CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 62 0000. ref SDS 52 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 -    1.  On 090108 Millie's blood counts were very low at UCSF.
040902 -        ref SDS 48 YN8O  Millie had a follow up blood draw at Kaiser on
040903 -        090116, showing further decline in blood counts. ref SDS 52
040904 -        075H  A week later on 090122, Doctor Rugo stopped treatment
040905 -        with sunitinib clinical study, ref SDS 57 AT6N; she scheduled
040906 -        Millie for meeting at UCSF a week later to begin new treatment
040907 -        for recovering from a 6th relapse of IBC.
040909 -         ..
040910 -    2.  On 090129 Millie had a blood draw at UCSF to guide examination
040911 -        by the medical team in the Breast Care Clinic. ref SDS 58 075H
040913 -         ..
040914 -        Millie did not start a new treatment on 090129 due a
040915 -        communication glitch, reported in the letter to the medical
040916 -        team on 090130. ref SDS 59 AY8Q
040918 -         ..
040919 -    3.  On 090210 Doctor Rugo's office scheduled Millie to meet with
040920 -        the doctor at UCSF on 090312 to evaluate response to treatment
040921 -        which was delayed from 090129 to 090219. ref SDS 60 XU5N
040923 -         ..
040924 -    4.  On 090213 Doctor Johnson ordered a blood draw for 090310
040925 -        (today) testing INR, and other diagnostics, including CA 15-3,
040926 -        and to flush Milli'e port according to Kaiser requirements.
040927 -        ref SDS 61 6P3F
040929 -         ..
040930 -    5.  On 090309 Millie had a blood draw at Kaiser to support
040931 -        examination at UCSF on 090312. ref SDS 62 S65I
040933 -         ..
040934 -    6.  On 090310 0351 Millie's letter to medical team requests report
040935 -        on blood test the day before on 090309 for submission to UCSF
040936 -        guiding meeting on 090312 to review progress recview recovering
040937 -        from IBC. ref SDS 63 O63Q
040938 -
040939 -
040941 -  ..
040942 - Lab Blood Test CBC to Evaluate Neupogen and Cancer Treatment Plan
040943 -
040944 - Follow up ref SDS 62 6Z4F, ref SDS 52 6Z4F.
040945 -
040946 - Called Kaiser this morning at 0830, to talk to Florida, per planning
040947 - yesterday on 090310. ref SDS 64 8F60
040949 -  ..
040950 - Took over an hour on hold to get through to the Oncology receptionist.
040951 -
040952 -            [On 090312 1437 called clinic to follow up and was on hold
040953 -            again for 90 minutes. ref SDS 67 JO8O
040954 -
040955 -            [On 090317 1120 Arlette reported she could get through
040956 -            using the telephone to the Chemotherapy Clinic to order
040957 -            follow up lab to correct mistake omitting cancer marker,
040958 -            and so had to walk to the clinic and make arrangements.
040959 -            ref SDS 69 YP6S
040961 -             ..
040962 -            [On 090415 0911 Millie had problems getting the report for
040963 -            the blood test on 090413; the first report was incorrect
040964 -            omitting 90% of the data, ref SDS 71 RY4Y; after finally
040965 -            getting the the full report, it was still missing ANC
040966 -            required for evaluating ability to get treatment.
040967 -            ref SDS 71 QP68
040969 -             ..
040970 -            [On 090325 0830 primary care physician disappointed by
040971 -            continual delays submittng data to UCSF, and notes conflict
040972 -            with requirements to streamline delivery of care in order
040973 -            to treat Millie's 6th relapse of cancer as a chronic
040974 -            disease. ref SDS 70 RB3G
040976 -             ..
040977 -            [On 090420 1451 Doctor Mason reported that other patients
040978 -            have not reported problems having labs performed at Kaiser
040979 -            and submitted to UCSF for referral treatment. ref SDS 72
040980 -            2H8J
040982 -  ..
040983 - Asked for Florida, as she requested yesterday.
040985 -  ..
040986 - The receptionist said Kaiser has new procedures today.  Everyone's
040987 - assignments in oncology have changed.  Florida is now assigned to a
040988 - doctor, rather than to the Chemotherapy Infusion Clinic.  She is no
040989 - longer Arlette's backup.
040991 -  ..
040992 - Asked to talk with Arlette.
040994 -  ..
040995 - The receptionis said Arlette is also assigned to a doctor, so she
040996 - cannot take calls directly.  The receptionist said she has to direct
040997 - all calls to a particular doctor.  She asked who is Millie's doctor?
040999 -  ..
041000 - Explained that Florida said to call today about getting Millie's
041001 - blood test report.
041003 -  ..
041004 - The receptionist said her new rules are not to put calls through
041005 - directly to nurses.  Calls must go to an answering machine, and then
041006 - when the department has time, they will return the call.
041008 -  ..
041009 - Explained that this call already took over an hour on hold.
041011 -  ..
041012 - This illustrates delays and frustrations that increase health care
041013 - costs, cited by Doctor Johnson in the meeting on 090213, when he
041014 - described why cancer survival is problematic. ref SDS 61 NY7L
041015 -
041016 -            [On 090325 0830 primary care physician disappointed by
041017 -            continual delays submittng data to UCSF, and notes conflict
041018 -            with requirements to streamline delivery of care in order
041019 -            to treat Millie's 6th relapse of cancer as a chronic
041020 -            disease. ref SDS 70 RB3G
041022 -             ..
041023 -            [On 090420 1451 Doctor Mason reported that other patients
041024 -            have not reported problems having labs performed at Kaiser
041025 -            and submitted to UCSF for referral treatment. ref SDS 72
041026 -            2H8J
041028 -  ..
041029 - The receptionist said an exception can be made only for today; she
041030 - transferred the call to somewhere.
041032 -  ..
041033 - Someone possibly named Lupe took the call.
041035 -  ..
041036 - Explained background and planning yesterday for Millie to get a copy
041037 - of the report for the blood test on Monday, 090309. ref SDS 62 OT8J
041039 -  ..
041040 - Lupe said she knows Florida.
041042 -  ..
041043 - Lupe looked on the computer and said that CA 15-3 has still not been
041044 - posted for Millie's lab on 090309.
041046 -  ..
041047 - Lupe will fax a copy of the lab report to UCSF so Tara has time to
041048 - review in preparing for the meeting tomorrow with Millie.  Lupe asked
041049 - for the UCSF fax number.  She said she could look up the number, but
041050 - it would save time, if the number is handy.
041052 -  ..
041053 - Gave Lupe the fax number for the Breast Care Clinic, and suggested
041054 - noting to attention of Tara.
041056 -  ..
041057 - Lupe said the Oncology Department has been having problems with the
041058 - fax machine.  They have reports that some faxes are not getting
041059 - through.
041061 -  ..
041062 - This has been happening a lot lately.  Millie's letter on 090109
041063 - explained fax breakdown that caused failure to get the CT test report
041064 - for examination at UCSF on 090108. ref SDS 49 UE6U
041065 -
041066 -            [On 090325 0830 primary care physician disappointed by
041067 -            continual delays submittng data to UCSF, and notes conflict
041068 -            with requirements to streamline delivery of care in order
041069 -            to treat Millie's 6th relapse of cancer as a chronic
041070 -            disease. ref SDS 70 RB3G
041072 -             ..
041073 -            [On 090420 1451 Doctor Mason reported that other patients
041074 -            have not reported problems having labs performed at Kaiser
041075 -            and submitted to UCSF for referral treatment. ref SDS 72
041076 -            2H8J
041078 -  ..
041079 - She asked if Millie still needs a printed copy?
041081 -  ..
041082 - Decided to get what is available today, and get CA 15-3 when it is
041083 - posted later today or tomorrow.  Hopefully, it will be posted in time
041084 - for the meeting with UCSF in the Breast Care Clinic.
041086 -  ..
041087 - Lupe will print a copy of the lab report and put it in an envelope,
041088 - and leave it on the front counter for Millie to pickup up later today.
041089 -
041090 -            [On 090312 0800 UCSF did not receive the fax from Kaiser
041091 -            with the blood test report. ref SDS 66 XE3K
041093 -             ..
041094 -            [On 090325 0830 primary care physician disappointed by
041095 -            continual delays submittng data to UCSF, and notes conflict
041096 -            with requirements to streamline delivery of care in order
041097 -            to treat Millie's 6th relapse of cancer as a chronic
041098 -            disease. ref SDS 70 RB3G
041100 -             ..
041101 -            [On 090415 0911 Millie had problems getting the report for
041102 -            the blood test on 090413; the first report was incorrect
041103 -            omitting 90% of the data, ref SDS 71 RY4Y; after finally
041104 -            getting the the full report, it was still missing ANC
041105 -            required for evaluating ability to get treatment.
041106 -            ref SDS 71 QP68
041108 -             ..
041109 -            [On 090420 1451 Doctor Mason reported that other patients
041110 -            have not reported problems having labs performed at Kaiser
041111 -            and submitted to UCSF for referral treatment. ref SDS 72
041112 -            2H8J
041114 -  ..
041115 - Thanked Lupe for helping out getting us the report with new
041116 - procedures, per above. ref SDS 0 G68F
041117 -
041118 -
041120 -  ..
0412 -
0413 -
0414 - 1220
0415 -
041501 - Called and left a message on Millie's cellular phone, to go to Kaiser
041502 - after her meeting at the Wellness Community, and pick up a copy of the
041503 - report for the labs.
041504 -
041506 -  ..
0416 -
0417 -
0418 - 1243
0419 -
041901 - Millie called back.  She got the message.  Millie has some errands to
041902 - run.  She will stop at Kaiser first to get the report, and will be
041903 - home later in the afternoon.
041904 -
041906 -  ..
0420 -
0421 -
0422 - 1517
0423 -
042301 - Millie arrived home with the report for the laboratory blood test
042302 - drawn at Kaiser in Walnut Creek on 090309, ref SDS 62 OY9L,
042304 -  ..
042305 - Posted results to the record on 090309. ref SDS 62 OT8J
042306 -
042307 -        [On 090312 submitted results of blood test to Tara for the
042308 -        meeting at UCSF to evaluate response to treatment.
042310 -  ..
042311 - CA 15-3 has not yet been posted.  Will try to check tomorrow morning
042312 - in time to support the meeting at UCSF, per Millie's letter to the
042313 - medical team yesterday on 090310. ref SDS 63 O63T
042314 -
042315 -        [On 090312 complexity compounded evaluating Millie's response
042316 -        to treatment for prescribing care after radiation and
042317 -        hyperthermia, because interim analysis shows worsening symptoms
042318 -        signal recovery from strong reaction to radiation; indicates
042319 -        IBC receiving significant treatment. ref SDS 66 9L7K  Without
042320 -        cancer marker CA 15-3 results for the blood test on 090309, the
042321 -        only metric of recovery is visual observation based on
042322 -        experience. ref SDS 66 YX5F  Tara clarified that she has very
042323 -        limited experience caring for patients with IBC who have been
042324 -        treated with radiation and hyperthermia in the UCSF Radication
042325 -        Oncology Department, ref SDS 66 SP8J; Doctor Hsu cited
042326 -        extensive experience treating IBC patients with radiation and
042327 -        hyperthermia, and advised that examination shows rising IBC
042328 -        symptoms are actually evidence of side effects from treatment
042329 -        with radiation and hyperthremia, and this worsening condition
042330 -        will get worse, but eventually recover, and further signals
042331 -        expected recovery from IBC. ref SDS 66 F84U
042333 -         ..
042334 -        [On 090312 1437 called Kaiser talked to Cisi; she reported that
042335 -        CA 15-3 was not ordered for blood test on 090309, and
042336 -        recommended Millie contact the doctor to order the test.
042337 -        ref SDS 67 SV90
042339 -         ..
042340 -        [On 090313 0943 called Arlette to ask Doctor Johnson about
042341 -        getting CA 15-3 results for the blood test on 090309 to support
042342 -        the record of examination at UCSF on 090312. ref SDS 68 Y077
042343 -
042344 -
042345 -
042346 -
042347 -
042348 -
042349 -
042350 -
042351 -
042352 -
0424 -