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

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…

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.

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.

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!

.

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...

.

Enjoy the fall colors - and have some cranberries! They're good for you! BB

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!

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!