Unhappy Doctor

Barb and I felt pretty good going into the appointment with the oncologist yesterday morning. We expected to discuss my PET scan results from Wednesday. And like always I had a few side effect issues I wanted to discuss with him.

We were very positive an upbeat. Afterall, what could the PET scan tell me that I didn't already know? I certainly already knew I had cancer. And I already knew the cancer had spread all over. So, how bad could it be? If anything, we figured it could only be good news.

But as soon as the oncologist entered we could tell that he wasn't happy. One of the first things he said to us, after a little small talk, was "I'm not very happy about these PET scan results."

That threw us for a bit of a loop. That was the start of our confusion.

One of the things that I don't like about our healthcare system is the little amount of time you get to spend with a doctor. Doctors are on rigid schedules and plan out appointments in 15-minute increments. That's not much time.

My oncologist does come prepared for appointments, which I appreciate. But being prepared he also had a pre-set agenda, which pretty much took up our entire 15-minutes. It was kind of like bombarding us with his perspective and then sending us home with our heads whirling about with all the information we just tried to digest.

Barb and I drove home yesterday relatively confused.

In my oncologist's defense, he has given me his cell phone number and he does welcome my calls (I've used it only twice). And yesterday, upon leaving, he did say, "If you want to talk some more give me a call."

The PET scan shows any areas of high metabolic activity in the body. So by the nature of it, it will show more than a normal CT scan.

The oncologist felt that the PET scan had shown further spread of the cancer, enough so that he felt it was time to switch to a different chemotherapy.

I was OK with this because this chemo had been going for about six-months and that is about the expected time for the chemo to work before failiing.

But I wasn't as convinced over his reasoning. A lot of things that the PET scan showed were not new tumors but areas of general activity that the PET scan would have picked up and traditional CT scans would not.

The oncologist questioned me thoroughly about my lungs and my breathing. I've had no trouble with either. He inspected me closely, listened closely to my lungs, and there were no problems.

The oncologist had me undress and he did a thorough inspection of my buttocks.

Confused, he finally explained to me that the PET scan showed activity along the lining of my lungs, and the surface of my buttocks. He almost seemed disappointed that he didn't find any evidence of anything in either area.

He barely touched on a lot of the good news: there was activity in the liver before and now there was none; there was activity in the kidney before and now there was none; there was activity in my right hip bone and now there was none.

All in all, I take this as a "push." There was possibly some bad, but certainly some good. I'm still feeling good. And I'm OK with switching up chemos. Some of the best results I have had from chemotherapy have come from transitions from one type of chemo to another.

There is work to do. I've acquired a copy of the PET scan report and have been able to study it. I want to see if a traditional CT report also accompanies this. That will tell me a lot more about the lungs.

We also have to pursue the activity in the brain, and the potential successes of my last radiation treatment. I have an MRI scan of the brain scheduled for early Monday morning.

I'll meet with the oncologist again in the first week of August, as well as the neurologist.

The new chemo is not a pill but an IV administered at the health campus. I'll have to have the IV for two-hours one day every other week.

My approach today is no different than yesterday or the day before. As unhappy as the doc was over the PET scan results, I just can't justify it and feel that he may be over reacting a little.

As Barb said, "We'll just have to do daily butt inspections."

Meeting with the Doc

We're both up early again. The coffee is brewed. Freckles has been fed. We're getting ready to go see the oncologist.

Our oncologist is an impressive doctor. We're fortunate to have him on our team. He really addresses the complete picture of cancer, physical, emotional, quality of life, everything.

Upon our first meeting with him I was immediately impressed when he turned around, looked at Barb, and simply asked "How are you doing?" He not only recognized the trials and tribulations this disease puts me through, but also the effects it has on those who are close to me.

We expect to discuss the results of yesterday's PET scan this morning. It should be interesting.

I've also been concerned about the possibilities of neuropathy after more than three-years of continuous chemo. In the past two-months I have random moments of numbness and my eyes will get very tired and go a little blurry on me. I'd like to question the doctor extensively on these issues.

We have learned that there are yet two more chemo drugs that have been approved by the FDA for the treatment of kidney cancer. The current chemo Sutent has really been working like a champ. But, like all kidney cancer chemos, the day will come when it stops working.

I've really been pushing lately to spend more time outside. It can be tough because at home I always know that I have my best chances of handling however I might feel day-to-day. But it is important to get out too.

We've started taking walks, which has been great. Everyday I want to get out.

Today after the visit with the doctor I'm hoping to make a couple stops in Columbia. We need wine, white and red. No we don't drink it. We don't drink at all. But we do cook with it.

It is ironic. I've always loved a nice pint of Guinness. Now I live within two-blocks of two great, historic pubs who both serve Guinness and I don't drink. I don't drink at all. My stomach just can't take it. No big deal though. I laugh at the irony of it. Life is peculiar. All you can do is laugh.

So we're going to stop quick to pick-up some cooking wine. I need some Cabernet to deglaze the pan and finish off my tenderloin filets.

Then we're hopiing to visit a farmer's market in Columbia (just a mile south of Marietta) that we didn't know existed. Our hopes are high that this will be a nice market. I've definitely been on a hunt for a good local source of produce.

We were in the grocery store the other day and they had a big sign up in the produce department "California Strawberries."

I thought to myself, "I wouldn't be too proud of that."

Well That's Done

Barb and I woke up at 4 a.m. this morning. With very sleepy eyes we got ourselves ready and drove to LGH's Health Campus for my 6:45 a.m. PET scan.

The PET scan is specifically used to detect cancer. Cancer cells divide very rapidly. Rapidly dividing cells draw and gather sugar. So cancer cells draw and gather more sugar than other areas of the body. So for the PET scan they inject me with radioactive sugar, let me sit for an hour reading old magazines so it can run throughout my system, and then run me through a tweaked CT scanner.

We'll get the results tomorrow morning when we meet with the oncologist.

I'm not feeling very anxious about any of this.

I already know I have cancer. So there's not going to be any big news there.

The reason for this scan is to see if some of the small spots I have are just dead cells and scar tissue or active areas. If areas are active they will "light up" on the PET scan.

The lack of sleep and the early hours, combined with an hour of bad magazines, has taken its toll on me. There could be a nap this afternoon.

But I have learned about creating stark, muted designs from some home decorating magazine.

State of My Profession

Someone named "Rennie D." called me the other day from India. In broken English he told me that he worked for a company that offered excellent graphic design.

I told him, "No thank you." I was not interested.

He pushed on. I hung up.

I never thought I'd see the day when my profession was threatened by cheap labor from places like India or Brazil. But it's happening.

There are several sites online where businesses can post jobs for interested graphic designers, photographers, copy writers, videographers, etc. They are all littered with bids from around the world. And the bids are incredibly low.

I don't know how many companies may actually be using communications services from places like India or Brazil. But it looks like fairly many may be because companies from these countries always seem to rank the highest on these sites for money made and jobs acquired.

Now someone in my position could try to take advanatage. I could hire someone in India for five dollars and hour and resell their work for fifty dollars an hour.

NEVER! There is so much wrong with that, I don't even know where to begin. First of all I am a professional communicator. It's what I do. If I want to buy and sell services from around the world I would have studied business.

Secondly, anyone who buys designs from other countries enjoys no intellectual rights to the design. Designers in India can set-up simple templates and dump client after client into the same framework. Nothing like building a business image by using a look that shows up again and again and again.

Thirdly, have you ever made a call to a customer service department and ended up in India? Enough said.

I could go on and on.

Graphic Design has always been a rough profession. People think it's easy and it's fun. You just color stuff right?

Every year there are hundreds and hundreds and hundreds of new, young, graphic artist. Almost all of them quickly melt away into other professions. They learn that it's actually work. It's actually difficult and requires a lot of technical knowledge. They didn't count on that. Not to mention there are very few positions available for way too many candidates.

The profession is also a favorite of housewives, raising children and hoping to do a little work from home. Again, there is a feeling that this is a fun profession, and not really a difficult job.

No one tells a surgeon where to make the first incision. But everyone knows design. No one tells a civil engineer how to build a bridge. But you'd be amazed how many people are experts at what I do.

I've met with a lot of young graphic artists, and interviewed many as well. I often ask them why they wanted to do this? Almost all of them tell me they think it seems fun. I always tell them, "Well, when it starts to feel like a job, then you'll know you're actually starting to become good at it."

I don't mind competing with the rest of the world. As long as the competition is fair. If I'm charging $50 an hour and someone in Brazil is charging $5 an hour...how can I compete with that?

It's not just manufactured goods being sent abroad any more. It's also professional services.

When I worked for an outerwear company (who made everything in the U.S.) the owner of the company decided to start manufacturing in China. Why? Greed of course.

I thought it was a terrible decision. But the whole sales force just shrugged their shoulders and reasoned that everything else was already made overseas. Shortly after the goods from China started coming in, sales fell tremendously, eventually the business laid-off many, many workers, and had to sell to a competitor.

I left the company when I saw the downward spiral starting.

Change of Plans

Barb and I were just about out the door this morning when the health campus called to inform us that my PET scan had been cancelled.

Apparently the maker of the radioactive sugar in Philadelphia had a machine break down and the order for Lancaster General Hospital couldn't be delivered.

LGH gave me the impression that they would be back and rolling again very soon, just not in time for my appointment. Soooo....we rescheduled for Wednesday, 6:45 a.m.

Yesterday we had to scramble a bit to get ready for this scan, and tomorrow we'll have to do it again. A nurse from the PET scan area called me on Friday and requested that I do not eat any sugar or carbohydrates on Sunday, all day, before the scan scheduled for today.

We're at the end of our two-week menu, and we're due for another grocery trip. There wasn't a lot of options in the house. Jeesh, I eat bread with everything.

I figured out that I could make Chicken and Andouille Gumbo, all protein, veggies, seasonings and no carb or sugar. Throughout the afternoon into the evening I had five bowls of Gumbo. It was the best I ever made, and I'm sure it had something to do with Barb and I making it as a team.

Earlier in the day yesterday I had to fill up my gas tank for the trip to the health center this morning, that was cancelled. Barb went into pay while I pumped. She told me she was going to look for lunch for me in the gas station.

The gas station?

Barb came out of the gas station with a chicken caesar salad. My expectations were pretty low. I mean a chicken caesar salad from a gas station?

It was surprisingly good. I mean I've had much better. In many ways it good have been much better. But...the lettuce was very crisp and fresh, the chicken was OK, they didn't forget the parmesan cheese, and the dressing was tasty.

I had no idea how I would get through the day on a diet of no carbs and no sugars. But it worked out with Chicken Caesar Salad and Chicken and Andouille Gumbo. I felt like I was on some Food Network TV show successfully meeting some odd challenge.

Now with the PET scan moved to Wednesday morning, I have to recreate the challenge of Sunday. I have to figure out how I'm going through tomorrow eating no sugar or carbs.

Any ideas? Please share?

Monday Morning PET Scan

Barb and I are getting ready to take off for the health campus for my scheduled PET scan.

I haven't had a PET scan since 2006. Back then it was the first sign that my cancer was spreading.

I've had some good results from chemo so my oncologist ordered today's scan to see if my tumors are really tumors or just dead cells. I think it's an excellent idea and I look forward to the results when we meet with him on Thursday.

The PET scan is relatively simple on me, well except for the part where I'm not allowed to eat. I'm so hungry right now. My body does prefer some breakfast.

Basically they inject radioactive sugar into me and then I have to sit around and read bad magazines for an hour until the radioactive sugar has had a chance to make it through my body. Then it's 20-minutes on the scanner and I'm done.

If cancer is congregating in any part of the body it will draw the radioactive sugar to it and "light up" on the scan. Who thinks of this stuff?

Barb is going to try to get me a banana nut muffin at the health campus for me to jump on as soon as the scan is over.

Happy Monday everyone!

Harleys, Freckles and Ellis

My Mom has reached Detroit safely to visit with her old Michigan friends.

At the half-way point, on the Pennsylvania/Ohio border she settled into a dog-friendly Marriott with Noel after a quick bite to eat.

Around 9:30 p.m. the phone rang. It was the front desk.

"Mrs. Albert? This is detective soandso down in the lobby. Could you possibly come down to the lobby?"

My Mom ventured down to the lobby, met the detective, and learned that a motorcycle had crashed into the rear end of her parked car. She was parked right in front of the hotel.

The biker was there. His bike was in a couple pieces. He reported the accident. He had insurance. He continuously apoligized, according to my Mom.

He must have had one wheel up in the air because he completely missed the bumper but smushed in the tailgate. My Mom said the car was ok to drive. And she drove it the final six hours, through Detroit and arrived at her good friends the Plouff's.

It's like a movie, "Alice and Noele the three-legged dog travel across America."

Enjoy, relax, and return safe guys!

Freckles knew yesterday that something was up when I closed the door between the kitchen and the sunroom. He hid in the corner underneath the pub table. So I moved the pub table.

Yesterday was time for Freckles annual check-up with the veterinarian. Our vet and his staff are great. They didn't hesitate at our request for house calls for Freckles since he hates to travel.

Still...what a scene.

Barb donned long sleeves and picked up the beast. We set him on a card table covered with newspapers. The vet noticed a story about a musician coming to town on one of the newspapers. The vet is also a fiddle player we learned.

The nurse grabbed Freckles by the scruff of the neck, completely controlling him, very professionally. Freckles hissed and cried and showed his teeth as the vet sped through all of his checks.

Freckles has a spot on his back near his tail which he cannot reach to take care of. A large clump of hair always gathers here over time and he won't let us near it.

We took advantage of the situation to cut off the clump of hair. Freckles didn't seem happy about it at the time. But he did seem happy about it when everything was all over and that big clump of hair was gone.

After a little shot in the butt, Freckles was done. He took off as soon as the nurse left go. He stopped in the kitchen and looked over his shoulder to see if anyone was following him. I could just see him thinking, "What was that all about?" as we all stood there smiling at him.

This is also the Ellis birthday weekend celebration. Happy fifth birthday Ellis!