THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: April 7, 2009 09:56 AM Tuesday;
Rod Welch
Called Roy clarify authorization and schedule Millie at UCSF Apr 23rd.
1...Summary/Objective
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 27 0000, ref SDS 25 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - 1. On 080829 1200 Doctor Johnson reported in the medical chart
040902 - that examination at Kaiser diagnosed 5th relapse of IBC,
040903 - ref SDS 1 1Z6O; advised Millie to notify Doctor Rugo that
040904 - Kaiser will authorize treatment with "targeted drugs" for
040905 - Millie's relapse, because Millie has been treated with all of
040906 - the chemotherapy agents available at Kaiser. ref SDS 1 PX5V
040908 - ..
040909 - 2. On 080829 2256 Millie's letter to the medical team reports
040910 - Doctor Johnson's finding of swelled LN in left supraclavicular,
040911 - ref SDS 2 RP8T, and Millie's progression of disease requires
040912 - targeted treatments, ref SDS 2 RP9R; Kaiser wants UCSF to
040913 - prescribe new treatment in time to be effective. ref SDS 2 RP9W
040915 - ..
040916 - 3. On 081024 1150 Doctor Johnson authorized payment for Millie
040917 - continuing treatment on clinical study at UCSF, ref SDS 3 K67J;
040918 - explained requirements for treatment to start in time to be
040919 - effective because Millie's cancer has mutated into a more
040920 - aggressive disease; the doctor entered into Kaiser's medical
040921 - chart approval for treatment on referral at UCSF. ref SDS 3
040922 - OZ5F
040924 - ..
040925 - 4. On 081024 1354 Millie's letter notifies medical team that
040926 - primary care physician authorized treatment on referral to UCSF
040927 - with clinical study for double agent "targeted" treatment,
040928 - because Kaiser does not have treatments that can help Millie
040929 - recover from IBC. ref SDS 4 XZ8W
040931 - ..
040932 - 5. On 081219 1140 Doctor Johnson finds favorable response to
040933 - treatment of IBC 5th relapse with sunitinib, ref SDS 5 3L9L;
040934 - doctor cites urgency of timely treatment increases when Millie
040935 - suffers relapse; delay increases risk of losing control for
040936 - cancer that mutates into more aggressive disease. ref SDS 5
040937 - KU6F Doctor Johnson asked Millie to notify Doctor Rugo about
040938 - planning treatment for the 6th relapse to ensure treatment
040939 - starts in time to be effective, ref SDS 5 V93O, and asked for a
040940 - letter from UCSF to facilitate the next referral, ref SDS 5
040941 - SU8G; because the 6th relapse will be very serious, ref SDS 5
040942 - NS8H; further emphasized need for letter from UCSF recommending
040943 - treatment on referral from Kaiser. ref SDS 5 E84J
040945 - ..
040946 - 6. On 090115 0700 response to sunitinib treatment indicates IBC
040947 - on breastbone area stable to worse, everything else looks
040948 - stable. ref SDS 6 124N
040950 - ..
040951 - 7. On 090116 0913 Glenna called to ask about Millie's response to
040952 - treatment; cited the record no 090115. ref SDS 7 JY6L
040954 - ..
040955 - 8. On 090116 1030 Millie blood test at Kaiser cancer marker CA
040956 - 15-3 303 rises 100 points - 3 times higher than at anytime in
040957 - patient history. ref SDS 8 PQTQ
040959 - ..
040960 - 9. On 090116 1348 Glenna letter notifies Doctor Rugo Millie's
040961 - response to treatment causing rising fatigue, and IBC on
040962 - breastbone area looks worse. ref SDS 9 4P5M Millie's letter
040963 - later in the afternoon confirms understandings that IBC in
040964 - breastbone area looks stable to worse. ref SDS 10 IS6G
040966 - ..
040967 - 10. On 090118 0700 respnose to sunitinib treatment IBC now seems
040968 - worse in breastbone area. ref SDS 11 124N
040970 - ..
040971 - 11. On 090121 1017 Glenna calls to ask about Millie's response to
040972 - treatment, ref SDS 13 AJ3J; reported rising cancer marker CA
040973 - 15-3 303 on test at Kaiser 090116, and signals 6th relapse of
040974 - cancer, ref SDS 13 N95K; aligns with IBC worse in breastbone
040975 - area, reported in patient history on sunitinib treatment
040976 - reported 090120. ref SDS 12 124N
040978 - ..
040979 - 12. On 090122 2321 after Millie returns from treatment in
040980 - Emergency Room Department for injury to shoulder; message on
040981 - answering machine from Glenna, Doctor Rugo diagnosed 6th
040982 - relapse, wants Millie to end treatment with sunitinib in order
040983 - to remove toxicity from system so that she can start a new
040984 - treatment next week on 090129. ref SDS 14 J47F
040986 - ..
040987 - 13. On 090123 1326 Doctor Johnson called and concurs Millie has
040988 - suffered IBC relapse with cancer marker CA 15-3 303 in blood
040989 - test on 090116 at Kaiser; confirms Millie's cancer has mutated
040990 - to resist treatments available at Kaiser, authorizes UCSF to
040991 - prescribe next treatment. ref SDS 15 RK6O
040993 - ..
040994 - 14. On 090130 1722 reports meeting at UCSF 090129 0830 finds
040995 - cancer spreading rapidly, ref SDS 16 4S8O, Doctor Rugo
040996 - prescribes treatment with hyperthermia and Doxil to regain
040997 - local control, ref SDS 16 4S8O; starting treatment for 6th
040998 - relapse of IBC was delayed by communication problems.
040999 - ref SDS 16 AY8Q
041001 - ..
041002 - 15. On 090204 0219 Millie asks Doctor Rugo to submit an opinion on
041003 - likely scenarios and possible treatment options so that
041004 - proactive management will avoid scrambling at the last minute
041005 - to get things done for the next treatment, ref SDS 17 278T,
041006 - that were required for the current hyperthermia treatment
041007 - scheduled to begin tomorrow on 090205, and shown by case study
041008 - in the record on 09204 1914 listing chronology of delays.
041009 - ref SDS 18 MN5I
041011 - ..
041012 - 16. On 090204 1914 Doctor Rugo advised that Millie's treatment for
041013 - IBC would be evaluated in a meeting after treatment with
041014 - radiation and hyperthermia on referral from Kaiser to the UCSF
041015 - Radiation Oncology Department. ref SDS 18 278T
041017 - ..
041018 - 17. On 090204 1930 Millie letter advises that Kaiser and UCSF have
041019 - become a winning team providing effective and comprehensive
041020 - care treating cancer as a chronic disease. ref SDS 19 W84Q
041022 - ..
041023 - 18. On 090210 Lena called to schedule meeting with Doctor Rugo at
041024 - UCSF on 090212 0830. ref SDS 20 XU5N
041026 - ..
041027 - 19. On 090213 1140 Doctor Johnson supported proactive planning to
041028 - treat Millie's next relapse of IBC as a chronic disease,
041029 - ref SDS 21 GD3I, and approved meeting with Doctor Rugo at UCSF
041030 - to start research so that treatment can begin in time to be
041031 - effective. ref SDS 21 WZ6K
041033 - ..
041034 - 20. On 090317 0915 Millie completes treatment wtih radiation and
041035 - hyperthermia; Doctor Hsu scheduled to see Millie on 090423 1315
041036 - to evaluate response to treatment. ref SDS 22 5Q42
041038 - ..
041039 - 21. On 090324 0548 Millie's letter notifies medical team that
041040 - follow up meeting to assess response to treatment will be at
041041 - UCSF on 090423 1315. ref SDS 23 CT9R
041043 - ..
041044 - 22. Millie sent a letter to Glenna on 090402 asking for assistance
041045 - following up on Doctor Rugo's request to involve the
041046 - "authorization person," with respect to discussions yesterday
041047 - with Pam at Kaiser. ref SDS 27 U25I
041049 - ..
041050 - 23. Glenna called and said she forwarded Doctor Rugo's letter from
041051 - last night, and including a copy of Millie's letter on the
041052 - authorization issue to two people with request to follow up as
041053 - Doctor Rugo requests. ref SDS 27 PPTS
041055 - ..
041056 - 24. The next day On 090403 1054 Millie sent a letter to Juanella
041057 - Faison, listed as an assistant for Doctor Rugo, ref SDS 29
041058 - L494, asking to implement planning for Millie to meet with
041059 - Doctor Rugo on 090423 0800.
041060 -
041061 -
041062 -
041064 - ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Called the UCSF Breast Care Clinic this morning, and talked to Roy.
041402 -
041403 - Roy checked the UCSF computer.
041405 - ..
041406 - He said there is no record of Juanella Faison scheduling Millie for
041407 - meeting with Doctor Rugo and Tara on 090423, as discussed in the
041408 - letter to UCSF on 090403 1047, ref SDS 29 L494, and referenced in
041409 - Doctor Rugo's letter on 090401 0121, ref SDS 24 K56O, about deferring
041410 - the date to meet with Millie from 090402.
041412 - ..
041413 - Roy was unable to find anything in UCSF's records on scheduling Millie
041414 - for medical care in the Breast Care Clinic.
041416 - ..
041417 - Reviewed discussions with Glenna that Amanda Lawrence was notified to
041418 - schedule Millie for meeting with Doctor Rugo on 090423 1013.
041419 - ref SDS 28 BC7K
041421 - ..
041422 - Roy will notify Doctor Rugo's assistant, Amanda, to investigate and
041423 - make necessary arrangements.
041424 -
041425 - [On 090407 1121 Amanda called who assists Doctor Rugo and
041426 - advised UCSF cannot find Millie's letter to the medical
041427 - team today, and further advised that UCSF has no record
041428 - showing Kaiser has authorized referral for Millie to meet
041429 - with Doctor Rugo on 090423 0800, and so the meeting has not
041430 - been scheduled; Millie's letter on 090401 1520 was
041431 - resubmitted to Amanda at UCSF. ref SDS 26 MV5K
041433 - ..
041434 - [On 090407 1121 Amanda calls and schedules Millie for
041435 - another meeting with Tara, because Doctor Rugo will be out
041436 - of town again on 090423 0830. ref SDS 30 4N3F
041437 -
041438 -
041439 -
041440 -
041441 -
041442 -
041443 -
041444 -
041445 -
0415 -