CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS B2 0000. ref SDS B1 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 87
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy.  The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 87 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 88 F25O
040915 -  ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 89 HH4I
040920 -  ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 91 YX8L  Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 91 MZ4N
040926 -  ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 92 TD5W
040930 -  ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 93 YL5N
040936 -  ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 94 6X7S
040942 -  ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 95 NT5N
040949 -  ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 96 KE4K
040954 -  ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 97
040958 - L54I
040960 -  ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 98 KE4K
040964 -  ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 99 PK9O
040967 -  ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS A0 IZ7N
040973 -  ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS A1 QQ6N
040978 -  ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS A2 4W5F
040983 -  ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes.  He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice.  Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 -  ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS A4 036C
041001 -  ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS A5
041007 - 036C
041009 -  ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS A6 036C  Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS A6 MZ5H  Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS A6 UN4M  Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS A6 I33H  Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS A6 UN5P
041023 -  ..
041024 - On 100603 1112 Linda called to schedule a visit for Hospice social
041025 - support. ref SDS A8 036C
041027 -  ..
041028 - On 100604 1350 Linda visited to begin case management for Millie's
041029 - Hospice care. ref SDS A9 036C
041031 -  ..
041032 - On 100606 1243 Judy visited Millie to begin Hospice social support,
041033 - covering from Linda. ref SDS B1 036C
041035 -  ..
041036 - On 100611 0900 Linda visited again.  She has not read the record to
041037 - verify understandings. ref SDS B2 036C  Linda doubled Millie's pain
041038 - medication with morphine. ref SDS B2 QK5O
041040 -  ..
041041 - On 100618 1451 Linda continued current pain medication; she ordered
041042 - medication for Millie coughing up food. ref SDS 0 036C
041043 -
041045 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Linda said she has still not received the record for meeting with
041402 - Millie on 100604 1350. ref SDS A9 036C
041404 -  ..
041405 - Linda asked Millie about her pain level?
041407 -  ..
041408 - Millie said her pain is 1 or 2.
041410 -  ..
041411 - Linda discussed increasing Decadron.
041413 -  ..
041414 - Millie said this is not necessary.
041416 -  ..
041417 - Discussed Millie's recent upset stomach that has caused caughing and
041418 - food coming up, and reduced eating.
041420 -  ..
041421 - Linda prescribed Prilosec.  She called Doctor Johnson and requested a
041422 - prescription.  Doctor Johnson was not available.  Linda called
041423 - Christine, the doctor on call for Hospice.  Christine was not
041424 - available.  Linda called Bob, the pharmacist.  He was not available.
041426 -  ..
041427 - Christine called back.  She approved prescribing Prilosec for Millie.
041429 -  ..
041430 - Linda called the Kaiser pharmacy.  She ordered Prilosec, and for pick
041431 - up at the Park Shadelands pharmacy.
041433 -  ..
041434 - Millie said she will get it on Monday.
041436 -  ..
041437 - Linda advised that hurrying, the prescription can be picked up today.
041439 -  ..
041440 - Millie confirmed that Monday will be okay.
041442 -  ..
041443 - Linda observed that lymphedema swelling in Millie's left arm has
041444 - significantly reduced, in that the arm now shows very little swelling.
041445 - The right arm is significantly swelled, due to cancer spreading on the
041446 - right side from untreated in the breastbone area, and since Millie's
041447 - left side was treated with radiation, nothing can grow in the skin, so
041448 - cancer has spread to the right side.
041450 -  ..
041451 - Linda took vitals...
041452 -
041453 -        BP..................... 110 62
041454 -        Pulse.................. 56
041455 -        Temperture............. 97.8
041457 -  ..
041458 - Linda used a stethoscope, and commented that she has very good skills
041459 - evaluating breathing.  Linda said that Millie has excellent breathing
041460 - today.
041462 -  ..
041463 - Linda feels Millie is in excellent health, and commented that Millie
041464 - must be an athlete.
041466 -  ..
041467 - Millie said she used to be an athlete, before her breathing was
041468 - injured by over-radiation, and her cancer got worse from being
041469 - untreated by radiation.
041470 -
041471 -        [On 100623 1452 Linda reported again that Millie's looks great,
041472 -        and seems healthy like an athlete. ref SDS B3 VE4W
041474 -  ..
041475 - Linda scheduled the next meeting on Thursday, 100624, rather than
041476 - Friday next week, because Friday is her day-off.
041477 -
041478 -        [On 100623 1452 Linda called and changed schedule to 100623
041479 -        1500, rather than Thursday. ref SDS B3 036C
041481 -  ..
041482 - Millie thanked Linda for visiting.  Linda told Millie to keep up the
041483 - good work, because she looks great.
041484 -
041485 -
041486 -
041487 -
041488 -
041489 -
0415 -