So Far, No Snow

It’s been a while since I have blogged so I thought I would leave a quick note. I hope you all enjoyed your Thanksgiving and that you had the chance to get together with family, enjoy some good home cooking and watch football. Thanksgiving is my favorite holiday – it’s much more relaxed and non-commercial than Christmas.


And now we are in mid-Hannukah. We had a nice family time with more, good home cooking and even a little football. Morristown High School played on Saturday for their section’s state championship at Giants Stadium (sorry Jet fans, it’s still Giants Stadium to me, even if that’s no longer the official name!) I took David since some of his buddies from the freshman team were promoted to Varsity for the playoffs. While he tells me that they all lamented their role as practice dummies and side-line cheerleaders, I have to believe that it was a great experience. They got to play (well, warm up and then cheer) in a pro stadium and, I’m told, will get rings just like the regular Varsity guys as Morristown won! What a thrill that must be!

Rob and the kids are doing well – Vicki is finishing up her college applications and David preparing for his first meet on the Winter Track team. They both press their tired noses to the window each morning hoping for a snow day, a wish I am sure will eventually be granted. Enjoy the season!

November Turkey

With our calendar pages firmly turned to November, it is time once again to celebrate that uniquely American experience of gluttony and sacrifice. Yes, it’s time for your annual benefits enrollment! And the big benefit issue on the platter at the center of our tables is, of course, healthcare. While I am a firm believer in setting aside a large portion of your favorite side dish – the 401(k) plan – I recognize that it is not the main event. So, in the interest of recipe-sharing, I add this contribution:


I have the good fortune of still being considered an employee, although a disabled one, until next June. At that time, I will have been on Long Term Disability for 2 years and thus eligible for Medicare. My employer will then drop me from the rolls and I will become a ward of the state, albeit a paying ward. I have further good fortune in that my family will not be similarly dropped but, instead, are eligible to move into the unsubsidized “Retiree” health plan, which provides coverage for both retired employees and those who left employment due to disability. The plan is different, and no doubt much more expensive, but hey - it’s better than going without.

My employer subsidizes health insurance at a rate of over $1,100 per month per employee. So each employee receives a company subsidy of $13,200 per year. The cost of insurance above that is born by the employee. For the “Cadillac plan” (my phrase) with the lowest deductible and coinsurance, the cost for a family is about $300 per month ($3,600 per year). The least expensive plan, with higher deductible and highest coinsurance, costs half that amount - $150 per month or $1,800 per year. There are also two “high deductible” plans – generally more attractive to young, healthy and/or optimistic employees – which have a high threshold to meet before receiving any insurance coverage but have “low” premiums. The cheaper of these costs $73 per month (a bit under $900 per year). So the true cost of insurance for a family, inclusive of the company subsidy, ranges from about $14,000 per year for the least-coverage High Deductible plan to almost $17,000 for the most-coverage traditional plan.

These numbers bring to mind several thoughts about healthcare in America:

1. Median family income in New York, where my job is based, is $56,000 per year ($4,000 higher than the national median of $52,000). At that income, a premium of $14,000 to $17,000 per year is unaffordable. Only with a very large subsidy is coverage possible for the average family.

2. I am surprised how expensive the High Deductible plan is. The idea behind these plans is to pay smaller premiums and then fund a Health Savings Account for paying medical bills, should they occur. If an average unsubsidized family still has to shell out $14,000 for the premium, how much more could they really put into an HSA?

3. In the past, I have always selected the “Cadillac” version of my employer’s offerings since the additional monthly premium amount was well within my budget. For the past two years, I have paid about $5,000 to $10,000 in copays, coinsurance, etc above the premium amount. (Note: My insurance is out-of-pocket for about $170,000 over those two years). Could an average unsubsidized family really afford $17,000 in premiums and then pay another $10,000 on top of that each year? If a non-insured person got the same treatment I did (admittedly doubtful) and not paid, would the $200,000 over two years just be passed on from doctors to insurers (and ultimately insured people)?

4. The value of the company subsidy is one of the reasons that working for a large company is better than for a small one. Unfortunately, small companies create the most new jobs in America. Therefore, we are shifting the “true” cost of healthcare to America by virtue of the increase in the portion of Americans who work for small companies with no or low-subsidy healthcare. There are those who feel that healthcare costs will only fall when consumers feel the cost and bargain with doctors for lower charges. I am certain that consumers are feeling the cost but they are powerless to bargain and thus, simply go without and hope not to get sick.

5. State-run healthcare insurance exchanges do nothing to change this dynamic. The core problem is the cost of healthcare, not the method of paying for it.

Okay, so that’s my entry in the recipe contest. For a while longer, I will still be one of the lucky ones, but the cost of healthcare in America is still November’s biggest turkey.

Mysemicolonstory Expands

If you have been on since my last post, you probably noticed some design changes on the blog. I thought it was time to freshen things up a bit. Also, in looking over the technology available from Blogger, I noticed that I could add “static” content – that is, non-blog pages of additional content. So I decided to make some changes.

In recent months, there have been several people who mentioned to me that someone close to them had been diagnosed with cancer. They told me that they passed my blog address on to that person. That got me thinking about how this blog might help someone new to cancer. Reading my blog, with all my family updates and non-cancer ramblings, might be rather off-topic for someone struggling to get a grip on things in those early days.

When I was in the initial phase of dealing with cancer, I did get a lot of medical information from internet sources. But those were “credible” sites, like American Cancer Society and Colon Cancer Alliance. I also read blogs of cancer survivors -not for cancer information but to see how they were coping. I wanted to see what was on their minds, what issues they faced and how they coped with them. Reading their stories helped to beat back the feelings of loneliness and isolation that come with a poor prognosis. For a new patient reading my blog, that’s the most I can offer since I don’t write this blog as advice or information on colon cancer.

So, I added the Welcome and About Me tabs across the top for these new readers to give them a quick sense of who I am and where to find the entries from those early days.

I then added the tab with the travel log of a typical trip to the Oncologist since strolling around the city is always the best part of any visit. I thought that would be fun to share. And finally, I added the fall photos just because I liked them and thought you might like them too.

So those are the changes to Mysemicolonstory. In the future, I plan to update or add to the static content from time to time. And I’m glad to take suggestions if there’s something you’d like to see!

Third Chemo Holiday Scan

I met with Dr. S yesterday to get the results of last Friday’s scan and was very pleasantly surprised! My cancer continues to grow at about the same rate as the prior two scans. However, since I “look good” to Dr. S, he feels that it’s okay for me to stay on a chemo break through the coming holidays. I will start chemo again in early January. We will do another scan in mid-December and then plan for renewed treatment after I get fat on Christmas pudding. He did say that I should get in touch with him if I have any issues before then – specifically cancer pain or signs of jaundice. I have yet to have either, so I hope that trend will continue.


We talked a little bit about how the tumor measurement is interpreted. I have often described them as “freckles” on my liver since the measurement is quoted as a diameter. I pictured them as spots each the size of a different coin – a penny, nickel, quarter, etc. But that’s not quite right. The tumors are three dimensional like a marble or a small ball and they aren’t necessarily on the surface of the liver. My larger ones are now just under an inch in diameter.

So, in trying to picture what my liver really looks like, I did some homework last night on how big a human liver is. The answer in part depends on the size of the person. Women have slightly smaller livers than men but that’s just because they’re slightly smaller anyway. The liver is shaped like a right triangle with the long side running horizontally under the ribcage from the right side of your body to the middle. The short side runs down the right side of the body. For an “average” man, it is about 9 or 10 inches across, 6 inches tall and – amazingly I think – 4 inches deep! It weights 3 to 3 ½ pounds and has a volume of about 1.4 liters (about 48 fluid ounces). In other words, it takes up about the same amount of space as four cans of soda.

So, if we drop into these four cans of soda three or four marbles of about 1 inch in diameter and perhaps 8 or 10 smaller marbles (like the kind we played with as kids), that’s my liver. Hope you liked that visual! BB

October Scan and Assorted Other Items

October is heading for a finish that’s a lot more “normal” now. Most importantly, my father’s dementia has cleared substantially. He is still in need of regular assistance but he is aware and capable. Our plan was to have him come up yesterday to stay for a month or two either with us or in a facility nearby. We had found one near my brother in Pennsylvania that sounded good and was reasonably priced (insurance wouldn’t cover it). However, at the eleventh hour, Robbie located a nurse in my father’s community who agreed to stay with him in his guest room and help him while he recuperates. Dad wanted to stay in his own house which, beside the comfort of being home, is much better laid out for someone with difficulty walking. So, we struck the deal and Rob came home solo yesterday.

We were all very glad to see her! The kids and I did fine in her absence, but she has a way of running the place that everyone likes. So, the boss is back and we’re all getting back to the usual routine. And just in time!

I had a CT scan today and have my meeting with the onc next Tuesday. I expect that there will be more growth and that he will have me start chemo again very shortly. There’s an outside chance that the growth will be so slight that I can have a little more time, but I’m not counting on it. So for the next few days, I am preparing myself to go back into treatment. As you might imagine, I’m not that psyched about it. I like having hair and eyebrows. I like being able to eat anything I want without all the GI problems. I like not feeling sleepy or like a truck ran over me or both. But, you can’t always get what you want (copyright: Rolling Stones 1969).

In the meantime, we’re doing the usual things you’re probably doing this fall. The pumpkin is on the front stoop. The yard is full of leaves and acorns (to be cleared this weekend). Mid-semester progress reports have arrived from Morristown High and parent-teacher conferences are being scheduled. Dave had a game this afternoon (winning 22-8, improving to a season record of 4-2-1). Vicki and Dave are planning their big Halloween party at our house next Saturday. And…one of my favorite October activities…the Yankees are still alive (barely) in the playoffs!

Hope you are enjoying the season! Go Yanks!! BB

Mid-October Update

I returned late last week from Florida to find the fall in full swing! The days are cool, the evenings even cooler and the leaves are starting to change. What a difference from the 90 degree days of the past three weeks. The only sign of fall I saw down there was that the Sand Hill Cranes had started to return.

My father is still in acute rehab but he is getting better. He is physically getting stronger and with it, his dementia is fading. He is mostly in the present with just lapses of confusion. But, in talking about his situation with the case manager in his facility, it sounds like Dad’s insurer will release him this week and send him home. He is certainly not ready to live on his own just yet. We had expected him to be moved to a skilled nursing facility for a bit first but I am told now that that seems unlikely.

In the meantime, I didn’t want Dad to be alone in rehab for too long, so Robbie volunteered to go down for a while. She flew down yesterday. The idea was to have her visit him and monitor what the doctors were doing until he was ready to move to skilled. Now it looks like she will be there for his release. Glad we booked that trip. I hope my father will agree to come straight to Morristown upon his release. He can stay with us for a few weeks to regain more strength and to start working out a plan for whether he should move to some kind of assisted living. We also want to look into him permanently moving back north.

So I am now Mr. Mom for a while as Rob does the heavy lifting in Florida. I think she may be able to find some time to hit the beach, which would be a good reward for her. This weekend, I had the pleasure of getting to one of David’s football games. It was a beautiful fall Saturday morning for a home game on the high school’s fancy new field. The boys played exceptionally well for an easy 32-20 win, improving their season record to 3-1-1. Here’s a picture of David making a nice solo tackle!

Deep in the Heart of Florida

Well, a new month begins and I, for one, am glad that September is over. I have spent a large chunk of the month "deep in the heart" of Florida but there haven't been any beautiful beaches or umbrella drinks.

I came down at the beginning of the month to take my Dad to have a procedure that involves two of my least favorite surgical terms - cardiac and groin. In other words, he had an angiogram. This procedure involves threading a line into your heart through an artery in your groin in order to take lewd pictures of your heart's innards. While he came through that procedure with minimal complications, the results of the test were a need to have his aortic valve replaced and a double bypass. We scheduled that surgery for the 20th.

I came back for the open heart surgery starting on the 19th and it has been quite a haul since then. He made it through the surgery extraordinarily well from a physical perspective. No complications and surprisingly, he hasn't taken a single painkiller! Unfortunately, he has had a very, very difficult time with the mental effects of the anesthesia. I can't even begin to describe what it's been like other than to say that it's been all dementia all the time. Sometimes the dark side and sometimes the daydreamy kind but seldom any reality. Thankfully, he is starting to come out of it and today was a really good day for connecting perception and reality. I am actually incredibly excited that things are finally turning for better. We're not in a normal place yet ( in many different ways) but at least we can see it from here.

As with everyone who goes through open heart surgery, I know that the recovery is long and I'm sure it will be for him. But, it sure is good to have him back to a place where we can at least talk. He'll be able to walk again and dress and do all those other things we all take for granted as he gains his strength. It may take some time, but I am confident he will get there. If the dementia continues to improve, as it now looks like it will, he may well make a "full" recovery.

I know many of you have gone through this with family members or, in some cases, personally. And as far as I can tell, you are no more demented now than you were before the surgery! So I can now say that I feel your pain and I congratulate you on the mountain you have climbed!

As for me, I am greatly looking forward to (eventually) leaving this flat, humid, unforgiving panhandle and returning to my sweet, oak-shaded hilltop where I can ponder the wonders of Man and Nature.

Wishing you all an October full of beautiful foliage, apple cider and pumpkin pies...BB