Saturday, December 26, 2009

Omens


I’m not a superstitious person but I have a little story of omens to share. Last winter, when I was quite sick and still dealing with my diagnosis, I was awakened every morning by a group of crows that alight on the trees outside my bedroom window. Every morning for weeks on end, these crows would come caw and squawk to wake me up. It was rather annoying and, since crows are traditional symbols of death, their morning greeting was that much less enjoyable. It was odd to me that of all the trees in our neighborhood, these darn crows chose my window to serenade every day. When spring came, they found somewhere else to go and I was glad to be rid of them.

I had forgotten about the crows until late summer, when I went up to Cape Cod for a few days. One afternoon, I was taking a quick nap on the couch while waiting for a friend to drop buy. A group of crows chose that moment to come sit on the railing of the deck right outside the window and cawed their lungs out as I tried to nap. When my friend arrived, I mentioned to her about how the crows seem to be following me. She emailed me a few days later to say that she had looked into the symbolism of crows. They are not just symbols of death but are often viewed in mythology as symbols of transition or change. That is a less ominous interpretation so I prefer it.

So, yesterday, on Christmas morning, I went down to the curb to get the paper and heard a loud knocking, like someone hammering. Above me in the tree were two large Pileated Woodpeckers. They were pounding away at the tree and knocking off chunks of bark looking for a six-legged breakfast. I was pretty impressed. I often see the little Downy woodpeckers in our tress and the Flicka, which also ground feeds. But Pileateds are pretty large and I have only seen or heard their calls or hammering when deep in the woods. I have never seen them in the more open, residential areas. So, I decided to look up the mythology of the woodpecker.

Woodpeckers are a symbol of opportunity (as in Opportunity Knocks – what other animals see such hope for a good meal in a dead tree?). They are also associated with a source of creativity or returning to ones roots. Now that’s a good omen for Christmas day.

I am still not a big believer in the supernatural. But the crows and woodpeckers do make a good catalyst to ponder 2009 and 2010. 2009 was certainly a year of transition. Not just for my family but for the many thousands who have been affected by layoffs, foreclosures and the trials of a bad economy. But perhaps 2010 will bring about new opportunity, new sources of creativity and a returning to the important things – like family and friends – who are the roots of who we are. So I wish you all the best for new opportunities in 2010 as we transition to the New Year. Merry Christmas!

Saturday, December 19, 2009

Round 29 and Snowflakes


As I await the coming foot or so of snow, I thought I'd post a quick blog. On Tuesday I went for Round 29. I also had a scan on Monday. My scan came back stable - so treatment is still working nicely.
To thank the staff for all their help this year, I brought them a big tray of cupcakes from Crumbs. If you are not a New Yorker, Crumbs is a bakery chain in the city that makes the most incredible cupcakes. I went to the one on 3rd Ave at 53rd Street but there are many other locations. I recommend a visit if you are a cupcake lover (which I am)!
So far, it's been a nice start to the holiday season. All the Hannukah candles have been lit and it's now time to put up my Charlie Brown tree in the window. The snow will make a nice backdrop for the season. For Northeasterners, the foot or so we expect will be handled well I expect since we have lots of plows and salt spreaders. I doubt there will be school closings on Monday - much to the dismay of the kids. But they'll get some sledding in! As for my good friends in Richmond, your kids will probably get the week off! I saw on WTVR.com this morning that Richmond got about a foot! That's probably a "10 year event" so digging out will take a while! Or perhaps y'all will just have to wait for it all to melt! Hope you got in that last run to Ukrops to stock up on milk and bread!
And a piece of trivia for you - I researched today how many snowflakes it takes to build a snowman. The answer is about 2 to 3 million! First kid to gues the answer gets dibs on the hot chocolate!

I hope you are enjoyng the season...think I'll go build a fire in the fireplace now...BB

Saturday, December 12, 2009

Rep Allyson Schwartz and Healthcare


Hey all, one of the Reps I spoke with in DC this fall was interviewed on the healthcare issue on CSPAN this week. Here's a link to her interview. It's about 25 minutes long but if you are interested in her perspective, it's all here.http://cspan.org/Watch/Media/2009/12/11/WJE/A/27140/Rep+Allyson+Schwartz+DPA.aspx
Now back to baking cookies....BB

Monday, December 7, 2009

Thanksgiving and Rounds 27 and 28

Well, it’s been quite a long time since I have blogged. The holiday season has gotten off to a busy start!

We had a good crowd at Thanksgiving – about 20 people – and everyone seemed to have a good time. I went down to Florida for a weekend and brought my father back up to spend the week here during Thanksgiving and spend some time with the family. That was fun – plus I got in a couple of 80 degree days in Tampa!

At Thanksgiving, I did a small pre-dinner ceremony by reading the two known personal accounts of the first Thanksgiving and going through the answers to the Thanksgiving trivia quiz we handed out during the cocktail hour. But more importantly, I had the opportunity to thank our family and friends who were present for their tremendous support this past year. It was a tough one for our little family but everyone’s good wishes and support made a real difference. I am very happy and thankful to be here and be in relatively good condition. Thank you all for your help!

As for my treatment, since my last post I have had two more rounds of chemo – Numbers 27 and 28. And fall has turned to winter. The rounds were the usual routine; which is a good thing. The city is abuzz with holiday shoppers and vacationers. I see a lot of people speaking foreign tongues and huddled around tourist maps on 5th Avenue. Perhaps that’s a good sign for the economy.

And just for fun, here's my picture of Rocky the Squirrel, who has for several weeks been sitting on our deck eating acorns to fatten up for winter. Like us, the holiday season is nuts for him, too.

I hope you are all enjoying the season and planning lots of festivities. I also hope to see many of you before it gets bitterly cold and I start dreaming again of heading south!

Monday, November 16, 2009

Football Season is Over (at least for now)



Since I've blogged about Vicki's sports, I thought I'd give David some airtime. Yesterday was his team's last football game of the year. The boys played well but alas, they lost 14 -12 on missed extra points. It's the third time this year they lost on extra points! But it was a very good game that literally came down to the last play - where they came up just short of scoring the winning TD as time ran out (they were down to the 12 yard line).

Dave played a great game including stripping the ball from the runningback at their own 1 yard line to stop a drive (he played linebacker this game although he played a lot more free safety during the year). So, we are on to basketball season - and next year - freshman football at the high school!

Here are a few pics - of Dave about to make a tackle (number 81 in red in the center of the shot). of him also about to make a tackle and getting blocked in the back (so he got the tackle and some penalty yards), and his disappointed I-don't-want-my-picture-taken post game portrait.

Am going for treatment tomorrow...hope you like the pictures (and are patient with me braggin' on my boy!) BB

Wednesday, November 4, 2009

Round 26

I moved my chemo treatments this month to Tuesdays to work around some other scheduling things this month so I had it yesterday. It was a very, very long day as the place was packed and Dr. S had to cover other patients. I didn't get home until about 9 pm! But, treatment was the usual fare. I did confirm with Dr. S that he wants me to stay the course on treatment for as long as I can put up with the side effects. Since I've been able to manage them so far, I told him that I will just suck it up and keep going. If it gets really bad, I may get a holiday - but I'm going to do my best to just stay the course.

Today, we leave for a couple of days in Washington, DC to take Vicki to see some colleges. (Vicki in college - I can'r believe it!). But junior year is the year to do your homework on schools. We will be seeing American University, George Washington and Georgetown. And we'll have a half day off to just see things in DC. Since I'm on the bottle for the next day or so, I hope I have the energy to take the tours. I may just do the info sessions and then sleep in the car while Vicki and Robbie get the campus tour. We'll see.

As a brief aside to yesterday's trip to the clinic, I had lunch during my break with a former colleague at AXA. I went to her place on 46th street so I got my walk in. On the way, I passed a construction site and two guys with shovels were mixing a wheelbarrow of concrete on the sidewalk. As I passed, I heard one say to the other "It's not my f**king fault that Darwinism failed!" I really wonder what these two philosophers were arguing about!

Be well! BB

Thursday, October 29, 2009

Red, Green and Blue


I’ve been thinking about the polarization of America along the famous Red and Blue state lines and thought I’d do a little investigating. Specifically, politicians from Red states have consistently promoted a line of lowering taxes and keeping government out of people’s lives. This message is currently on tour with a new Tea Party campaign which will run a route from California through the Plains states and into the Deep South – basically a red state tour.

In trying to diagnose why Plains-state and Southerners are so concerned about federal taxation and government programs, it dawned on me that perhaps the difference between Red and Blue staters is in our everyday experience with governmental activity. Specifically, Blue states are more industrialized and have larger, more dense populations than Red states. As such, Blue staters see road projects, bridges, governmental agencies, public security, help for the poor, programs for the elderly, etc every day. Thus, they see the “benefit” of government programs every day. Conversely, if you live in a rural county, down a country road or across a big corn field, perhaps you don’t “see” the benefit of government spending and thus, don’t see the value of your tax dollar.

So I looked for research on which states pay the most taxes and which states receive the most federal dollars – assuming that Red states are net tax payers and Blue states are net federal funds receivers. I was dead wrong.

In fact, Red states are overwhelmingly beneficiaries of federal funds. Federal expenditures (from a Tax Foundation report - see below) are the sum of federal purchases, direct payments (social security, medicare, etc), and salaries to federal employees. In addition to state-by-state per-capita tax burden and expenditures, the report calculates the ratio of the same. For example, if your state has a ratio of 1.10 this means that for every tax dollar paid by residents, the state receives back $1.10 in federal spending.

The state with the greatest per capita federal spending and the second highest ratio of spending to taxes paid is: Alaska! With over $13,000 in annual spending per resident and a ratio of $1.87, Alaska takes the cake as the largest beneficiary of the federal government! The highest ratio state is New Mexico at $2.00 received for every dollar in taxes paid. (Perhaps this is because we keep all the UFO’s that have landed in the US in New Mexico and they are expensive to maintain??) In fact, the top 10 states that are making out in federal spending are, in order of ratio: NM, AL, WV, MS, ND, AL, VA, HI, MT and SD. By my count, that’s 8 traditionally Red states and two Blue (NM and HI)!

And who are the “losers” – ie, the “donor states”? The top ten donors are NJ, CT, NH, MI, IL, NV, MA, CA, NY and CO – or 8 Blue states and two Red (NV and CO)! In fact, the ratios for the biggest donor states are very low with New Jersey (the “biggest loser!”) at 55 cents, CT at 66 cents and NH at 67 cents. For my reading audience in NY and MA, your ratios are 79 and 77 cents respectively. And my pals in PA and VA, your ratios are $1.06 and $1.66. I think Virginia’s ratio is likely skewed because so many northern Virginians work for the government in DC and thus their salaries, etc would be in the ratio.

I did my own calculation of the average ratios for Red and Blue states but added the wrinkle of defining several states as “Purple” – meaning that they have mixed populations that sometimes swing Democratic and sometimes Republican. The purples are: LA, WV, VA, AR, MO, AZ, OH, FL, CO, NH and NV. My calculated average ratio for Red states is $1.34, for Purple $1.20 and for Blue states $1.00. The average for the entire US was $1.17 which implies that domestic expenditures exceed federal taxes received by 17% - hence a big national deficit!

There’s much more detail in the report and data to parse, but in short, the people who pay the least taxes and get the most back from the government want less taxes and less government. And, the people who pay the most taxes and get the least back from the government are willing to expand the system. So, unlike many things in life, who get the most “Green” doesn’t explain who is Red and who is Blue!

My source of info is a report issued by the Tax Foundation in 2006 (latest available). The report “Federal Tax Burdens and Expenditures by State” can be found here: http://www.taxfoundation.org/files/sr139.pdf

Sunday, October 25, 2009

Round 25 and My Scan


Went for Round 25 last Thursday. It was a gorgeous day in NYC. Dr. S was on vacation so I met with another doctor for my checkup before chemo. My scan came back stable again (woo hoo!). So, although the doctor can’t make the decision that Dr. S and I have to discuss, I asked his opinion of me getting a break. He said that a recent study came out that looked to prove that taking a couple of months off if you are stable doesn’t negatively affect outcomes. Unfortunately, the study showed the opposite – stable patients who took time off had worse outcomes than those who kept up their chemo. So, I think my hopes for some time off may be dashed and I’ll stay on the great ferriswheel of chemotherapy - staying in the same place but having my ups and downs. We’ll see what Dr. S says next time.

Since it was a very nice day, I walked over to Rockefeller Center and had lunch with a former colleague at AXA. No cranberry bogs this time but a nice time nonetheless…

Monday, October 19, 2009

More on my trip to DC

I thought I’d share a little about the experience of working with an advocacy group in talking to MoCs. Our day on the Hill started with a breakfast at the Capitol Hill Club. The CHC is right behind the three buildings that hold the offices of Senators and Congressmen. It is also the home of the National Republican Club of Washington DC. The CHC is well decorated in formal style and houses quite a large collection of elephant statues and trinkets. I ate my breakfast under a large portrait of Dwight D. Eisenhower next to a cabinet full of little crystal elephants. But they served no peanuts…

After breakfast, we all made our way to the Rayburn office building to hold a press conference. The Imaging folks gave us all T-shirts to wear at the “presser” – which I thought was a bit hokey. The room held about 100 people, including the 30 or so patients. The PR firm that organized the conference also made hand-painted signs – ala a grass roots protest. They asked some of the older ladies in the front of the room to hold them up in their seats. I thought this was a bit cheesy as well (see pic above). The speakers were allotted 4 minutes each for about 6 or 7 key people to make a short statement. The first to go was the CEO of Colon Cancer Alliance – the group that sponsored my visit. He took 20 minutes. The next was a doctor who runs an imaging clinic in Arkansas. He took another 20 minutes. By then, several patients had to leave to start their day of meeting with MoCs! They cut the speakers to just two more – each of which took their allotted 4 minutes. As a result, the press conference ran about an hour instead of a half hour. And I have now added a new expression to the “Great Book of Brianisms” – “Give a man a seat and he’ll chat for 5 minutes, Give a man a podium and he’ll talk for an hour”

After the “presser”. I had a few hours to kill so I returned to the hotel for a quick lunch and a good nap.

I was a bit surprised that you don’t need an appointment to get into the MOCs office buildings. You just go through a metal detector and you are free to roam the halls. And there are plenty of halls! All marble with high ceilings. As you stroll about, you pass the offices of Senators and Congressmen along with doors marked for committees such as “Ways and Means” or “Democratic Caucus”. I arrived at the appointed time at Rep. Schwartz’ office but she was in the Capitol voting. So, her staffer in charge of health (who was meeting with us, too) took us to the basement. There, you go through another metal detector, have your bag hand inspected and get a little pass to wear on your jacket. From there, we went through a passageway into the Capitol and up an elevator to the floor where Congress meets.

We waited for the Representative in a large room – about the size of a tennis court - with a very high ceiling and a huge portrait of George Washington. The room was packed with people meeting in small groups at sets of couches and conference tables. At the largest conference table, Rep. Eleanor Holmes Norton (D-DC) was holding a meeting. Several other politicians I recognized came through as well, including Sen. John Boehner (R-OH, Minority Leader) and Sen. Mitch McConnell (R-KY) . I’m sure there were many other Reps there as well who I just didn’t recognize. The room was loud and a real buzz of activity as the various parties huddled together to hear each other. After Rep. Schwartz finished voting, she came out and we met in this room – standing – as all the seats were occupied.

For my later meeting with Rep. Pallone, we met in his office. The office suite for a congressman isn’t very large. It had three rooms and a foyer. The two staff rooms held more than one staffer each. Rep. Pallone’s office is spacious, with a seating area of couches enough to hold about eight people. He also had a framed poster of Bruce Springsteen on his wall (after all, he represents Asbury Park!)

After my day of meetings, I returned to my hotel and then went to dinner with my cousin at a nice place around the corner. It was a very long day, but quite interesting. And you can definitely sense the atmosphere of work and activity in the Congress.

Sunday, October 18, 2009

Meeting Members of Congress (MoCs)


At the meetings in DC, there were about 30 or 35 patients along with some doctors and lobbyists for various groups including advocates and medical imaging equipment manufacturers. The patients were from various parts of the country based on which MoCs were scheduled for meetings. There were quite a number of MoC’s – both Senators and Congresspeople on the list including Senators Schumer (NY), Durbin (IL), Franken (MN), Lincoln (AR), Hagan (NC) and Mikulski (MD). The House side Representatives were from a variety of states including NJ, NY, PA, FL, TX, SD, MD, MI, AL, IN, WI and so on. I was assigned to meet with Rep. Allyson Schwartz (D-PA) who represents a part of Philadelphia and western suburbs and serves on the House Ways and Means Committee and Rep. Frank Pallone (D-NJ) who represents a convoluted central NJ district that stretches from Plainfield through New Brunswick and then down along the shore to Asbury Park. Ah, the gerrymandering of congressional districts! Rep. Pallone is the chair of the House Subcommittee on Health.

At each meeting, I was part of a group of about six people including one other cancer patient, a couple of advocacy group lobbyists and a lobbyist for an imagining equipment manufacturer. In one case it was Seimans and I don’t recall the firm of the other.

Both meetings lasted about a half an hour. In both cases, the representatives showed an excellent command of healthcare issues and in Rep. Pallone’s case, a great familiarity with the minutia of imaging issues. Both Reps had their staffer who was in charge of healthcare attend. Most of the talking, as you might imagine, was done by the lobbyists – with the Reps asking specific questions. The lobbyists stuck to their key talking points (which we patients were all briefed on the night before). The Reps were interested in hearing a little from we patients and also commented that bringing actual patients into meetings with MoCs was an effective way to gain their attention.

In both meetings, I thought the lobbyists did a good job of explaining the issues succinctly and I was impressed by the Representatives’ demeanor, intelligence and logic. In neither case could they make promises about what any final legislation would hold but both were very sincere in their interest and supportive. So, overall, I think the meetings went well and the points were made. The lobbyists were all happy after the meetings – feeling like they got a chance to be heard.

Medical Imaging – The Issue


It was a pretty full day and a half in DC so I will post several entries. But to start, I thought I would get to the core of it. The purpose of going was to meet with members of Congress on the relatively narrow issues surrounding medical imaging. The brief version of the talking points is that 1) the Deficit Reduction Act of 2006 cut Medicare reimbursements for imaging (MRI, CT scans, etc) by 20% 2) the Senate and House health reform bills use further cuts in reimbursement and an excise tax on equipment manufacturers to pay for the bill 3) the coalition of manufacturers, doctors and patient advocacy groups is asking congress not to cut as deeply on the reimbursement and not pass the excise tax. If both go through “as is” in the Baucus (Senate) bill, there is deep concern that access to imaging will be severely restricted or unavailable.

Medical imaging can actually save money – but it’s more difficult to “prove a negative” statistically so I will give you my personal example. Earlier this year, I was on the drug Avastin at a cost of about $10,000 per month. Because of the severity of the side effects, I asked the doctor about coming off of it (something he was hesitant to do). We decided that, if my next scan was stable, I could come off Avastin. That scan (and every scan since) has been stable. So, for the cost of about 4 scans (at $2,000 each or $8,000 total), I have not taken Avastin – which would have cost about $60,000 total since the spring. Hence, monitoring and adjusting my meds through the use of the MRI has saved my insurer about $52,000 this year. I used this example with the Members I met.

Friday, October 9, 2009

Round 24 at the Cranberry Bog


Yesterday I went for Round 24 (but who's counting...) of treatment. At the break, I decided to take a walk over to Rockefeller center to see the old "neighborhood" from my work at AXA (the office was right around the corner on 6th Ave.) To my surprise, I ran across a cranberry bog (see picture)! It was set up right next to the skating rink (which is now set with ice for you skaters). There were cranberry experts wading around in it and explaining how cranberries are grown and harvested. It was a fun diversion - there's always something interesting happening in NYC!
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As for the treatment, it was the "usual". But the doctor did tell me that I now have macrocytosis which is an enlargement of the red bloodcells. I understand that it is yet another side effect of chemo (you can also get it if you have liver disease or are alchololic). In any case, they are doing a few additional blood tests. But it seems that the therapy for macrocytosis is to take a vitamin B12 (folic acid) supplement. I'm sure I can fit another pill into my regiment! Other than that, I am scheduled for my next CT scan on the 20th and hoping for good results...
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Enjoy the fall colors - and have some cranberries! They're good for you! BB

Sunday, October 4, 2009

Mysemicolonstory goes to Washington!



Next week, I will be going to Washington DC as a part of a coalition of cancer-related organizations to speak with congress people about health care. Specifically, we will be talking to them about medical imagery - CT scans, MRI's etc - and the critical need to have these tests as a core tool in treating cancer patients. I hope it will be a productive visit and I look forward to sharing the story with you all! I don't go until mid-next week, but I'll let you know all about it when I get back!

And I promise to wear matching socks....

Healthcare Reform - Business Roundtable



In this post, I am going to add more detail to my previous posts in order to adress these questions:

1. Is there really a healthcare "crisis"?

2. Is the issue just about the uninsured?

3. Are the proponents of healthcare reform really just socialists in disguise?


All of these questions can be answered in a single document - the study produced by the Business Roundtable. Before going into the study, let me tell you who the Business Roundtable (BR) is. Th BR is a group of CEOs from America's largest corporations. As stated on their website: "Business Roundtable is an association of chief executive officers of leading U.S. companies with more than $5 trillion in annual revenues and more than 10 million employees. Member companies comprise nearly a third of the total value of the U.S. stock markets and pay nearly half of all corporate income taxes paid to the federal government." The companies involved are named on the web and include a "who's who" of US corporate elites - from Boeing to GE to Exxon to Yahoo to American Express to Coca-Cola, etc etc etc



The BR is so concerned about the growing cost of healthcare that they commissioned a study by Hewitt Associates (a large consulting firm with a long record of involvement in employee benefits). This report, dated September 2009, is called "Health Care Reform: the Perils of Inaction and the Promise of Effective Action". It states unequivocally that "Doing nothing is simply no longer an option".

According to the report, total healthcare cost per employee has risen from $4,918 in 2001 to $10,743 in 2009. It further projects that the cost per employee will rise to $28,530 by 2019! And it states "America's businesses cannot win in the marketplace when bidding against global companies shouldering significantly lower healthcare cost burdens" and further "runaway healthcare costs are threatening the employer-based system that provides coverage for the majority of Americans and their families today".

BR points out that the approximately $2.4 trillion dollars that America spent on healthcare in 2008 "is as much as we spent on food, clothing and national defense combined!" And, "If our healthcare spend was a country, it would be the 7th largest in the world, larger than the total domestic output of Italy, Russia, Spain, Brazil or Canada!"

Without change, health-related spending will consume 20% of GDP by 2019 and "will outstrip increases in cash wages causing a decline in consumer purchasing power that will hinder economic growth".

The report goes on in detail about recommendations for reform all of which conform with my previous blogs - so no need to rehash the specifics. It closes by saying "We need game changing strategies and we can't wait much longer."

So - Is there a crisis? You bet there is!

Is the issue only about the uninsured? No - it effects every family in the US and is a major concerm for the prosperity of all Americans.

Is this just a socialist agenda in disguise? Well, I seriously doubt that the CEOs who represent 1/3 of the US stock market and half our corporate tax revenues are secretly all marxists!

Friday, October 2, 2009

Healthcare Reform (Part III)


With all this research, I have formed some opinions:

In My Humble Opinion (IMHO) – I think that the President and health reformers in Congress have done an abysmal job of explaining both what they are doing and the broad based support they have. It has lead to confusion in the public and an opportunity for “Fabricators” to invent scary notions and feed them to a public already stressed by the economy and terror-related issues.

IMHO – The leadership of the Republican party – by this I mean Rush Limbaugh, Sean Hannity and Glen Beck – who strike fear into the Party - have been outright deceitful in their characterization of reform. And their false rhetoric has been repeated by untold members of congress who don’t seem to have paid much attention to the facts of the various proposed legislation. Their opposition to reform seems more based on their desire to see President Obama fail at something than on a reasonable discussion of the needs of the country.

IMHO – Senator Baucus (D-MT) Chairman of the Senate Finance Committee is a coward. Although he says in principle that he supports a public option, he voted against both proposals in committee (by Jay Rockefeller and Chuck Schumer) because he “didn’t think they’d get 60 votes on the Senate floor”. Now there's "leadership" for you! If you vote against your “principles”, you have no principles.

IMHO –Our national press has failed miserably at sorting fact from fiction and explaining the national consensus that is revealed if you bother to look into the various positions and opinions of concerned parties and the public. They would rather get extremists on the show and “debate” without any fact checking or rational context.

IMHO – There should be a compromise struck on the one truly divisive issue – the Public option. And here’s my proposal. Pass an Exchange program for both individual and group markets along with the other elements of reform (universal coverage, requirement to be insured, multistate access, etc). Give the insurance companies five years to implement. Set a firm measuring stick on both cost and quality of care. If the Exchange succeeds in lowering cost while maintaining quality and access, do not institute a public option and re-measure every five years for future compliance. If the Exchange does not meet the cost and quality hurdle, institute a public option and measure again in five years. I think this is a reasonable way to let the marketplace have a chance to make meaningful reform with a “safety net/incentive” to get it right before starting a big, new government program.

OK – I’m done being political…BB

The National Consensus for Healthcare Reform (Part II)

In support of my previous blog on the national consensus for healthcare reform, I thought I would share a few stats from the recent surveys and give some citations so you can read the various positions directly. I found two sites particularly valuable – the Kaiser family Foundation has a lot of good material and research and Consumers Union has a very good page explaining the various elements of reform.

In addition to the data below, I do have one additional fact/concern. Some of the proposals that discuss the private insurance marketplace (often called an Exchange) want to limit the exchange to just those people who buy their insurance on their own. According the Kaiser Foundation, only 5% of health insurance is individual compared with 53% employer sponsored, 15% uninsured, 14% Medicare and 13% Medicaid (data as of 2007). So what’s the point of an Exchange if it only reaches 5% of the population (perhaps 20% if you assume all uninsured will go to the Exchange)?

Here are your stats:

The New England Journal of Medicine survey of 5,000+ doctors from the AMA database which crosses over all geographic regions, specialties, etc shows:
58% support healthcare reform with 23% opposed and 18% unsure.
Further on the topic of a public plan:
63% prefer a system with both a public and private plans, 27% prefer private only and 4% prefer public only

The Kaiser Family Foundation public opinion survey from September 11-12, 2009 shows the following ideas to be preferred among the general public:

74 % Expand Medicare to cover age 55 -64
68% Require all Americans to have health insurance with support for those who can’t afford it
67% Require employers to offer health insurance or pay into a government fund
67% Offer tax credits to help people pay for private health insurance
59% Create a government run health insurance program to compete with private plan
40% Have a national health plan where all Americans would get their coverage from a single government plan


Citations for your perusal:
American Medical Association – http://www.voicefortheuninsured.org/amaproposal.html
New England Journal of Medicine - http://healthcarereform.nejm.org/?p=1790
American Nurses Association –http://www.nursingworld.org/healthcarereform
AARP –http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts
Phrma – http://www.phrma.org/about_phrma/ceo_voices/healthcare_reform_getting_it_right/
Business Roundtable –http://www.businessroundtable.org/healthstudy/
America's Health Insurance Plans (AHIP) – http://www.americanhealthsolution.org/assets/Uploads/healthcarereformproposal.pdf
Chamber of Commerce – http://capwiz.com/chamber/issues/alert/?alertid=13529411
Kaiser Foundation - http://healthreform.kff.org/
Consumers Union –http://www.prescriptionforchange.org/2009/09/our_prescription_for_change.html#

The National Consensus for Healthcare Reform (Part I)


The healthcare proposals in congress are tremendously detailed and many of the items are inter-related or are parts of a solution that requires work at many levels. Unfortunately, an ordinary citizen, like me, is challenged to understand all the details and their implications. So as a way of leveraging the “experts” – and by this I mean reasonably interested, credible parties who have long histories of being involved in health issues – I decided to investigate their positions. The assumption is that these non-extremist points of view reflect a more sensible and less hysterical analysis. I also investigated current polling of doctors and citizens on their views of healthcare reform.

To my surprise, I have uncovered a broad-based consensus of opinion across a diverse spectrum of organizations and people in favor of meaningful healthcare reform. You would never know this from watching the news which on this issue seems to be unable to sort fact from fiction or to report on this national consensus, instead favoring the titillation of extremist arguments.

For my analysis, I investigated the positions of the following organizations:
The American Medical Association
The American Nurses Association
AARP
Phrma – the Pharmaceutical Company lobbying group
America’s Health Insurance Plans (AHIP) – the health insurance lobbying group
The Business Roundtable – an organization of large company CEOs
The Chamber of Commerce – an organization of small businesses
The Kaiser Family Foundation – a non-profit focused on health issues
Consumers Union – publisher of Consumer Reports

In addition, I read through two recent polls:
The Kaiser Foundation’s recent public opinion poll (September 2009)
The New England Journal of Medicine’s recent poll of AMA doctors

From this research of their stated positions, proposals and research, I found that all of the organizations and polls appear to support:

1. Universal care for all Americans based on the requirement that all Americans must have health insurance with help for those who can’t afford it.
2. Governmental definition of a basic level of insurance for all Americans
3. Reform of the way Medicare pays benefits, which are currently based on activity rather than outcomes
4. The creation of a private insurance marketplace in which insurers compete based on government defined plan formats – basic, enhanced, premium, etc (this element only seems to be opposed by the Chamber of Commerce)
5. A multi-state system that would allow insurers to enter all states rather than the current system where, in any given state, fewer insurers compete. This would likely be done through item 4 above.
The one defining characteristic of disagreement is in the “Public option”. On this issue, the Nurses Association, AARP, Phrma and Consumers Union support a public option. In addition, the polls of AMA doctors and of the public support the public option. The AMA, AHIP and the Chamber of Commerce oppose the public option. The Business Roundtable and the Kaiser Foundation reveal no opinion on the public option that I could find.

So, overall – there is near universal support for significant healthcare reform and the establishment of national standards and a national marketplace: from industry associations like Phrma and AHIP to medical associations like AMA and ANA to consumer groups like AARP and Consumers Union to business groups like Business Roundtable and the Chamber of Commerce (although the Chamber’s position is very squirrelly – while they state that they are in favor of reform, their pre-canned “letter to your congressman” basically says they don’t like any of the proposals currently out there).

The Un-truthful Politics of Healthcare Reform

I have been doing a lot of research on the Healthcare reform issue and have some info to share that I think you may find helpful. Unlike most people (and seemingly a lot of congressmen), I downloaded the big controversial house bill – HR3200 - and read it. Well, to be truthful I read most of it – it’s 1,100 pages long! But it is reasonably well organized so you can follow along (if you can stay awake). I have read and commented on legislation before, in my work life, since I was involved with the Government Relations activities of my firms so I have a bit of a grip on how these things are constructed.

As is usually the case, the legislation references other legislation through amendments to those laws. Real experts who deal with the topic all the time are well-versed in those other laws so they can immediately understand the reasoning and implications of those changes. I can’t claim that to be that knowledgeable, but many of the changes were seemingly at the margin – essentially tweaks to existing law. The core items in the bill are much more understandable.

I can say this about HR3200 – it has been incredibly misrepresented by right wing pundits, politicians and tea-partiers. In fact, I received a letter from someone who claimed to have read the bill and who pointed out specific pages and sections of the bill which, the writer claimed, contained such items as coverage for illegal aliens, death panels and medical rationing. Using this rather detailed list of citations as a guide, I looked up the sections mentioned. To my surprise, every single citation I looked up said absolutely nothing of the sort. Any congressional staffer with knowledge of HR3200 would have clearly seen through it, but I imagine that many people who received the same email I did would presume that a knowledgeable person compiled it. In fact, it was a complete fabrication. As an example, the writer cited a certain section as allowing illegal aliens to participate in healthcare. That section said nothing of the sort. In fact, what the section said was that the bill would not override state law in matters relating to healthcare.

The writer, and frankly my own congressman, Rodney Frelinghuysen, through his mailings and editorials claimed that the bill represents a “one-size fits all approach” to healthcare. In fact, the bill goes into detail about four distinct categories of insurance (whose parameters would be set by a large panel of government and private experts). Those plans were a basic plan, an enhanced plan, a premium plan and premium-plus plan. Each with a greater degree of covered services and a higher price.

In short, all this talk about rationing, death panels, illlegals, etc are fabrications. And I find it very distressing that many of our politicians not only remained silent in the face of these falsehoods but actually repeated them consistently in their rhetoric. And worse, the press has picked up on these falsehoods and discussed them as if they were true.

Thank You - 1 Year And Counting


Tomorrow, October 3, is the one year anniversary of my diagnosis and to be quite honest, I'm doing a lot better than I expected a year ago. I just want to recognize this "occasion" with a huge THANK YOU for all of your support. You have been wonderful to me and to my family and I can't tell you how much that has meant. Friendship is the best medicine...

Round 23 meets the Secret Service


Last Thursday (9/24), I had treatment again. It went more smoothly than ever in terms of timing. I got in and out of there at lightning speed even though I saw some additional doctors. Seems I was part of "new doctor" training day so I had company in each of my appointments. I talked again with Dr. S about a break since we're now beyond my original treatment plan. I wanted an idea of what's next. I'm not really begging for a break since treatment seems to be working and over the last several rounds, my side affects have been much more manageable. My diet and exercise adjustments seem to be helping a lot. The plan now is that, if I am stable on my next scan - which I'll have late this month - then I might get a break. If not, then I'll keep going, probably with the next line of defensive drugs. I have a funny feeling that Dr. S thinks that the effectiveness of my current treatment is going to diminish and I'll need to go to a new protocol. But we'll see...
I also met with an oncologist-geneticist who wants me to be part of a new study she is doing. The point of the study is to determine if my DNA mutated and caused the disease. To do the study, the patient must be under 50 with both parents alive and cancer free. So I meet the criteria. They will collect a DNA sample - from saliva - from me and each of my parents and do a comparison. It won't help me in my treatment nor will I ever know what my DNA reveals. But I agreed and asked my parents who also agreed. We're all willing to spit in a cup for the betterment of science!
Now for the secret service part. The day I went for treatment was the day President Obama spoke at the UN. As a result, there were diplomatic convoys and closed street all over the east side. I walked over a few blocks to have lunch with my sister-in-law and passed the Waldorf Astoria on Park Ave. The place was practically in lockdown (I think the President spent the night there). There were barricades everywhere, lots of police and secret service and Park Ave between 49th and 52nd was full of parked police cars and black-windowed SUVs. One had the back doors open with two guys facing out the back with assault rifles and combat gear on (similar to the photo I posted above). It was quite a site. But nonetheless, they let me stroll right past the front door, carrying my black briefcase. I guess I don't look too threatening! And alas, none of the mob of paparazzi with their huge telephoto lenses took my picture...ah yes, another day in the big city!

Monday, September 21, 2009

Cape Cod

Okay - one more post for today. Last week I took a little break and drove up to my sister-in-law's house on Cape Cod. I wanted one last dose of summer! And I do love the Cape even if I go alone. As it turned out, Jackie's off season renter had just moved back in so I had some company. Her boyfriend, Greg, had recently purchased a 25 foot sailboat and he invited me to sail in Nantucket Sound. When we got out of the harbor, we ran into about 4 foot waves and we really started to pound them - spray breaking over the bow, etc, I thought it was great! But after a few minutes, Greg said that his boat wasn't really meant to take this kind of punishment so we turned around and went back to the harbor where we sailed back and forth in calmer water for a couple of hours. It was a good time!

And so, I got a chance to walk the beach and take a few pictures (I like to watch the sunset from Payne's Creek -here's a shot of it for you). I also saw an old friend who drove down from Boston and we had some good chowder and a chat. So - semi-retired life ain't so bad!

Labor Day Weekend


So just to catch up - over the Labor Day weekend, the entire Veit clan went to a camp up in the Poconos for the weekend. It was very nice and had a lot of activities - swimming, archery, a zip line, etc. To do the zip line, you had to climb a 65 foot pole to a small platform and then jump off! The line carried over a pond. David did the line a couple of times (made me more nervous than him I think!). Grampa Walt and my 6 year old nephews did, too! I chose the safer route of watching and hanging out by the water cooler!

Dave also earned the title Master of Disaster for the weekend. In consecutive days he managed to give me a black eye - an accident at the archery range - and break his sister's finger - via a well tossed football. So for the rest of the weekend, I insisted on a five foot radius from him!

Vicki's finger is healing...

Round 22


I can't believe it's been so long since I have blogged. Guess I've been busy! I will try to post a few today to catch up.

Round 22 was pretty straightforward although again long delays. I think I waited about 2 1/2 hours to meet with Dr. S. The problem was that he had to cover another doctor's patients and some folks evidently had some significant issues he needed to look into. He also mentioned to me that the back up may get worse before it gets better because there is evidently a new regulation that will require the chemo drugs to be mixed under a sterile hood. This means that MSK will have to source the chemicals from the main hospital on 68th street and have them transported to the clinic (where I get treatment) on 53rd street.

As for my treatment, my scans have been stable and the side effects more manageable for the last few cycles. I asked about re-evaluating my treatment plan - but that conversation will have to be at my next session this Thursday. I did tell Dr. S that, as much as I hate saying this - I'm willing to stay the course on treatment and not keep asking him for a break since it seems to be working and I seem to be coping. But I'm hoping he'll say I can take a break anyway...

Sunday, August 30, 2009

Round 21


Had chemo again last Thursday. Just the usual fare. My scan from last week came back “stable” so that’s good. Also my CEA level did not change from its current reading of 11. No news is good news! Seems like we are succeeding in turning my cancer into a chronic rather than an acute problem. I have chemo again on September 10 and will ask the doctor about getting a break.

Vicki is Driving!


No, not just driving us crazy! She got her permit yesterday and I let her drive us to the library. She’s very cautious – which is good. These kids are getting so grown up!

Richmond – Part II


Last weekend, Robbie, David and I went to Richmond for a long weekend. It was great to see friends from our time there. David slept over at his buddies’ houses every night. I got to see some of my former Genworth colleagues for breakfasts, lunches and dinners. Good folks - and it was fun to catch up. One has bought a horse farm and has about a dozen young horses on it so I drove out to the countryside to see it. Very nice – even though I don’t know anything about horses. Another was getting married that day but met me for breakfast anyway. Talk about organized! Did you have free time on your wedding morning? I sure didn’t!

Rob and I reminisced about the things in Richmond we really enjoyed. It’s a curious thing that when we lived there, we reminisced about the things we missed in Morristown and now that we’re here, we think about the good qualities of Richmond. I suppose most places to live have their advantages.

Saturday, August 15, 2009

Round 20 and Survey results

Ok, so Round 20 is now in the books. Just the usual fair but an exceedingly long wait at the clinic because they were short of chemo nurses. I have the results of the mini-survey from my last entry. It’s not statistically significant but here are the results and thanks to all of you who participated.

79% of you use Facebook or Myspace. Nobody Twitters or uses other services. The remaining 21% do not use a social network (yet!)

83% report that they sign on daily or more than once a day. 8% say weekly and, curiously 8 % say they never go on. This is curious because if 21% say they don’t have a social network account but only 8% say they never go on a network, it implies that there are folks who don’t have accounts but look at social networks anyway.

71% have never written a review about a product or service on-line. 29% have done so occasionally.

These numbers are generally in line with what I have read. I particularly find the recommendation stat interesting. There is a decided minority (usually reported at about 15%) of people who post their reviews, comments or recommendations on products or services they have used. In internet parlance, these folks are referred to as “e-fluencers”. As a group, they can be very powerful in how others decide on a purchase. I certainly read the reviews of others when I’m looking to buy something. But, like most of us, I have never put my own opinion on any website. As such, being an e-fluencer can be a powerful thing. A potential idea this gives me is that if you have a particular expertise in something (perhaps you are an avid knitter or book reader or big game hunter), you could start your own website with your reviews and recommendations. This could later be a sustainable business model as vendors might seek to advertise on your site. There are also more robust ways of making some bucks once you have established your readership. Just an idea for you entrepreneurial types!

Enjoy the weather on these long, warm summer days! BB

Monday, August 10, 2009

Social Networking



I've been looking at social networks lately such as Facebook and find the phenomenon rather intriguing. So I put together a simple online survey to see who's doing what. I won't actually know how any particular person answered the questions but I'll get the stats. Then, I'm happy to share them with you. To take this 3 question survey, use the link below. BB

Sunday, August 9, 2009

Just Birds


OK, on an entirely different note, I thought I’d give you all a list of the birds of Morristown. Below is a list of the species I’ve seen in the last few months – a total of 34. The vast majority are common species that I bet you’ve seen too. But it is a testament to our biodiversity to have a wide variety of bird life. BB

Barn swallow
Black duck
Black-capped chickadee
Blue heron
Blue Jay
Boat-tail grackle
Canada goose
Cardinal
Catbird
Cedar Waxwing
Cormorant
Cowbird
Crow
Dark-eyed junco
Downy woodpecker
Eastern goldfinch
European sparrow
Flicker
Great egret
House sparrow
Mallard
Mockingbird
Mourning dove
Mute swan
Pileated woodpecker
Red wing blackbird
Redtailed hawk
Robin
Ruby throated hummingbird
Starling
Tufted titmouse
Veery
White breasted nuthatch
Wood duck

Healthcare Reform


There was an interesting article in the Times magazine a couple of weeks ago discussing the philosophy of rationed healthcare. Its main point was that we effectively have rationed healthcare now based on income. If your income is high enough, you can get any level of care you wish and if you are poor, you use the emergency room when things get acute. It talked about national healthcare in England where there is a board that determines which therapies the state will cover. Of particular interest is that the board does a cost-benefit analysis of various drugs and therapies and only approves those that can meet a certain test of effectiveness. In particular, it seems to use a test that says that a therapy or drug that can extend your life by one year must cost $50,000 or less per year to be approved. Essentially, they are assigning a value of $50,000 for a year of life.

This is an interesting philosophical problem. What would you pay to live another year? I thought I would share a little of my prognosis/cost equation as an example. The average lifespan for a person with my diagnosis is 21 months. I asked one of the oncologists I originally interviewed how long I would live if I decided not to go on chemo (She was aghast that I asked this question!). She told me 6 months. So, all my treatment and expense, on average, buys another 15 months of life. Of course, there’s a 10% chance that a person with my prognosis could live for 5 years so results vary quite a bit. I’ve already well exceeded the “$50,000 rule” so what does that mean – in England would I have not been covered by the national healthcare? Or would I just have gotten the less expensive drugs? The article does note that the cost of drugs is lower in England than here but didn’t say by how much.

So, this leads to the question of going without insurance. How much would you pay to extend your life for a year? And, not being a bachelor, I am as concerned about leaving my family with sufficient assets after I go as I am about living a short time longer. So, if I had no insurance, how much would I be willing to spend before refusing further treatments for financial reasons? I’ve been lucky so far in that I have good health insurance so I don’t have to make this hard choice. But certainly, many Americans must and do make this choice all the time. Not just for life threatening situations but for routine healthcare that we all take for granted.

Coincidently, I asked my onc recently about the liver transplant that Steve Jobs of Apple just had. Sloan Kettering does not support such a procedure for me, even though my cancer is entirely in my liver. The reason is that the anti-rejection drugs that you take to maintain the new liver lowers your body’s immunity and makes it hard to fight further cancer that may show up elsewhere (or perhaps again in your new liver). They have evidently studied the issue and decided that the procedure isn’t particularly effective over time. Since the hospital makes pretty good money for transplants (something like $250,000 to $300,000), they feel it borders on unethical to collect a large sum for a treatment unlikely to yield the desired result (a future without cancer). On the issue of Steve Jobs, Dr. S said that the form of cancer he’s reported to have is a relatively non-aggressive form, so perhaps it makes some sense for him. But he did point out that having a lot of money to spend on medicine doesn’t necessarily mean you get the best treatment.

So now that we are in the midst of the healthcare reform debate, I think it makes sense to look at these other models – the so-called rationing models. Not just what it means to people with serious illnesses but what it means to people who just need the normal “maintenance” that we take for granted. I wish there was more detailed information available about the proposed legislation. It is supposed to be a 1,000 page bill? That’s longer than a Harry Potter novel! What does it say? Would there be rationing under the proposal and if so, how would that work? Will it bring down the cost of drugs? It seems like the countries that have national health pay a lot less – why is that? I feel like there are more questions than answers and, due to extremist politics, we can’t see the real details. Life is just a soundbite in Washington!

Ok, my rant is done – but this is an important issue with moral, ethical and financial implications for the country. The various forces and parties are lining up on either side, and yet I feel like we still don’t really know what we’re talking about.

BB

Breaking Radio Silence


Hi All. Sorry it’s been so long since I’ve blogged. Actually, the reason is that I’ve felt rather good! I had Round 19 in mid-July and Round 20 on August 2. Both went without a hitch and much to my surprise, the side affects I’ve had for the last 3 weeks have been the mildest to date. Many days have been pretty affect-free (except for my need to take naps!) I’m not sure what to attribute this to other than 1) I changed my diet to focus more on fiber and vegetables 2) I’ve started running again (well, let’s say jogging) and, 3) perhaps, my body is getting used to the chemicals since the allergic reactions aren’t occurring as severely.

On the running front, with encouragement from my old running partner, I am slowly working my way up to something I would refer to as a “distance”. Prior to getting sick, my usual runs were 5 or 6 miles about 3 or 4 times a week. When I started jogging the trails again a few weeks ago, I could only make about 3/4th of a mile before becoming breathless. I’m now up to 1.75 miles and the goal for next week is 2 miles. I love being out on the trails again and working up a good sweat! I also notice that at my slower pace, I swallow fewer bugs!!

It’s also been a good few weeks for summertime fun. David had a buddy from Richmond stay with us for a couple of weeks and we took in a Yankee game at the new stadium. Very nice stadium – not sure it’s worth the billion+ that they paid for it but it’s certainly nicer than the old one. Of course the ticket prices are crazy. Last year I went to three games but they were all in company seats (including one game in the front row!). It was also easier to get to the game since I was living in the city so it was just a subway ride away.

For the rest of the summer, we have a pretty good August planned. Dave has football practice 4 nights a week and the field is right near one of my favorite trailheads. So I can drop him off, take a run and make it back to catch the last ½ hour of practice. It’s a nice routine. I also have a night at the Jersey shore coming up – staying in a place right on the beach. And in a couple of weeks, we’re going down to Richmond for the weekend to see some friends. I hope you all have been enjoying the rather nice weather and having a good summer!

I did write two blog entries over the last few weeks which I’ll post. BB

Friday, July 17, 2009

Round 18

A quick update on Round 18. Mostly it was the usual fare but it was a nice day. So, during my wait for my meds to be ready – usually 2 to 3 hours - I took a little walk around midtown-east. There sure are a lot of really good looking restaurants in the neighborhood (between 2nd and Lex from 43rd to 53rd)! Perhaps we’ll go in and try one during my off week one of these days, Sparks steakhouse is also in the neighborhood – that’s the place where John Gotti rubbed out Paul Castellano in the late 70’s. I’ve been there on business dinners in the past – good steak but I like to sit facing the door!

A little tidbit on health. There’s a marker in the blood that is used to judge the activity of colon cancer called CEA (Carcinoembryonic Antigen). People without cancer have a zero or near zero reading. When I started treatment last December, my level was 183. In the spring, it had dropped to 4. My onc told me that it is starting to slowly rise – to 8 and now 11. We’ll need to keep an eye on it. Although it’s a bit disturbing to see it rise, 11 is still a far cry from 183! So like a gunshot heard in the distance, it reminds me that danger is out there but still likely out of range.

Hope you are all enjoying the great weather! BB

Monday, July 13, 2009

Vacations and Bears in the Woods

Hey all. I haven’t blogged in some time so I thought I’d post a quick note. Since my last entry, I had another round of chemo (Round 17) and a CT scan to check my progress. My scan was “stable” again so I asked Dr S when I could get a break. He wants to stay the course for a couple of more months. I must admit that I’m getting antsy for a break because the side affects kind of grind on you. But I’m happy for the stable scan.

Last week, we went to Cape Cod for a little family vacation. As usual (we’ve gone to the Cape many, many times over the last 25 years or so), I enjoyed the salt air and the nice water. The weather was a little cool but we enjoyed it nonetheless. Cape Cod league baseball, walks along the salt marsh trails and good "chowda" is always a winner with me! We were planning to go for a few days to Cooperstown, NY to see the baseball hall of fame this week, but I unfortunately had one of my periodic medical breakdowns so we postponed the trip. Nothing serious but the side affects catch up to me for a day or two each week, and I‘m really pretty useless during those bouts. It’s unlucky that I had one right at the end of the Cape trip and so I couldn’t do the Cooperstown one. On a good note, however, we’ll probably re-plan it for the fall when there may be really nice autumn foliage!

This week David has one of his Richmond buddies staying with us for the week and I took them for a good walk in my beloved woods today. Caught a few frogs, jumped a few streams and kept an eye out for the bear reported in the woods this week. That bear’s been roaming around those woods for years now and does no harm – but I did give the kids the “how to handle yourself when you see a bear” instructions – and it kept them on their toes!

I go for Round 18 on Thursday. Can’t wait! ;)

Hope you are all well….BB

Monday, June 22, 2009

Happy Fathers Day

I hope you all had a good Father's Day. We had the family over for some griling and the weather actually cooperated! I also completed Round 16 on Thursday, Just the usual but I am scheduled for a CT scan before my next treatment on July 2 - so we'll see if I'm still holding the line. If I am, I'm going to ask my onc when I can get a rest from the chemo.

I took a few pics in the garden again today as it actually didn't rain (a rare treat)! Here's a sample. I hope you are all well...BB

Wednesday, June 10, 2009

Acceptance


I thought I’d share some thoughts on the stages (at least my stages) of dealing with my new situation. I was diagnosed on October 3 of last year and had the surgery on October 8. After six weeks at home recovering, I went back to work and started chemo right away. Two cycles later (4 weeks), I realized that I couldn’t work and go through treatment at the same time and so I (reluctantly) went out on disability. During this period, I must admit, I was a bit off-center in dealing with cancer. In the whirlwind of my first three months, I moved forward, almost in a daze, without thinking much about the emotion of a bad prognosis.

In the next three months, roughly the first quarter of this year, all my concerns seemed to surround me. I couldn’t make it through a day without considerable concern about how to support my family, how to cope with the seemingly endless stream of doctor visits, drugs and side effects and, perhaps most importantly, my sense of loss about the life I once lived. I just wanted things to be “normal” again.

I feel now that I’ve come out of that fog and am starting to accept the consequences of my misfortune. I’ve realized that my former life – particularly my work life – may be behind me. I would love to return to it but I’m not convinced that it’s possible. I may be able to go back to work at some point but I doubt it will be in the capacity that I had before. Having spent the last 5 years or so in entrepreneurial pursuits, I know how much it demands great focus, planning, energy and faith. If I can return to work, I’m not sure I’ll have the ability to be lead sled dog. I may need to find another way to pull my load.

In any event, this acceptance has brought me some peace and some ability to focus on the next stage of my life. Life is a path with no turning back. We can’t unwind it. We can’t backtrack on decisions made or actions taken. For some, perhaps, they go with the path laid out before them without hesitation. That’s not really my personality. The happenstance of my cancer has brought me to the end of the trail I was on well before I imagined. I need to now find a new course. I’m not sure where it will lead and, frankly, I still find it difficult to plan more than a month or two ahead. My days of long view thinking may be behind me as I know I will be subject to the bimonthly scan on cancer progress and the course adjustment needed if I don’t hold the line medically. For now, I’m stable but I’m acutely aware that this may not always be the case. So I’m recognizing and accepting that the old trail may have come to an end. It’s time to find or make a new one. Where the trail will lead, I can’t yet say, but at least I can see the need to start working on building it.

Everyone has hardships. Particularly in the economy we are in now, many are suffering. But action over inaction would still be my rule. If you are coping now with your situation, keep the faith and remember that all trails have an end but usually they end at the start of another one. Maybe a better one.


I thank you all for your help and I wish you all the best…BB

Crash


As I mentioned previously in a blog entry, I have been editing some photos. They are from the Evans Photograpy archives and are all auto crash photos from 1959 to 1976. Here’s a sample. Do you find it compelling?

Round 15


It’s been quite a while since I’ve written. It’s been busy. I have now completed Round 15 (7 months of chemo) and I’m starting to get the hang of it (I guess I’m a slow learner). Side effects are always a problem but they have settled into a groove so I know what to expect and how to deal with it.

Last week my father came up from Florida for a week. It was a nice visit. Here's a picture including my brother and neices. It was also fortunate that we have two couches so there was plenty of room for the mid-day nap for both of Dad and me!

Tuesday, May 19, 2009

Picture from my Garden



Hey All - just a quick blog before my next treatment. I go for Round 14 on Thursday. Side effects this week have been "as usual". So, when I have energy, I'm still puttering in the garden. I've been growing a special hybrid daisy - see picture. It's an odd variety but very photogenic!

I've also been doodling a bit with photography and am going to try to teach myself some photoshop. I've also been editting some film from Evans photography (the family biz). When I get it sorted out, maybe I'll share some. In the meantime, the weather's warm and I hope you are all enjoying it! Best, BB

Thursday, May 14, 2009

Round 13



Just a quick note since it's been a while. I had chemo (Round 13) last Thursday. More importantly, I got the results of my scan. It shows no change. While I will admit I was hoping for more, Dr S pointed out that cancer's goal is to grow. So, showing no growth means that the chemo is working.

Round 13 marks my six month anniversary of being on chemo. It's still a grind but I suppose I'm getting used to it. In a couple of months, I may be given a "chemo holiday" to rest my liver (evidently chemo is hard on your liver but my levels have been stable from the start). Anyway, I thought I'd let you all know that no change is good and I'm still here. In the meantime, I am switching from short term disability to long term disability and social security disability. This means a lot of forms to fill out but I don't expect any issues. It's a little odd being out of work for so long - and I'm not sure how long it will really be. But, when I have energy, I have been doing a little gardening - see pic above from the garden. Be well! BB

Saturday, May 2, 2009

Prom Night

Vicki is going to the junior prom tonight! See pic with doting father. She looks great and is very excited to go. I kidded her that her date would need to pass a test on Yankee and Giants trivia in order to take her but she said it would only serve to embarass her -so I have to trust the guy (yikes!)

As for me, I had a scan on Thursday to check on progress but I won't hear the results until next week. Perhaps even not until I go in for juicing on Thursday. In the meantime, I'm filling out forms with the insurance company and social security, applying for long term disability. I'm having the usual side effects - most annoying as usual is the fatigue and neuropathy. I had to bail on going to a bar mitzvah today because it was a long drive and I just wasn't up to it.

For those of you interested in birds - I set up our hummingbird feeder this week and instantly got a ruby-throated visiter. We've named him Arnold after Arnold Swartzenegger since he looks like a tough little hombre (and hummingbirds are notorious for vigorously defending their turf!) I also need to print a retraction for my earlier blog about the beavers in Burnham Pond. I got a close up look at them a couple of weeks ago and they are not beaver - they are muskrats. But I haven't seen them in a couple of weeks and I'm wondering if the park service trapped them. In the meantime, three swans have settled in the pond much to the consternation of the canada geese! They were fighting a lot the last couple of days but seem to have settled into a truce. In addition to them, the population seems to have gotten into a rhythm - the red-wing backbirds, barn swallows, boattail grackles and cormorants are all co-existing peacefuly!

Wishing you a great week and good weather...BB

Friday, April 24, 2009

Round 12

Went to the city yesterday for Round 12. It was a pretty routine visit other than my meds came up from the pharmacy quickly so we got to take an early train home. I also have an appointment now for my next scan (on May 7th). I’m hoping for more tumor stability which would be an indication of what we used to call “remission” when I was a kid. Now they call it a “progression-free interval”. I have come to despise chemo but when in a long fight, you gotta keep on swinging. My next treatment will mark six months of the stuff - at least the weather is warm so I'm not always freezing!

Also, here’s a link to an interesting article from the NY Times today – it quotes my oncologist extensively towards the end.

http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?ref=todayspaper