CONTACTS
SUBJECTS
Birthday Everywhere-Elegance-Personalized-Handbag Purse Purchased fr
0703 -
0703 - ..
0704 - Summary/Objective
0705 -
070501 - Follow up ref SDS B6 0000. ref SDS B5 0000.
070502 -
070503 -
070504 -
070505 -
070507 - ..
0706 -
0707 -
0708 - Progress
0709 -
070901 - Meeting scheduled at Kaiser, in connection with cancer CA 125 50,284,
070902 - reported on 210508 1028. ref SDS B1 IS5H
070904 - ..
070905 - Meeting started at 1032.
070907 - ..
070908 - Questions...
070909 -
070910 - 1. What is driving CA 125 50,284???
070911 -
070912 - What is causing ground glass opacities found in CT test on
070913 - 210501 2034. ref SDS A8 5C98
070915 - ..
070916 - 2. What is driving recurrent pleural effusion buildup in lungs?
070918 - ..
070919 - Doctor Skilling said he has never seen CA 125 at such a high number,
070920 - so he is referring her immediately for systemic treatment to prevent
070921 - cancer from spiraling out of control beyond reach of recovery.
070923 - ..
070924 - The cancer marker will be tested prior to getting chemotherapy. This
070925 - will evaluate response to treatment - CA 125 should be falling
070926 - significantly with each treatment.
070928 - ..
070929 - The doctor said Kathy has stage 4 cancer in the peritoneum lining of
070930 - the abdomen. This is therefore called...
070931 -
070932 - peritoneal cancer
070934 - ..
070935 - Symptoms in lungs of ground glass opacities and pleaural effusion do
070936 - not represent cancer in the lungs, but are caused by cancer in the
070937 - "peritoneum".
070939 - ..
070940 - Peritoneum is a serous membrane which lines the walls of the
070941 - abdominal cavity and lies on abdominal and pelvic organs. Between its
070942 - two layers - parietal and visceral - is the peritoneal cavity. The
070943 - peritoneum functions to support and protect abdominopelvic organs.
070945 - ..
070946 - He seemed to say there are no large cancer masses that can be removed
070947 - with surgery. In this case, there are a great many small dots of
070948 - cancer, which together are causing symptoms, and so can only be
070949 - treated using systemic chemotherapy initially with...
070950 -
070951 - taxol (paclitaxel) and carboplatin
070952 -
070953 - ...which will be injected in patient's arm sequentially during 5-hour
070954 - treatments on 21 day intervals.
070955 -
070957 - ..
070958 - After the meeting research found...
070959 -
070960 - MacMillan Cancer Support
070961 - Paclitaxel and carboplatin
070962 -
070963 - https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/paclitaxel-and-carboplatin
070965 - ..
070966 - On the first day, you will have paclitaxel and carboplatin.
070967 - You then have no treatment for the next 20 days. At the end of
070968 - the 21 days, you start your second cycle of paclitaxel and
070969 - carboplatin. This is exactly the same as the first cycle.
070971 - ..
070972 - Treatment protocol
070974 - ..
070975 - Side effects are listed
070976 -
070977 -
070979 - ..
070980 - Research further found...
070981 -
070982 - Primary Peritoneal Cancer: Know the Basics
070983 - March 22, 2019
070984 - Sonya Collins
070985 -
070986 - https://www.curetoday.com/view/primary-peritoneal-cancer-know-the-basics
070988 - ..
070989 - As of 2019, the five-year survival rate for women with all
070990 - types of ovarian, fallopian tube, and peritoneal cancers is 47
070991 - percent. This figure is higher for women under 65 (60 percent)
070992 - and lower for women over 65 (29 percent).May 22, 2019
070994 - ..
070995 - Primary peritoneal cancer is a rare relative of ovarian cancer
070996 - - in every 1 million people, fewer than seven cases occur.
070998 - ..
070999 - Stage 4, cancer has spread beyond the abdominal cavity,
071000 - potentially including fluid around the lungs and lymph nodes in
071001 - the groin. Women with primary peritoneal cancer usually have a
071002 - combination of surgery and chemotherapy, just as they would for
071003 - ovarian cancer.Mar 22, 2019
071004 -
071005 -
071007 - ..
071008 - 3. Work plan
071009 -
071010 - VIDEO APPOINTMENT VISIT
071012 - Wednesday May 19, 2021 ...Time: 3:00 PM
071013 -
071014 - [...below on 210519 1030 at 1319 Bronda called and
071015 - scheduled call with oncology Doctor Hui on 210527 0930, and
071016 - chemotherapy begins the next day on 210528 [...time to be
071017 - determined...]. ref SDS 0 FD4O
071018 -
071020 - ..
071021 - Telephone Visit
071023 - Friday May 21, 2021 ... Time: 3:00 PM
071024 -
071026 - ..
071027 - VIDEO APPOINTMENT VISIT
071029 - Monday May 24, 2021 ....Time: 9:00 AM
071030 -
071031 -
071032 -
071033 -
071034 -
071035 -
071037 - ..
0711 -
0712 -
0713 - 1324
0714 -
071401 - Kaiser Doctor Skilling progress notes...
071402 -
071403 - Logged onto Kaiser.org...
071404 -
071405 - https://healthy.kaiserpermanente.org/northern-california/front-door
071406 -
071407 -
071413 - ..
071414 - Office Visit
071415 - Date................................... 2021 05 19 1032
071416 - JEFFREY STEVEN SKILLING MD
071417 - WOMEN'S HEALTH 3RD FL
071419 - ..
071420 - Gynecologic Oncology Evaluation
071422 - ..
071423 - Clinical/Path Dx: Stage IV peritoneal cancer
071425 - ..
071426 - Primary Tx: chemotherapy
071428 - ..
071429 - Adjuvant Tx: possible adjuvant surgery following completion
071430 - of chemotherapy
071432 - ..
071433 - CC: CONSULTATION
071435 - ..
071437 - evaluation and treatment of newly diagnosed advanced stage
071438 - peritoneal cancer. Patient presented with shortness of breath.
071439 - Right pleural effusion found; cytology positive for
071440 - adenocarcinoma, favor gyn primary.
071442 - ..
071443 - CT scan chest 5/1/2021:
071444 -
071445 - There is a moderate to large dependent right pleural
071446 - effusion
071447 -
071448 - There is complete collapse of the right lower lobe.
071450 - ..
071451 - There is an ovoid soft tissue lesion measuring 2.4 x 4.4 cm
071452 - in the medial aspect of the right lung adjacent to the
071453 - heart. It is uncertain if this is a mass or complete
071454 - collapse of the right middle lobe
071456 - ..
071457 - No lymphadenopathy is seen.
071459 - ..
071460 - Tiny ascites is present
071462 - ..
071463 - Collected: 5/1/2021 Case #: SSCN21-430
071465 - ..
071466 - Cytology Report
071467 - Addendum and/or Procedure Present
071469 - ..
071470 - Addendum Reported: 5/6/2021 10:29
071472 - ..
071473 - Addendum Diagnosis
071475 - ..
071476 - P53 is mutated pattern (completely negative), no change of
071477 - final diagnosis.
071479 - ..
071480 - FINAL PATHOLOGIC DIAGNOSIS
071481 - PLEURAL FLUID:
071482 - - MALIGNANT CELLS, LIKELY METASTATIC HIGH GRADE SEROUS
071483 - CARCINOMA(GYNECOLOGIC ORIGIN)
071485 - ..
071486 - Comment
071488 - ..
071489 - The tumor cells are positive for Pax8, but negative for
071490 - TTF-1 or GATA3. This immunophenotype often seen Mullerian
071491 - origin tumor.
071493 - ..
071494 - CT scan abdomen/pelvis 5/13/2021:
071495 -
071496 - 1. Ascites with scattered peritoneal implants, concerning
071497 - for metastatic disease.
071498 -
071499 - 2. Ongoing right pleural effusion with airspace opacity
071500 - and consolidation within the right lung base. Partially
071501 - visualized nodule within the right middle lobe. See
071502 - recent CT chest dated 5/1/2021 for further details.
071504 - ..
071505 - 3. Sigmoid colonic diverticulosis.
071506 -
071508 - ..
071509 - Component............................. 5/8/2021
071511 - ..
071512 - CA 125................................ 50,284 (H)
071513 -
071515 - ..
071516 - PMHX:
071517 - Active Ambulatory Problems
071518 - Diagnosis
071519 - HX OF CLONIC POLYP 11 06 2014
071520 - TOBACCO SMOKER 11 06 2014
071521 - OSTEOPOROSIS 11 06 2014
071522 - PREDIABETES 06 04 2015
071523 - ATHEROSCLEROSIS OF AORTA 12 07 2016
071524 - EMPHYSEMA 12 07 2016
071525 - HIGH DENSITY LIPROTEIN DEFICIENCY 03 24 2017
071526 - MULTIPLE PULMONARY NODULES 03 24 2017
071527 - BILAT PSEUDOPHANKIA 01 17 2019
071528 - LEFT SHOULDER DISLOCATION 04 13 2020
071529 - CASE / CARE MGMT, OSTEOPOROSIS 04 24 2020
071530 - MALIGNANT PLEURAL EFFUSION 05 07 2021
071531 -
071533 - ..
071534 - Additional diagnoses from the Past Medical History section
071535 - Diagnosis
071537 - ..
071538 - COLON POLYP 08 / 2014
071539 - DIVERTICULOSIS
071540 - INTERNAL HEMORRHOID
071541 - OSTEOPENIA dx 2014
071542 -
071544 - ..
071545 - PSHx:
071546 - Past Surgical History:
071547 - Procedure Laterality Date
071548 - OL-PHACO CATARACT SURGERY BILATERAL Bilateral 01 16 2019
071549 - Performed by Long, Jennifer Rizzo (M.D.) at RCO-AMBULATORY-OR
071551 - ..
071552 - NEGATIVE PAST SURGICAL HX 10 23 2014
071553 - ORIF FRACTURE SHOULDER 04 13 2020
071554 - Performed by Hallare, Domingo Alcantara (M.D.) at SSC-MAIN-OR
071555 -
071557 - ..
071558 - MEDS:
071559 - Current Outpatient Medications
071560 -
071561 - (see online list)
071562 -
071564 - ..
071565 - FAM Hx:
071566 - Family History
071567 - Problem
071568 -
071569 - (see online list - all "None")
071570 -
071572 - ..
071573 - SOC Hx:
071574 - Social History
071575 - Tobacco Use
071576 -
071577 - (see online list)
071578 -
071580 - ..
071581 - ROS: negative except for that mentioned in the history of the
071582 - present illness.
071584 - ..
071585 - OBJECTIVE:
071586 - BP 102/60 | Pulse 80 | Ht 5' 3" | Wt 59.5 kg (131 lb 3.2
071587 - oz) | BMI 23.24 kg/m²
071589 - ..
071590 - General - well developed, well nourished female in no apparent
071591 - distress, accompanied by her son and daughter at today's visit
071593 - ..
071594 - Lymph Nodes - no enlargement
071595 - Breasts - deferred
071596 - Abdomen - soft, non-tender with active bowel sounds; no
071597 - hernia, masses, or ascites
071598 - Extremities - no edema
071600 - ..
071601 - PELVIC EXAM:
071602 - Ext. Gen (B.U.S. vulva) - no lesions
071603 - Vagina - no lesions or unusual discharge
071604 - Cervix - no lesions
071605 - Uterus - mobile, not enlarged or irreg.
071606 - Bimanual/Rectovaginal Exam - no masses or nodularity
071608 - ..
071609 - Assessment/Plan: Stage IV peritoneal cancer. No large masses
071610 - on CT imaging. Recommend primary chemotherapy. Med Onc
071611 - referral sent. Discussed surgery following completion of
071612 - chemotherapy to remove uterus/adnexa and re-assess the cancer,
071613 - but likely to add little to her survival advantage. Genetics
071614 - referral sent to check for genetic predisposition.
071615 -
071617 - ..
071618 - Encounter Diagnoses
071619 - Code Name
071620 - Z86.010 HX OF COLONIC POLYP
071621 - I70.0 ATHEROSCLEROSIS OF AORTA
071622 - Comment: Chronic
071623 - J43.9 EMPHYSEMA
071624 - Comment: Chronic
071625 - R73.03 PREDIABETES
071626 - M81.0 OSTEOPORISIS
071627 - Comment: Chronic
071628 -
071629 -
071630 - - Have confirmed with the patient and/or the medical record
071631 - the presence of the above diagnoses, and the diagnoses are
071632 - followed or will be followed by his or her PCP or appropriate
071633 - specialist.
071635 - ..
071636 - The total visit time face to face with the patient was 50
071637 - minutes. Time spent in counseling and discussion with the
071638 - patient was 40 minutes, and we discussed surgical therapy
071639 - for her advance stage peritoneal cancer as outlined above.
071640 -
071642 - ..
071643 - Jeffrey S Skilling, M.D.
071644 - Division of Gynecologic Oncology
071645 - 1650 Response Road, Suite 3c
071646 - Sacramento, Calif. 95815
071647 -
071648 - 916-614-4120
071649 -
071651 - ..
071652 - Staff Note
071653 - MONICA J BENNER MA at 5/19/2021 10:59 AM
071654 - Examination chaperoned by MONICA J BENNER MA.
071655 -
071656 -
071658 - ..
071659 - After the meeting went to lunch at Applebees, on Arden a few blocks
071660 - from Kaiser.
071662 - ..
071663 - Discussed understandings from the meeting, per above. ref SDS 0 AZ8M
071664 -
071665 -
071666 -
071667 -
071669 - ..
0717 -
0718 -
0719 - 1339
0720 -
072001 - Bronda called and said the earliest she can schedule telephone
072002 - meeting with...
072003 -
072004 - Doctor Lai Fong Hui, MD
072005 -
072006 - ...is next week on 210527 0910. At that time, Doctor Hui will
072007 - discuss treatment options. If Kathy agrees, Kaiser will schedule a
072008 - date to begin getting chemotherapy treatments.
072010 - ..
072011 - Bronda was not aware Kathy's CA 125 is 50,284, reported on 210508
072012 - 1028, ref SDS B1 F87L, and that Doctor Skilling said in the meeting
072013 - today, that he had never seen a cancer marker that high. This may
072014 - indicate immediate treatment is needed to prevent cancer from
072015 - spiraling out of control.
072017 - ..
072018 - Bronda will notify Doctor Hui of Kathy's CA 125, and advise that
072019 - immediate treatment to lower CA 125 50,284 may be needed to achieve
072020 - therapeutic response to treatment.
072022 - ..
072023 - Bronda kept the meeting date on 210527, to have something on the
072024 - books. She will send Kathy a letter notifying of the date and time
072025 - for the meeting.
072026 -
072027 -
072029 - ..
0721 -
0722 -
0723 - 1344
0724 -
072401 - Bronda called back.
072403 - ..
072404 - She talked to the doctor. They will schedule Kathy to get treatment
072405 - with Carboplatin and Taxol on 210528, the day after talking with
072406 - Doctor Hui.
072408 - ..
072409 - Asked Bronda to advance the treatment date.
072411 - ..
072412 - Bronda will do her best.
072413 -
072414 -
072415 -
072416 -
072417 -
072419 - ..
0725 -
0726 -
0727 - 1625
0728 -
072801 - Baronda called.
072802 -
072803 - Kathy is scheduled to attend a class online tomorrow explaining
072804 - procedures getting chemotherapy...
072805 -
072806 - 210520 0930
072807 -
072808 -
072810 - ..
0729 -
0730 -
0731 - 1737
0732 -
073201 - Kathy received letter from Kaiser saying...
073202 -
073203 - 1. Subject: FW: Virtual Living With Cancer Class
073204 - From: SRY-ONN
073205 - Date: 5/19/21 16:25 (GMT-08:00)
073206 - To:
073208 - ..
073209 - 2. Hi There,
073211 - ..
073212 - 3. As discussed, we have registered you for the Living with Cancer
073213 - Class on+ Thursday, May 13th at 09:30 AM.  Please see the
073214 - below instructions to join the class.
073216 - ..
073217 - 4. Please do not respond to this message, as this mailbox is not
073218 - monitored.
073220 - ..
073221 - 5. You may forward this message to other family members who may
073222 - want to join from other locations.
073224 - ..
073225 - 6. Please print, or at least review the 3 attached PDF files.
073227 - ..
073228 - 7. The PowerPoint slides are what will be covered during the class.
073230 - ..
073231 - 8. The Patient Instructions are step by step on how to join the
073232 - virtual class.
073234 - ..
073235 - 9. The Patient Information contains various handouts.
073237 - ..
073238 - 10. Just a few items to remember when joining the Living with
073239 - Cancer virtual class. To launch the class, go to the Microsoft
073240 - Teams meeting click on the class link below:
073242 - ..
073243 - 11. Join on your computer or mobile app
073245 - ..
073246 - 12. Click here to join the meeting
073247 -
073248 - https://teams.microsoft.com/l/meetup-join/19%3ameeting_N2YyMjUxYzItMmE4Ni00NzYxLTgxZWUtZTI4NThlY2YxMDc2%40thread.v2/0?context=%7b%22Tid%22%3a%223f8a7bc4-e337-47a5-a0fc-0d512c0e05f1%22%2c%22Oid%22%3a%22b65e38d2-520b-418a-a259-cf94b507535a%22%7d
073250 - ..
073251 - 13. Desktop Device:
073252 -
073253 - If you are joining from your desktop device select "continue in
073254 - this browser"
073256 - ..
073257 - Select "Allow" for Teams to access your microphone
073259 - ..
073260 - Confirm your audio is turned on
073262 - ..
073263 - Enter only your first name and last initial as other
073264 - participants may be able to see your personal information
073266 - ..
073267 - Select "Join Now"
073269 - ..
073270 - 14. Mobile Device:
073271 -
073272 - From your mobile device, open the App Store (iPhone) or the
073273 - Google Play Store (Android)
073275 - ..
073276 - Search and download Microsoft Teams
073278 - ..
073279 - 15. Class Reminders:
073280 -
073281 - Please keep yourself muted during the class. There will be time
073282 - for questions at the end
073284 - ..
073285 - Click on the hand icon to raise your hand when you have a
073286 - question. Please be sure to unmute yourself by clicking on the
073287 - microphone icon when it is your turn to ask a question.
073289 - ..
073290 - If you do not want your video on, be sure to+ click on the camera icon+ to turn off the camera
073291 -
073292 - 34.
073294 - ..
073295 - 16. NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. v.173.295 Thank you.
073297 - ..
073298 - 17. Attachments:
073299 - Patient Instructions.pdf 923 KB
073300 - SAC Living with Cancer_Presenter slides.pdf 708 KB
073301 - Chemo class patient information.pdf 2.4 MB
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