CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - There have been continuing discussions on setting a date for Millie to
040902 - meet with UCSF in the Breast Care Clinic for continued evaluation of
040903 - Millie's treatment requirements.  This was recently set to 090423.
040904 - Today, Millie submitted an agenda to UCSF for the meeting...
040905 -
040906 -    1.  Subject: Agenda Meeting Apr 23 0830 Doctor Rugo and 115p Doctor Hsu Treatment Plan IBC Spreading
040907 -        Date: Mon, 20 Apr 2009 23:59:07 -0700
040915 -         ..
040916 -    2.  I received a call last week confirming meeting with Doctor Hsu
040917 -        on Thursday at 115p.  Got a call this evening at 1920 (0720p)
040918 -        confirming a meeting with Doctor Rugo in the morning at 0830 on
040919 -        Thursday.
040921 -         ..
040922 -    3.  At this point I'm not sure what really to do on Thursday.
040923 -        Amanda called in the afternoon (090420 1451) and advised that
040924 -        UCSF does not have documentation from Kaiser for the meeting
040925 -        with Doctor Rugo. ref SDS 6 U25I  Amanda also sent a letter
040926 -        explaining documentation needed for Doctor Rugo to see me on
040927 -        Thursday.  I sent Amanda's letter to Kaiser's Outside Referrals
040928 -        office to expedite coordination between Kaiser and UCSF on
040929 -        authorization for may care.
040931 -         ..
040932 -    4.  Rod then called and talked to Pam in Kaiser's Outside Referrals
040933 -        office [090420 1538]. ref SDS 6 Q574  In the discussion with
040934 -        Pam, there seemed to be agreement that Kaiser's authorization
040935 -        A023242470 issued 090202 for my care at UCSF includes Doctor
040936 -        Rugo and her team. ref SDS 6 GK95  I would like to assume that
040937 -        the call received this evening saying I am meeting Doctor Rugo
040938 -        on Thursday at the regular time of 0830 reflects this issue has
040939 -        now been resolved.
040941 -         ..
040942 -    5.  I take this occasion to commend Pam for expediting
040943 -        administration of my referral.  I was desperate in early
040944 -        February about getting treatment started that was ordered by
040945 -        the doctor [reported 090202 1047, ref SDS 1 9Y5I, Pam was
040946 -        professional, courteous, prompt, and accurate aligning
040947 -        authorization with patient history. ref SDS 1 XF9F
040949 -         ..
040950 -    6.  I am very grateful to Doctor Mason, Chief of Outside Referrals,
040951 -        for calling today about getting lab work at UCSF to maintain
040952 -        continuity of care the past 2 years. [reported 090420 1620],
040953 -        ref SDS 6 Q57H  Doctor Mason explained benefits having lab
040954 -        diagnostics available quickly and accurately for doctors on the
040955 -        computer. ref SDS 6 2H41  Experience at UCSF shows that my care
040956 -        requires checking blood counts sometimes several times a day by
040957 -        a wide variety of doctors and nurses.  Since 90% of my care is
040958 -        for cancer, and since 90% of this care is at UCSF, lab data is
040959 -        needed on UCSF's computer in a form familiar to those
040960 -        responsible for providing care in order to efficiently monitor
040961 -        trends.
040963 -         ..
040964 -    7.  Doctor Mason asked an important question about how lab data is
040965 -        transmitted from Kaiser to UCSF and from UCSF to Kaiser.  This
040966 -        was discussed recently with Doctor Johnson at Kaiser on 090213.
040967 -        ref SDS 2 NY4H
040969 -         ..
040970 -    8.  Doctor Mason explained today that more work is needed to align
040971 -        Kaiser's authorization with requirements performing labs at
040972 -        UCSF in my case.  I will try to get this done.
040974 -         ..
040975 -    9.  In the meantime, here is the lab at Kaiser on 090413 to support
040976 -        the meeting on Thursday at UCSF. ref SDS 3 S65I
040978 -         ..
040979 -   10.  Results of the CT test on 090413 were submitted previously on
040980 -        090415, ref SDS 5 R18A, to support meetings at UCSF on 090423.
040981 -        Results have not yet been posted, however, attached is another
040982 -        copy of the letter from Kaiser submitting test results.
040984 -         ..
040985 -   11.  Good news -- my skin is very nearly clear now of radiation side
040986 -        effects.  Looks like IBC has miraculously disappeared in the
040987 -        areas treated by Doctor Hsu and Chris this past February and
040988 -        March, as Doctor Rugo expected in her recent letter.
040990 -         ..
040991 -   12.  Bad news -- as reported earlier on 090415, there seems to be
040992 -        new IBC on my lower left arm. ref SDS 4 8E7L  There is now
040993 -        also a vertical row of still small nodules, about 4, just to
040994 -        the left of the right breast.
040996 -         ..
040997 -   13.  This may account for slight rise in CA 15-3 271, about 20
040998 -        points from the test at Kaiser on 090317 CA 15-3 251.
040999 -
041000 -               [On 090423 0830 Tara plans to discuss nodules in
041001 -               breastbone area with Doctor Hsu. ref SDS 7 R15K
041002 -
041003 -               [On 090423 0830 Doctor Hsu does not mention during
041004 -               examination at 1200 discussions with Tara, ref SDS 7
041005 -               CP4J; feels few light nodules in vertical line through
041006 -               breastbone area may or may not be IBC and will heal from
041007 -               continuing effects of radiation that ended on 090317.
041008 -               ref SDS 7 EX4I
041010 -                ..
041011 -               [On 090423 2337 Millie's letter to medical team reports
041012 -               Tara plans to discuss with Doctor Hsu nodules in the
041013 -               breastbone area. ref SDS 8 ZL7V
041015 -                ..
041016 -               [On 090512 0830 blood test at Kaiser CA 15-3 320 rises
041017 -               to highest ever in 8 years. ref SDS 9 PQTQ
041019 -                ..
041020 -               [On 090521 2006 Doctor Johnson's letter to Millie
041021 -               without copy to medical team refuses to prescribe
041022 -               treatment and tells Millie she can "choose" any
041023 -               treatment she wants, because no treatment is superior
041024 -               for Millie's patient profile, ref SDS 10 9Q9H; Doctor
041025 -               Johnson warns Millie that she needs treatment by the end
041026 -               of the week, which is in just 12 hours, because her 8th
041027 -               relapse of cancer is progressing rapidly, ref SDS 10
041028 -               HC8O, and Kaiser tells Millie to call Medicare rather
041029 -               than Kaiser for prescribing her treatment to recover
041030 -               from 8th relapse of cancer. ref SDS 10 9Q9H
041032 -                ..
041033 -               [On 090602 1300 blood test at Kaier CA 15-3 289 declines
041034 -               30 points with no treatment. ref SDS 11 PQTQ
041036 -                ..
041037 -               [On 090609 Doctor Hsu advises there was a mistake
041038 -               performing radiation in February and March at UCSF that
041039 -               missed treating IBC in the breastbone area to the left
041040 -               of the right breast, and this untreated IBC tumor may be
041041 -               causing problems in Millie's lungs. ref SDS 12 TP9L
041043 -         ..
041044 -   14.  Also troubling is relatively low NEUTS 1.406 (1406 at Kaiser),
041045 -        despite the long pause since the last chemo on 090122.
041047 -         ..
041048 -   15.  My energy has increased significantly.  Recently did a 3 mile
041049 -        lap at Lafayette Reservoir in 50 seconds, improving by 20% the
041050 -        time after starting hiking again a week ago.
041052 -         ..
041053 -   16.  Hoping to see everybody on Thursday to get started on a
041054 -        treatment plan.
041055 -
041062 -
041063 -
041064 -
041065 -
041066 -
041067 -
041068 -
0411 -