CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 17 0000. ref SDS 16 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 100203, Millie resumed treatment after a 3-week pause ordered by
040902 - Doctor Johnson, on 100112 0830, ref SDS 5 G68H, while Millie was
040903 - treated to recover from a very severe case of shingles infection,
040904 - reported earlier on 100104 1115. ref SDS 4 0P9S
040906 -  ..
040907 - On 100217 0730 Millie got the 3rd treatment of the 3rd cycle with
040908 - Navelbine for Millie to recover from the 9th relaspe of cancer.
040910 -  ..
040911 - On 100218 1000 Millie got Neupogen treatment at Kaiser to maintain
040912 - blood counts essential for getting Navelbine chemotherapy treatment
040913 - for cancer. ref SDS 7 ER95
040915 -  ..
040916 - On 100218 1000 Millie had emergency meeting with Doctor Johnson,
040917 - primary care physician at Kaiser, after getting Neupogen treatment;
040918 - the doctor diagnosed relapse of shingles, and prescribed a 4th cycle
040919 - of treatment, but only with Acyclovir (Zovirax) 800 MG tablets,
040920 - ref SDS 7 0Y6O; the doctor also diagnosed Millie's 10 relapse of
040921 - cancer, and ordered switching treatment from Navelbine to Abraxane,
040922 - beginning on 100303. ref SDS 7 023N   The doctor further ordered a CT
040923 - test to evaluate rising pain. ref SDS 7 ES40
040925 -  ..
040926 - On 100218 1230 Millie had emergency CT test. ref SDS 7 PQ6R
040928 -  ..
040929 - On 100301 0005 letter to medical team cites findings of "improvement"
040930 - reported in CT test on 100218, and increased energy may indicate
040931 - Navelbine can continue another cycle. ref SDS 8 ER95  Cancer marker CA
040932 - 15-3 328 suddenly increasing more than 100 points in a month, reflects
040933 - 3-week pause in treatment for cancer, orderd by the doctor as
040934 - necessary to treat shingles. ref SDS 8 OO3X  The doctor prescribed
040935 - Abraxane to start the next cycle of chemotherapry to recover from the
040936 - 10th relapse of cancer; Millie is concerned about side effects.
040937 - ref SDS 8 OO4Q  Chemotherapy is not appropriate care for treating
040938 - stage V cancer. ref SDS 8 OO7Q  Millie needs another cetuximab
040939 - solution "targeted" to her patient profile to recover from cancer
040940 - without severe side effects. ref SDS 8 4Y6K  Millie requests
040941 - explanation in writing of trade-offs comparing alternate oncology
040942 - treatments. ref SDS 8 OO7T  Millie notifies Kaiser that
040943 - representations in the medical chart for the meeting on 091116 that
040944 - the doctor explained trade-offs is incorrect. ref SDS 8 OO9S  Millie
040945 - notes that advantage of "targeted" treatments for cancer enables
040946 - concurrent treatment for recurrent shingles, rather than pausing,
040947 - which causes cancer to rapidly increase. ref SDS 8 OP6Q
040949 -  ..
040950 - On 100302 0830 meeting at Kaiser, ref SDS 9 ER95; Doctor Johnson
040951 - prescribed Abraxane for Millie starting treatment tomorrow for
040952 - recovering from 10th relapse of cancer. ref SDS 9 FB67  Blood counts
040953 - dropped significantly, ref SDS 9 IC4N; since Abraxane side effects
040954 - reduce blood counts this increases chances of shingles recurrence; the
040955 - doctor advised that treatment for cancer will be paused again, if
040956 - shingles recurs. ref SDS 9 FC68  Only way for Millie to get treatment
040957 - for shinges concurrent with cancer is to switch from Abraxane to a
040958 - "targeted" treatment for cancer that does not injure bone marrow
040959 - producing blood. ref SDS 9 IC85
040961 -  ..
040962 - On 100303 0730 Millie received 1st treatment 1st cycle Abraxane at
040963 - Kaiser Oncology Chemotherapy Clinic in Walnut Creek. ref SDS 10 625I
040965 -  ..
040966 - On 100304 2251 Millie notifies medical team that 1st treatment of 1st
040967 - cycle started with Abraxane to recover from 10th relapse of cancer.
040968 - ref SDS 11 ER95  Reports possible recurrence of shingles. ref SDS 11
040969 - OP6W  Millie asks Kaiser for written report on trade-offs for
040970 - prescribing agents "targeted" to treat her cancer that do no injure
040971 - the bone marrow producing new blood. ref SDS 11 OQ4Y
040973 -  ..
040974 - On 100305 0822 Millie notifies medical team that shingles seems to
040975 - have subsided again, so that treatment with Abraxane can continue.
040976 - ref SDS 12 ER95  Millie requests prescription for medication to have
040977 - available in time to treat shingles recurrence so that treatment for
040978 - cancer can continue. ref SDS 12 0W3T  Millie further requests that the
040979 - medical team submit analysis of trade-offs for alternative oncologic
040980 - treatments. ref SDS 12 0W3W
040982 -  ..
040983 - On 100309 1238 Millie notifies medical team that shingles seems not to
040984 - have recurred despite side effects of Abraxane that lower immunity by
040985 - degrading bone marrow that replenishes blood counts. ref SDS 13 ER95
040987 -  ..
040988 - On 100309 1238 Millie notifies medical team that Kaiser's Knowledge
040989 - Management system is off-line, and so requests results of blood test
040990 - to evaluate getting treatment with Abraxane chemotherapy tomorrow for
040991 - recovering from cancer. ref SDS 13 HL4V
040993 -  ..
040994 - On 100309 1643 Millie notifies medical team that results of lab today
040995 - show "good-to-go" for getting 2nd Abraxane treatment tomorrow.
040996 - ref SDS 14 ER95
040998 -  ..
040999 - On 100310 0730 Millie gets 2nd treatment 1st cycle of Abraxane to
041000 - recover from 10th relapse of cancer. ref SDS 15 KE4K; Doctor Johnson
041001 - visits Millie at 0810, during treatment, and approves getting
041002 - treatment. ref SDS 15 OR3H
041004 -  ..
041005 - On 100310 1350 Millie thanks Doctor Johnson for visiting during
041006 - treatment today, ref SDS 16 ER95; notifies medical team that Kaiser
041007 - completed the 2nd treatment of the 1st cycle with Abraxane for
041008 - recovering from the 10th relapse of cancer. ref SDS 16 ER95  Doctor
041009 - Johnson advised that Kaiser's Knowledge Management internal email
041010 - system makes communication faster for emergency communications on
041011 - patient care. ref SDS 16 GY4U  Millie reported that Kaiser's Knowledge
041012 - Management system has been off-line for more than a week. ref SDS 16
041013 - GY4X; Millie explains that public domain email addresses for doctors
041014 - at Kaiser enable comprehensive care that optimizes patient outcome,
041015 - even though it may be a little slower for emergencies. ref SDS 16 GY6P
041016 - Millie will continue to support the medical team through continuity of
041017 - communications for the doctor/patient partnership. ref SDS 16 GZ3U
041019 -  ..
041020 - On 100311 0811 Doctor Johnson's letter dated 100310 said Millie may
041021 - need to get a new password. ref SDS 17 ER95
041023 -  ..
041024 - On 100316 Millie went to Kaiser in Martinez for weekly blood draw to
041025 - test immune system to evaluate starting 2nd treatment for 3rd cycle of
041026 - Navelbine, and how much Nupigen treatment is needed to maintain blood
041027 - counts. ref SDS 18 AS5H  Also testing INR 3.2 again, which was still
041028 - slightly high for interim blood test on 100205. ref SDS 6 IS7Q
041030 -  ..
041031 - On 100317 0730 Millie received the 3rd treatment that completes the
041032 - 1st cycle with Abraxane to recover from the 10th relapse of cancer.
041033 - At this time, Millie is experiencing rising pain from progressing IBC,
041034 - and rising lymphedema, most noticably in the right arm, which has been
041035 - free of disease for 10 years. ref SDS 19 KE4K
041037 -  ..
041038 - On 100319 0843 Millie notfies medical team that 1st cycle with
041039 - Abraxane chemotherapy was completed on 100317, and that she needs
041040 - dental work, which she will try to schedule for next week, which is
041041 - the bye-week for chemotherapy. ref SDS 0 ER95  Evident improvment in
041042 - cancer marker aligns with some initial reduction in IBC rash, which
041043 - together signal recovery from 10th relapse of cancer. ref SDS 0 1T3Y
041044 - Avoiding recurrence of shingles and avoiding drop in blood counts
041045 - supports the medical team treating Millie's cancer as a chronic
041046 - disease, planned by Doctor Rugo. ref SDS 0 1T4U
041047 -
041048 -
041050 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Millie's letter to medical team says...
041402 -
041403 -    1.  Subject: Response Abraxane 1st Cycle Begin Recovery 10th Relapse Cancer
041404 -        Date: Fri, 19 Mar 2010 09:26:01 -0700
041417 -         ..
041418 -    2.  First, by copy I am asking the Dentist, Russ Harris, DDS, for a
041419 -        meeting next week, during my bye week for chemotherapy, to
041420 -        examine and correct what feels like a cavity.   I will call
041421 -        Kristy later today on specific dates and times.
041422 -
041423 -            [On 100319 0939 Kristy received Millie's letter, and
041424 -            scheduled a meeting with Doctor Harris on 100323 0800, to
041425 -            fix the new cavity. ref SDS 20 P070
041427 -         ..
041428 -    3.  Second, Arlette called on Wednesday, and reported good news.
041430 -         ..
041431 -    4.  Cancer Marker CA 15-3 369 dropped about 60 points for the lab
041432 -        on 100316 [and after only 2 treatments for the 1st cycle of
041433 -        Abraxane].  This is the first decline in more than 2 months,
041434 -        and after a 200 point increase over the prior month that
041435 -        signaled the 10th relapse of cancer [reported on 100304 2251.
041436 -        ref SDS 11 OQ4T].  Improvement in the cancer marker aligns with
041437 -        some reduction in IBC rash the past week that had spread
041438 -        significantly, since January, when the team paused chemotherapy
041439 -        to recover from cancer for a 3 week period to treat shingles.
041440 -
041441 -           [On 100329 2322 Millie notifies medical team that she does
041442 -           not yet have a strong sense recovery from the 10th relapse
041443 -           of cancer is occurring, ref SDS 21 WA7S; and advises that
041444 -           recent reversal on the rise of the cancer marker gives hope
041445 -           for effective response to treatment with Abraxane.
041446 -           ref SDS 21 WA8S
041448 -            ..
041449 -           [On 100330 0830 Doctor Johnson finds during examination at
041450 -           Kaiser that first cycle of treatment with Abraxane has
041451 -           reduced Millie's cancer, ref SDS 22 FB9Y, including "drying
041452 -           up" of IBC nodules. ref SDS 22 HR9K, and, so orders starting
041453 -           2nd cycle of Abraxane of 100303. ref SDS 22 FB67
041455 -         ..
041456 -    5.  Thankfully, shingles has not recurred again, after recurring
041457 -        {on 100218, 100218 1000, ref SDS 7 PP5Y], prior to starting
041458 -        Abraxane on 100303, 100303 0730, ref SDS 10 625I].  As well,
041459 -        blood counts have held up concurrent with getting chemotherapy.
041460 -        This has allowed continuity of chemotherapy, essential for
041461 -        treating my cancer as a chronic disease, planned by the medical
041462 -        team and reported by Doctor Rugo at UCSF on 090616. ref SDS 2
041463 -        D647
041465 -         ..
041466 -    6.  With evident reduction in cancer, albeit only beginning for the
041467 -        10th relapse, energy has begun to recover.  Last Saturday I
041468 -        hiked nearly 3 miles, and on Monday did the full 3.3 miles by
041469 -        completing the Clayton trail, and without requiring any stops
041470 -        to rest along the way.  Yesterday, I "crashed" in bed all day,
041471 -        but have been able to reduce Percocet for controlling pain to
041472 -        only 1 pill every 4 hours, instead of 2 pills every 3 hours.
041473 -        Today, I seem more energetic, starting the 2nd day after chemo,
041474 -        than last week on Friday.
041476 -         ..
041477 -    7.  These metrics give hope for continued recovery sufficient to
041478 -        make the trip planned for mid-May, which just a few weeks ago
041479 -        seemed optimistic to impossible.
041481 -         ..
041482 -    8.  Recovering from the 10th relapse gives the team time to
041483 -        complete review of follow on treatments to compare trade-offs
041484 -        for the next relapse [...cancer spreading caused by UCSF
041485 -        medical mistakes and treatment with chemotherapy that is not
041486 -        effective from Millie's patient profile...].  As you can see
041487 -        from the rise in my need for Percocet (recently re-ordered from
041488 -        the [Kaiser] Oncology Pharmacy), pain control and energy have
041489 -        become significant criteria for quality of life, as discussed
041490 -        in the letter to the medical team on 100305. ref SDS 12 0W3W
041491 -        [...cited increasing Percocet to control rising pain reduced
041492 -        quality of life to being a "zombie" constantly drugged sleeping
041493 -        in bed, reported on 100301 0005. ref SDS 8 OP5U...], and citing
041494 -        case study on the doctor/patient partnership to develop a work
041495 -        plan for treating my cancer as a "chronic disease," listed on
041496 -        090725. ref SDS 3 X66O
041497 -
041498 -            [On 100329 2322 Millie notifies medical team again to
041499 -            submit trade-offs comparing oncology treatments in time to
041500 -            recover from next relapse of cancer. ref SDS 21 WA9U
041502 -         ..
041503 -    9.  Finally, INR has recovered to move back within range,
041504 -        reflecting timely case management by Gloria in Kaiser's
041505 -        Coagulation Control Clinic, and reflecting adjustments to
041506 -        Coumadin in relation to a complex array of medications for
041507 -        treating cancer, shingles, and pain.
041509 -         ..
041510 -   10.  Thanks to all for excellent work.
041511 -
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0416 -