - ref SDS 35 O64M
340593 -
340595 - ..
340596 - 6. Heavy chest - shortness of breathing
340597 -
340598 - Follow up ref SDS 76 UL6L, ref SDS 73 UL6L.
340599 -
340600 - Patient history was reported to UCSF on 070130. ref SDS 36
340601 - RT6I
340603 - ..
340604 - Condition seems improved, tracking continuing higher
340605 - energy, per above. ref SDS 0 CA4K
340606 -
340608 - ..
340609 - 7. Cough - clearing throat
340610 -
340611 - Follow up ref SDS 76 8N4G, ref SDS 73 8N4G.
340612 -
340613 - Condition seems less evident lately.
340614 -
340615 -
340616 -
340617 -
3407 -
SUBJECTS
Schedule Treatment Weekly Thursday 0830 4 Week Cycles Clinical Study
4203 -
420401 - ..
420402 - Schedule Weekly Treatments Continue on Thursdays
420403 -
420404 - Follow up ref SDS 76 QK6L, ref SDS 73 QK6L.
420405 -
420406 - Millie's next treatment is scheduled for 070607 0830, after meeting
420407 - with the medical team at 0800, as reported by Nola on 070510.
420408 - ref SDS 70 3E8L
420409 -
420410 -
4205 -
SUBJECTS
Port Catheter IV Connection Prepare for Drip Treatment 1 Try Require
5803 -
5804 - 0845
580501 - ..
580502 - Preparation for Treatment Required One (1) Attempt to Connect Port
580503 -
580504 - Follow up ref SDS 76 EB7J, ref SDS 73 EB7J.
580506 - ..
580507 - The nurse connected the IV tubes to the port....
580509 - ..
580510 - Interlink System Vented Paclitaxel set
580511 -
580513 - ..
580514 - Blood Draw Flow Sluggish from Port Catheter
580515 -
580516 - There was a problem today getting blood to flow from the port
580517 - catheter, unlike last week and earlier on 070301, when blood flow from
580518 - the port was normal, ref SDS 46 EB7J Difficult blood flow from the
580519 - port occurred previously on 070222, ref SDS 42 DC5W, and earlier on
580520 - 070201. ref SDS 37 DC5W
580522 - ..
580523 - Catherine advised that when problems drawing blood from a port
580524 - catheter occur, patients are sent to a work station on the 1st floor,
580525 - possibly the Lab, where some kind of maintenance is performed to
580526 - restore normal flow and functioning of the port.
580528 - ..
580529 - Millie's case is may require coordination with Kaiser where the port
580530 - was installed on 040419. ref SDS 4 0001
580532 - ..
580533 - The nurse flushed the port with saline.
580534 -
580535 -
580536 -
5806 -
SUBJECTS
Benadryl Pre-treatment Prepares Patient for Cetuximab Chemotherapy A
6703 -
6704 - 0835
670501 - ..
670502 - Benadryl Reduce Side Effects Cetuximab Chemotherapy Treatment
670503 -
670504 - Follow up ref SDS 76 DC7J, ref SDS 73 DC7J.
670505 -
670506 - Benadryl (diphenhydramine) started. 25 MG....... ref SDS 66 IJ44
670507 -
670508 - Purpose reported on 060721. ref SDS 16 DC7J
670510 - ..
670511 - Chemotherpay order calls for Benadryl (diphenhydramine) pre-treatment
670512 - 30 - 60 minutes prior to cetuximab infusion, shown below. ref SDS 70
670513 - IJ41
670514 -
670515 -
670517 - ..
6706 -
6707 -
6708 - 0905
6709 -
670901 - Benedryl completed equipment beeps.
670902 -
670903 -
670904 -
670906 - ..
6710 -
6711 -
6712 -
6713 -
671301 - Decadron (dexamethasone) IV pre-treatment........ ref SDS 53 FM4M
671302 -
671303 - On 070208 Decadron was not given because Millie did not experience
671304 - side effects of nausea and vomitting after treatment with cetuximab on
671305 - 070201. ref SDS 40 G57I Since this favorable condition continues, per
671306 - above, ref SDS 53 D19M, Decadron was not given again today.
671307 -
671309 - ..
6714 -
6715 -
6716 -
671601 - Decadron completed -- not reported.
671602 -
671603 -
671604 -
671605 -
6717 -
SUBJECTS
Buck Millie Meeting Patient Catherine Mitsuoka Nurse Infusion Clinic
7903 -
7904 - 0915
790501 - ..
790502 - Cetuximab Full Dose Blood Counts Below Targets Treatment 1 Hour
790503 -
790504 - Follow up ref SDS 76 4N5M, ref SDS 73 4N5M.
790506 - ..
790507 - Cetuximab started.
790508 -
790509 - Verify chemotherapy order for 070208.
790511 - ..
790512 - Chemotherapy order calls for cetuximab to start 30 - 60 minutes after
790513 - Beyadryl pre-tretment. ref SDS 0 IJ41
790515 - ..
790516 - Chemotherapy Orders...
790517 -
790523 - Auth# Stor BCC LOC
790524 - Visit: 12575738 DOS 20070201
790526 - ..
790527 - Date: 20070201
790529 - ..
790530 - Study Order for CC#05752: Phase II Trial of Cetuximab alone and
790531 - in combination with Carboplatin in ER-negative, PR-negative,
790532 - HER2-negative Nonoverexpressing Metastatic Breast Cancers
790534 - ..
790535 - Dates to be given: 070201
790536 - Arm 1:Cetuximab alone
790538 - ..
790539 - Diagnosis: breast cancer
790541 - ..
790542 - ICD-9 codes: 174.9
790543 - Allergies NKDA
790545 - ..
790546 - Pre-medications 30 - 60 minutes prior to cetuximab infusion
790548 - ..
790549 - 4. Diphenhydramine 25 mg IV or [illegible writing]
790550 -
790551 - Benadryl........... ref SDS 53 DC7J
790552 -
790553 - On 070329 Brigid changed the Chemotherapy Order reducing
790554 - Diphenhydramine (Benadryl) from 50 mg to 25 mg in order to
790555 - reduce side effects of "restless legs." ref SDS 56 IJ44
790557 - ..
790558 - This was effective, reported above. ref SDS 56 7R6H
790560 - ..
790561 - 5. Dexamethasone (??) 10 mg IB or 20 mg IV [handwritten ???]
790562 -
790563 - Further premed TBD [barely legible handwriting??]
790565 - ..
790566 - Medication: (plan to give weekly ********STUDY SUPPLY**********
790568 - ..
790569 - 6. Cetuximab (Erbitux) (loading dose)
790570 -
790571 - 400 mg/m [squared] = 684 mg IV over 120 minutes for
790572 - first dose x 1
790573 -
790574 - dose on dcte 20070201 Maximum infusion rate is 5 ml/minute
790575 - (concentration 2 mg/ml)
790577 - ..
790578 - 7. Cetuximab (Erbitux) (maintenance dose)
790579 -
790580 - 250 mg/m [squared] = 428 mg IV (or ____ mg/m[squared] =
790581 - ____mg) IV over 60 or ____ minutes.
790582 -
790583 - Maximum infusion rate is 5 ml/minute (concentration 2 mg/ml)
790584 - Infuse once weekly for 8 weeks. First dose to be given on date
790585 - 20070201.
790587 - ..
790588 - Cetuximab is administered undiluted through a low protien
790589 - binding 0.22 micro in-line filter. Use NS solution to flush the
790590 - line at the end of the infusion.
790592 - ..
790593 - ARM 2: Administer carboplatin of vital signs are unremarkable
790594 - one hour after cetuximab infusion.
790596 - ..
790597 - Vital signs at baseline, upon cetuximab completion and one hour
790598 - after cetuximab.
790599 -
790600 - ****please note start and stop times****
790602 - ..
790603 - Laboratory work:
790604 -
790605 - See carboplatin orders
790607 - ..
790608 - x Notify MD for dose modifications if patient has severe
790609 - acne in form rash
790610 -
790611 - CBC with differential and platletes every 4 weeks
790612 - Creatinine and magnesium every 4 weeks
790613 - BUN AST Alk phos Alt Total bilrubin, electrolyes every 8
790614 - weeks. If levels are outside of normal laboratory values
790615 - notify Brigid NP (MD/RN) at 415 443 4730
790617 - ..
790618 - x Physician has discussed risks/benefits of therapy with the
790619 - patient. Signed consent obtained.
790620 -
790621 -
790622 - Yes 5. O2 by nasal cannula at 2 liters/min prn for chest
790623 - pain or SOB
790625 - ..
790626 - Yes 6. Diphenhydramine 50 mg IV prn x1 for urticaria
790627 - [barely legible], pruritis SOB
790629 - ..
790630 - Yes 7. Hydrocortizone 100 mg IV prn x1 for urticaria
790631 - [barely legible], pruritis SOB
790633 - ..
790634 - Yes 8. Albuterol inhaler 2-4 puffs prn SOB or chest
790635 - tightness
790637 - ..
790638 - Yes 9. Epinephrine 1x1000 (1 mg/ml) 0.3 mg IV prn
790639 - anaphylaxis
790641 - ..
790642 - Breast CC05752 Cetuximab doc 20061024
790643 - Approved 20060615
790645 - ..
790646 - Physician signature [Hope Rugo]
790648 - ..
790649 - Provider# 35313
790651 - ..
790652 - Date: 20010131
790653 -
790655 - ..
7907 -
7908 -
7909 - 1015
7910 -
791001 - Cetuximab treatment completed.
791002 -
791003 - Millie had a 1 hour rest and observation period, required by the
791004 - protocol. ref SDS 70 G679
791005 -
791006 -
791007 -
791009 - ..
7911 -
7912 -
7913 - 1120
7914 -
791401 - Nurse disconnected the IV tubes.
791403 - ..
791404 - She inserted Herceptin to flush the port.
791406 - ..
791407 - She then removed the needle from the port, and swabbed the needle
791408 - wound, and placed a temporary bandage.
791409 -
791410 -
791411 -
791412 -
791413 -
7915 -
SUBJECTS
Vitals Blood Pressure Pulse Temperature Sa02 Weight Infusion Treatme
8803 -
8804 - 0830
880501 - ..
880502 - Vitals Show Patient Stable
880503 -
880504 - Follow up ref SDS 76 AW4L, ref SDS 73 AW4L.
880505 -
880506 - Conversion Celsius to Farhenheit...
880507 -
880508 - http://www.wbuf.noaa.gov/tempfc.htm
880509 -
880510 - Blood
880511 - Date Time Pressure Pulse Temperture Weight So2
880512 - .
880513 - 070531 1120..... 133 81 70 36.3c 97.34 98
880514 - 070531 1015..... 139 81 59 36.4c 97.52 98
880515 - 070531 0830..... 144 79 60 35.9c 96.62 100
880516 - 070524 1235..... 134 75 61 36.6c 97.88 99
880517 - 070524 1145..... 119 69 58 37.1c 98.78 98
880518 - 070524 standing.......... 67 ................
880519 - 070524 0945..... 132 80 56 37.0c 98.60 98
880520 - 070517 1120..... 126 72 56 36.7c 98.06 100
880521 - 070517 1020..... 140 75 54 36.6c 97.88 98
880522 - 070517 0940..... 140 75 54 36.1c 96.98 99
880523 - 070510 1145..... 145 86 54 35.9c 96.62 100
880524 - 070510 1045..... 149 82 69 37.0c 98.60 97
880525 - 070510 0900..... 132 75 62 36.8c 98.24 99
880526 - 070503 1150..... 113 67 59 36.8c 98.24 98
880527 - 070503 1055..... 125 72 54 36.1c 96.98 100
880528 - 070503 0915..... 127 70 60 36.9c 98.42 99
880529 - 070426 1130..... 119 70 57 36.3c 97.34 96
880530 - 070426 1030..... 141 73 67 36.4c 97.52 99
880531 - 070426 0900..... 130 78 52 36.5c 97.7 97
880532 -
880533 -
880534 -
880535 -
8806 -
SUBJECTS
Energy Normal Stable Alert Drive Home After Treatment Tired Sleep 2
A403 -
A404 - 1120
A40501 - ..
A40502 - Energy Normal Stable After Treatment Cetuximab Support Drugs
A40503 -
A40504 - Follow up ref SDS 76 F54N, ref SDS 73 F54N.
A40506 - ..
A40507 - On 060724 diary side effects for cetuximab chemotherapy treatment on
A40508 - clinical study drug trial. ref SDS 18 YP4I
A40510 - ..
A40511 - Millie was alert after treatment again today, and not wobbly nor
A40512 - disoriented. She was able to drive home without side effects of
A40513 - treatment.
A40515 - ..
A40516 - After arriving home about 1210, Millie took a nap from about 1420
A40517 - until about 1530. Could relate to side effects from cetuximab
A40518 - treatments that cause fatigue, reported on 070116. ref SDS 35 O64M
A40519 -
A40520 -
A40521 -
A40522 -
A40523 -
A40524 -
A40525 -
A406 -