CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 13 0000. ref SDS 12 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 091202 Millie had the 3rd treatment in the 1st cycle of Navelbine.
040902 - ref SDS 11 625I
040904 -  ..
040905 - She is experiencing some possible recovery, but also evident worsening
040906 - of cancer due to lack of treatment targeted to her patient profile.
040908 -  ..
040909 - On 091203, Millie submitted a letter notifying the medical team about
040910 - possible progression of disease, and requesting treatment targeted to
040911 - her patient profile, ref SDS 12 4P7G, following up the letter on
040912 - 091112, ref SDS 7 IL8L, and meeting with Doctor Johnson at Kaiser
040913 - later that day on 091112. ref SDS 8 UT7M  The following letter
040914 - confirms understandings from meeting on 091112, and sets agenda for
040915 - meeting at Kaiser on 091210.
040917 -  ..
040918 - On 091211 0018 Millie letter confirms understandings from meeting at
040919 - Kaiser and thanks thanked medical team for excellent care, ref SDS 0
040920 - BW8I, based on Doctor Johnson's report in the meeting at Kaiser on
040921 - 091210 that Kaiser is collaborating with Doctor Rugo for UCSF to
040922 - prescribe treatment targeted to Millie's patient profile. ref SDS 0
040923 - XM3X
040924 -
040925 -
040926 -
040928 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Millie's letter to the medical team following up the letter on 091203,
041302 - ref SDS 12 4P7G, and confirming understandings with Doctor Johnson at
041303 - Kaiser yesterday on 091210, ref SDS 13 BW8I, says...
041304 -
041305 -    1.  Subject: Treatment Plan 9th Relapse Cancer - Happy Holidays!!
041306 -        Date: Fri, 11 Dec 2009 01:38:38 -0800
041314 -         ..
041315 -    2.  I am very pleased to say Happy Holidays, and express my
041316 -        gratitude for an outstanding medical team.  Everyday you and
041317 -        Doctor Rugo extend the gift of life solving complex medical
041318 -        challenges for me and countless others.  Your combined skills,
041319 -        experience, leadership, and persistence are a blessing for all,
041320 -        indeed a national treasure.
041322 -         ..
041323 -    3.  I am grateful, as well, for Arlette who has "greased the wheels
041324 -        of progress" at Kaiser, so that plans and good intentions
041325 -        become effective care.
041327 -         ..
041328 -    4.  Doctor Rugo is equally blessed to have strong support at UCSF.
041329 -        Tara Lacey, NP, has been outstanding assisting Doctor Rugo in
041330 -        my case with examinations, briefings, and case management,
041331 -        shown by the record on 090716 reporting Tara's call to present
041332 -        UCSF's treatment plan for the 8th relapse. ref SDS 5 EE5W
041334 -         ..
041335 -    5.  During the meeting yesterday at Kaiser on 091210, you approved
041336 -        starting the 2nd cycle of Navelbine next Wednesday, on 091216.
041338 -         ..
041339 -    6.  Labs the day before on 091215 will report cancer marker CA 15-3
041340 -        a few days later on Thursday or Friday.  If the cancer marker
041341 -        remains relatively flat or even declines, we will complete
041342 -        cycle 2 of Navelbine.  Otherwise, if CA 15-3 increases
041343 -        significantly, consideration will be given to switching agents
041344 -        in order to maintain local control, and based on observing
041345 -        during examination today IBC progression, most notably the
041346 -        bulge of lymphedema on the upper left chest near my arm pit,
041347 -        but as well across my right chest.
041349 -         ..
041350 -    7.  Since these symptoms of progression occurred at the end of the
041351 -        Gemzar treatment last month, your plan is to give Navelbine
041352 -        another chance (cycle) to yield response.  During the meeting
041353 -        yesterday, you cited email communications with Doctor Rugo
041354 -        reporting that UCSF supports this work plan, which requires
041355 -        identifying follow on treatments for timely use upon
041356 -        progression.
041358 -         ..
041359 -    8.  For my next treatment after Navelbine, during the meeting at
041360 -        Kaiser yesterday, you left the examination room for about 20
041361 -        minutes to check on my getting treatment with PARP, which
041362 -        Doctor Rugo planned during the meeting at UCSF on 090616.  Your
041363 -        investigation found that Kaiser does not currently have PARP
041364 -        nor other treatments targeted to my patient profile.
041365 -        ref SDS 13 C06K  You planned to send a letter to Doctor Rugo on
041366 -        progress at UCSF scheduling this treatment for me, or such
041367 -        other treatments that Doctor Rugo feels gives the best chance
041368 -        for me to recover from the 9th relapse of cancer, and with
041369 -        minimal side effects, as achieved with cetuximab in 2007 and
041370 -        2008. ref SDS 13 0J65  "Recover" in my case means to reduce IBC
041371 -        rash, lymphedema, the cancer marker, and remain stable with
041372 -        relatively normal quality of life for 6 months more or less.
041373 -
041374 -            [On 091211 1452 Doctor Johnson notifies Millie he sent the
041375 -            letter to Doctor Rugo collaborating on treatment targeted
041376 -            to Millie's patient profile. ref SDS 14 BW8I
041378 -             ..
041379 -            [On 091215 1557 Millie notifies medical team blood counts
041380 -            are high enough to start 1st treatment 2nd cycle of
041381 -            Navelbine, but have fallen substantially, and so asks about
041382 -            prescribing 2 treatments with Neupogen to complete 2nd
041383 -            cycle, ref SDS 18 BW8I, Millie also asks about UCSF
041384 -            progress prescribing treatment targeted to Millie's patient
041385 -            profile, so that low blood counts will not prevent getting
041386 -            treatment required for quality of life. ref SDS 18 5U6V
041388 -         ..
041389 -    9.  Thanks also for approving my taking 2 percocet pills to control
041390 -        pain from progression of IBC.  You also said that morphine
041391 -        based pain relief can be prescribed, if this becomes necessary
041392 -        (reported on 091210 0950. ref SDS 13 4H5L].
041393 -
041394 -            [On 091215 0852 Millie's letter notifies Kaiser that, as of
041395 -            091215, she has not had to take 2 percocet pills at once
041396 -            for pain. ref SDS 17 I15X
041398 -         ..
041399 -   10.  As we discussed, please send me copies of correspondence
041400 -        showing collaboration with UCSF on my care, as planned
041401 -        yesterday.  Tara (tara.**********.edu) can support your letter
041402 -        by briefing Doctor Rugo on my patient history, shown in the
041403 -        record on 090213. ref SDS 2 ES7I [and requested by Doctor
041404 -        Johnson during the meeting at Kaiser yesterday on 091210 0950.
041405 -        ref SDS 13 OJ9F]
041406 -
041407 -            [On 091211 1648 Millie's letter thanking Doctor Johnson for
041408 -            his letter collaborating with Doctor Rugo on prescribing
041409 -            treatment targeted to Millie's patient profile, and
041410 -            confirms request for copies of all correspondence on her
041411 -            health care, and further asks if Doctor Johnson sent a copy
041412 -            of his letter to Tara for assisting Doctor Rugo on Millie's
041413 -            case. ref SDS 15 174W
041415 -             ..
041416 -            [On 091214 1649 Doctor Johnson notifies Millie that Doctor
041417 -            Rugo has not responded to Kaiser's letter on 091211; the
041418 -            doctor does not submit a copy of Kaiser's letter to Doctor
041419 -            Rugo, nor indicate that a copy went to Tara for assisting
041420 -            Doctor Rugo in prescribing treatment targeted to Millie's
041421 -            patient profile. ref SDS 16 BW8I
041423 -             ..
041424 -            [On 091215 0852 Millie asks Doctor Johnson if a copy of
041425 -            Kaiser's letter to UCSF went to Tara for assisting Doctor
041426 -            Rugo prescribing treatment targeted to Millie's patient
041427 -            profile. ref SDS 17 I15R
041429 -         ..
041430 -   11.  Again, I am grateful beyond measure for exceptional health care
041431 -        at Kaiser and UCSF.  This is a difficult time with Rod
041432 -        recovering from heart surgery in October, reported on 091022.
041433 -        ref SDS 6 01F9
041435 -         ..
041436 -   12.  So, I am hopeful we are moving forward.
041438 -         ..
041439 -   13.  Happy holidays to all!!
041440 -
041446 -
041447 -
041448 -
041449 -
041450 -
0415 -