CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 7 0000, ref SDS 6 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on Millie's blood test at Kaiser today is reported in
040902 - another record. ref SDS 6 LW5I
040904 -  ..
040905 - Glenna called this morning, ref SDS 5 JY6L, to ask about Millie's
040906 - response to treatment, and to request the EKG test report.  In the
040907 - afternoon, Millie received a letter from Glenna presenting plans to
040908 - meeting later today with the doctor. ref SDS 8 YN9H  Glenna also
040909 - attached a letter she sent earlier in the day to the doctor on
040910 - Millie's case management with issues to review during the meeting
040911 - later today. ref SDS 8 4P5M
040913 -  ..
040914 - Millie submitted a letter to the medical team reporting...
040915 -
040916 -    1.  Subject: **** TC and Labs at Kaiser Today Favorable NEUTS 1.768
040917 -        Date: Fri, 16 Jan 2009 14:37:24 -0800
040926 -         ..
040927 -    3.  Thanks for the copy of your letter to Doctor Rugo earlier
040928 -        today. ref SDS 8 4P5M  IBC rash in the breastbone area has
040929 -        flared up previously, and then subsided with continued
040930 -        treatment [reported in the letter to the medical team on
040931 -        090109, ref SDS 3 HD4J].  AT this time, the breastbone area
040932 -        looks stable to worse, and everything else, including the left
040933 -        arm, seems improved to stable [shown in Millie's patient
040934 -        history on 090115]. ref SDS 4 124N
040935 -
040936 -            [On 090118 Millie talks about wanting to end treatment with
040937 -            sunitinib that seems now less effective and has severe side
040938 -            effects after adding cycloposphamide. ref SDS 10 UC41
040940 -             ..
040941 -            [On 090118 Millie's letter to the medical team submits
040942 -            complete results for the blood test. ref SDS 9 5350
040944 -         ..
040945 -    4.  By copy to Doctor Johnson, request the report on the EKG test
040946 -        at Kaiser this past Monday on 090112. [as requested by Glenna
040947 -        in her call this morning. ref SDS 5 JY9G]
040948 -
040949 -            [On 090120 Millie letter to Kaiesr requesting report on EKG
040950 -            test performed at Kaiser on 090112. ref SDS 11 2P3P
040952 -         ..
040953 -    5.  By copy to Gloria in Coagulation Control Clinic advise of INR
040954 -        3.1 in the test today. ref SDS 6 PU7Y  This occurred after
040955 -        cyclophosphamide was paused for the past week, and that this
040956 -        treatment is scheduled to resume beginning tomorrow.  Unless I
040957 -        hear differently, will continue current Coumadin dose levels
040958 -        [shown in Kaiser's letter on 081219, ref SDS 1 EW3G].  The next
040959 -        INR test will be at UCSF on 090129.
040961 -         ..
040962 -    6.  I am disappointed that recovery observed at UCSF on 081218 did
040963 -        not continue after resuming treatment on 081226 following a
040964 -        week pausing treatment.  I am hopeful improvement will occur
040965 -        again with steady treatment, as it did after worsening on 2
040966 -        past occasions [reported in the letter to the medical team on
040967 -        090109, ref SDS 3 HD4J].
040968 -
040969 -            [On 090118 Millie talks about wanting to end treatment with
040970 -            sunitinib that seems now less effective and has severe side
040971 -            effects after adding cycloposphamide. ref SDS 10 UC41
040973 -         ..
040974 -    7.  Labs at Kaiser today show NEUTS 1.768 (WBC 5.2, Neutrophils L
040975 -        34%). ref SDS 6 QY6H  As a result, I did not get Neupogen
040976 -        today, and will cancel tomorrow, pending next review at UCSF on
040977 -        090129. ref SDS 7 649J
040979 -         ..
040980 -    8.  The work plan is to resume cyclophosphamide for 5 days starting
040981 -        tomorrow with NEUTS above 1.00, shown in para 4.2 of your
040982 -        letter on 090108. ref SDS 2 UX5S
040983 -
040984 -            [On 090118 Millie's letter to the medical team submits
040985 -            complete results for the blood test. ref SDS 9 5350
040987 -         ..
040988 -    9.  Please confirm this plan in light of rising side effects.
040989 -        Naturally, if the doctor feels adding cyclophosphamide will
040990 -        increase recovery, I will do this for the next 2 weeks as top
040991 -        priority, and do my best to tolerate side effects.
040993 -         ..
040994 -   10.  The most difficult side effect is sore toes that prevent hiking
040995 -        or even walking.  Is there a remedy that permits taking
040996 -        sunitinib and relieves sore toes to enable hiking/walking?
040998 -         ..
040999 -   11.  If you have time, you can look through the record for yesterday
041000 -        to see details on all side effects, ref SDS 4 KL4J, that may
041001 -        support discussions with Doctor Rugo planned in your letter for
041002 -        later today. ref SDS 8 YN9H
041003 -
041004 -           [On 090212 0017 Millie's letter to medical team reports
041005 -           rising fatigue, ref SDS 14 1N3U, even after ending
041006 -           chemotherapy on 090122, ref SDS 12 AT6N, and hoping does
041007 -           not signal cancer cascading out of control with CA 15-3 303
041008 -           at Kaiser on 090116, ref SDS 6 PQTQ, cited by primary care
041009 -           physician at Kaiser on 090123. ref SDS 13 RK6O
041011 -         ..
041012 -   12.  Very glad about the good lab results.  I will get the complete
041013 -        report entered in the record later today, and submit to the
041014 -        medical team.
041015 -
041016 -            [On 090118 Millie's letter to the medical team submits
041017 -            complete results for the blood test. ref SDS 9 5350
041019 -         ..
041020 -   13.  Thanks very much for calling this morning.  Look forward to
041021 -        Doctor Rugo's support.
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0411 -