Full of Gas

When I was at Ohio University I had to take an economics class as part of my required core classes.

The professor asked the class once, "If you own a store, and an item is hugely popular, do you raise the price of the item, or lower it?" Then, to my horror, he pointed at me and said, "Albert?"

I thought about it for a moment and said, "Well I'd be selling more. So I would still be making my profit margin if I lowered prices. I'd lower prices," I said.

"NO!" he screamed. "In a supply and demand economy you raise prices for popular items and lower prices for unpopular items in hopes of making them popular items."

I slumped down in my chair. The professor asked me to meet him in his office for a couple tutoring sessions. I passed with a "C" grade.

I guess greed just isn't part of who I am. And I consider the supply and demand philosophy that drives our economy greedy. And I don't consider greed good for business.

Everyone's pointing fingers these days trying to figure out who is responsible for skyrocketing gas prices. It's the supply and demand economy, which to be is based principally on greed.

Gas prices rise because we're over the barrel. We have no other choice then to buy gas. Those in control of the acquisition of oil and the production of gasoline can set the price of gas at any point they wish. We're stuck. We're screwed.

Who's to blame? We are.

Exxon's profits topped $40-billion dollars in 2007. In Saudi Arabia they bring in foreigners from adjoining countries to do all the work, native Saudis do not have to work.

From here to all points of the world, those involved in the oil business are swimming in money. It's supply and demand economics.

What a business! You produce and distribute something that everyone absolutely needs and you have little to no competition.

We should have, could have, done something about this years and years ago if we had the foresight. And we really did know this day would come. Typically people don't change behavior until it hurts. Now it hurts, and people are scrambling for alternatives. Meanwhile companies are working too to develop the supply for the next demand.

We're plenty smart enough to develop alternatives. We've had men on the moon, a vehicle roving around Mars. If we wanted to, I'm sure we could develop a vehicle that ran on Snickers bars.

So to my professor of Economics at Ohio University, I think I did have the answer to your question correct. Being greedy, and charging my customers excessively, because I have a product that they love and I can barely keep on the shelves is not good business, and not good for the economy.

Quick Sunday Night Notes

Sunday truly was a day of rest for us. I'm sitting back this evening watching the Phillies be quirky, and digesting Barb's scrumptdeelieicious Chicken Parmesan with spaghetti. And Sunday was a day of reflection for us, of our week behind, our week ahead, and our refections on our ongoing spiritual journey.

Yesterday I probably spent more time at my desk, working the computer, than I have for some time. A client wants me to be as creative as I can be, while still staying in the business environment of finishing equipment for manufacturers.

We'll show off my initial offering tomorrow, a proposed homepage that needs a little tweaking and expertise input from the clients themselves. I thought it was pretty funky though. What do you think? Click here to view the site in development.

Like always I appreciate feedback. You spend hours upon hours on something and you lose your objectivity.

I've decided that despite my health challenges, it does me good to get up and live my days and do the things I love to do - create things. There's something about taking a blank piece of paper, or a blank screen, and making something come to life. It's very satisfying to me, and even a little magical.

I have gained a couple of pounds, and I am feeling much better overall. As long as the Torisel is working I really don't care how it makes me feel. And after two more Torisel sessions we'll see how it's doing so far. The oncologist noted that after only one month it may be too early to truly judge the Torisel. But he did agree that we should take a look at things with some more CT scans.

We have a sizeable list of things to get done this upcoming week. We hope to get a couple hundred oversized postcards out to local business we're targetting. The hope is to gather a couple of free-lancers, and gather a couple clients, and start managing the business as well as working it. I'm hoping to give Barb a foundation for a business that she can grow, and prosper with, for a long time.

It should all give me a week where I keep moving - and that's great.

Another Chemo Friday

All went smoothly for another chemo Friday. I feel a little tired afterwords, like usual, but that's more from the Benadryl drip bag more than anything else.

I did ask one of the nurses, out of curiousity, what the length of time was for most people receiving chemo treatments. She said that it widely varies, from a few minutes to as long as eight hours. She added that the typical time was about four hours.

Four hour!!! Wow! I didn't realize that.

My chemo lasts about an hour and a half, and that includes the Benadryl, followed by a saline solution, and finally the Torisel. Or in other words, it lasts long enough to finish three crossword puzzles with Barb.

My oncologist is heading back home to India for a two week vacation. So today we set up appointments for a CT scan after next week's treatment, and then a consultation with an interventional radiologist.

I'll be a little nervous going into that CT scan, hopeful to at least see stabilization of the tumors in my liver, if not some shrinkage of the tumors.

This past week I haven't had the little headaches I've had the week before. But this week, every morning, I wake up with puffy, swollen eyes. Don't ask me why. I don't know. My eyes settle down after a bit.

Right now I'm tired, more from the Benadryl that anything else. So I'm going to tie up this blog and start thinking about a little nap.

What I Sometimes Miss

Ever since Jim was diagnosed with cancer, he and I both miss certain things that we would do together. Playing tennis, ride our bikes (fairly fast paced through town). I think one of the things I still would love to be able to do is go back to the Outerbacks in North Carolina. That may be grasping at straws a bit considering what we have to deal with. Although I am hopeful that even at some point when he feels well enough and I am confident that he does, that we may be able to take a weekend trip somewhere.

I had such a wonderful time in North Carolina, not just because it was our honeymoon, but because I had never been there before. I thought the area was beautiful and I got to see things Jim used to see when he had spent many times there in the past. The home we rented for that week may not have been right on the ocean, but I didn't care, I just loved the thought of being there. Even though we went in the midst of August when it is very busy, I had best time I had ever had in a very long time.

One thing is for certain, I have a ton of wonderful memories of that trip and even if I never get the opportunity to go there again, I have that to look back upon.

So Sorry

Sorry we didn't post a blog today. We hit the butcher and the grocery store early and I spent the remainder of the day working on a web site for an industrial equipment distributor. Both went well. And just the fact that I was able to put in that full of a day means a lot.

Off and running again, I have to make taco salad for dinner with Barbie.

Torisel Versus Nexavar So Far

Photo of the Day
Self portrait

So far the Torisel has been much kinder to me than the Nexavar had been. The Nexavar did have 14-months to eat away at me though. The Torisel has only had two-weeks thus far.

On the Torisel I still get fatiqued. But it's not as bad as the fatique from the Nexavar had become.

The Torisel also tweaks my belly and digestive system a bit. But it also is not as bad as the Nexavar. My appetite also seems to be down. On Nexavar my appetite could be a bit of a rollercoaster.

Since starting the Torisel I've had some minor headaches. But I'm not sure that is the fault of the chemo. My sinuses are active now, and seemed to be clamped down on the Nexavar. And the air conditioning at night seems to put the sinuses into motion too. My theory is that all of that is causing me some minor headaches not the Torisel itself.

But on the Torisel I'm free. I've actually woken up after Barb some days. Wait a second, let me say that again, I've actually woken up after Barb. Sorry that's something I have not been able to say for 14-months.

Albert Design Studio is rolling. I'm thick into the middle of a nice web site this week. And we've got a self-promotional post card we're trying to get on press. There are two more web sites in the works. And I want to talk to a friend about doing some more print design work.

I figure that life must go on. It's good for me to get back into it, although I can't pull the 12-hour work days that I used to do. That was never a healthy work schedule anyway.

I couldn't do it without Barb's help. With her handling all the administrative stuff I'm free to just be creative. She's been a huge help.

And I've got to get back to the web work. This client really enjoys all of the Flash animations and creativity that I specialize at. There are a lot of graphic artists out there that try to pander to the standard corporate designs that simply bore people to death. I think people want to be entertained, actually I know they do. And I walk to the beat of my own drummer, always have, ask anyone.

Tribute to George Carlin

Photo of the Day
A man of a million expressions

George Carlin did purposely try to tick people off and cross over acceptable lines. His coloring book certainly had more crayon outside the borders. This gained him animosity from many. He didn't have to do this because his insights alone were unique, insightful, and hilarious. But there was something about him that just wanted to be outrageous.

I saw him live three times and have two of his books. The following transcript of his comparison between baseball and football is my, and many peoples', favorite.

Baseball versus Football

In most sports the team is run by a coach; in baseball the team is run by a manager. And only in baseball does the manager or coach wear the same clothing the players do. If you'd ever seen John Madden in his Oakland Raiders uniform,you'd know the reason for this custom.

Now, I've mentioned football. Baseball & football are the two most popular spectator sports in this country. And as such, it seems they ought to be able to tell us something about ourselves and our values.

I enjoy comparing baseball and football:

Baseball is a nineteenth-century pastoral game.
Football is a twentieth-century technological struggle.

Baseball is played on a diamond, in a park. The baseball park!
Football is played on a gridiron, in a stadium, sometimes called Soldier Field or War Memorial Stadium.

Baseball begins in the spring, the season of new life.
Football begins in the fall, when everything's dying.

In football you wear a helmet.
In baseball you wear a cap.

Football is concerned with downs - what down is it?
Baseball is concerned with ups - who's up?

In football you receive a penalty.
In baseball you make an error.

In football the specialist comes in to kick.
In baseball the specialist comes in to relieve somebody.

Football has hitting, clipping, spearing, piling on, personal fouls, late hitting and unnecessary roughness.
Baseball has the sacrifice.

Football is played in any kind of weather: rain, snow, sleet, hail, fog...
In baseball, if it rains, we don't go out to play.

Baseball has the seventh inning stretch.
Football has the two minute warning.

Baseball has no time limit: we don't know when it's gonna end - we might have extra innings.
Football is rigidly timed, and it will end even if we've got to go to sudden death.

In baseball, during the game, in the stands, there's kind of a picnic feeling; emotions may run high or low, but there's not too much unpleasantness.
In football, during the game in the stands, you can be sure that at least twenty-seven times you're capable of taking the life of a fellow human being.

And finally, the objectives of the two games are completely different:

In football the object is for the quarterback, also known as the field general, to be on target with his aerial assault, riddling the defense by hitting his receivers with deadly accuracy in spite of the blitz, even if he has to use the shotgun. With short bullet passes and long bombs, he marches his troops into enemy territory, balancing this aerial assault with a sustained ground attack that punches holes in the forward wall of the enemy's defensive line.

In baseball the object is to go home! And to be safe! - I hope I'll be safe at home!

The African Bushman

Photo of the Day
The new decks and pavers, early Spring

Now this may not seem like a discussion of good taste or sophistication. But once you're diagnosed with cancer examination of bodily functions becomes a necessary daily event.

I regularly recall a conversation I had with a gastroenterologist last summer before I had my colonoscopy. (By the way, Dave Barry wrote a great column about his colonoscopy here.)

The gastro doc told me that the African Bushman had the best stool of anyone in the world.

OK. I thought to myself.

He explained that the African Bushman ate very little red meat and tons of fiber so their stool was the best, one gigantic, big, long stool - which is a sign of great digestion and good health.

This also added up to, he said, very, very little, if any colon cancers amongst the African Bushmen.

Considering one of the main side-effects of chemotherapy is a tank ripping through your digestive system, I always remembered what the gastro-doc said and did my best to strive to be like the African Bushman.

Not long ago I asked Alyssa and Charlie if they knew why cats and dogs examine the result of their bowel movements. Are they just proud? They looked at me in bewilderment.

I explained to them that animals have an innate nature about them. They examine their "stuff" to check on their own health.

"Really?" Alyssa asked.

Really.

We're not always as smart. We can learn somethings from animals.

So look at your "stuff." I do. I strive to be an African Bushman.

Friday is Chemo Day

Photo of the Day
Barb in her new Jackie O. shades

It's chemo day. Every Friday I'll be hooked up to the IV at the cancer center at Lancaster General Hospital's Health Campus.

First they drip a bag of Benadryl into me to offset possible "infusion reactions." Then they drip a bag of saline solution into me. And finally the big bag of Torisel comes out and that drips into me for 45-minutes.

One thing I noticed last Friday was that I was the youngest person in the room. No one else was younger, or really even close to my age range.

It's great that Barb is allowed in the chemo room with me. Last Friday we spent the time doing crossword puzzles. We do get the easy puzzles because it makes us feel smart. lol

Today I might take some work with me. I have a web site proposal due by next Friday. I need to sketch out a gameplan for the site.

But the Benadryl has a strong tendency to make a person sleepy. It certainly did last week. So...we'll see how it goes.

Next to me last week was an older lady who was hooked up to a bag of chemo that was five times larger than mine. She was sound asleep from the time we got there to the time we left. I imagine that the big bag she was hooked up to took hours and hours to empty.

The chemo room, I now know, is also very cold. So this time I'll be prepared and dress for the arctic temperatures.

We'll see what round two of the Torisel has in store for me, as far as side-effects. So far the Torisel has been much gentler on me than the Nexavar. But then the Nexavar had cumulative, changing effects as time went on. And I imagine the Torisel will be the same.

Eventually I might check to see if I can get a wireless connection at the hospital and maybe take the laptop with me. I'm not the greatest at sitting still without at least some type of mild entertainment.

I'll let 'ya all know how I'm feeling tomorrow. Thanks for all the continued support, prayers, and well-wishes. It keeps me fighting, and fight I will.

Back to the Needles

Photo of the Day
Alyssa being Alyssa

Today I'm off to have more bloodwork done. That means yet another needle in the arm.

For at least the first couple weeks of the new chemotherapy Torisel they're going to ask me to have bloodwork done to see if the Torisel is having any negative effects.

Barb and I did some research on potential side-effects from Torisel. One surprise was that I'm not allowed any grapefruit. It could be a fatal mix with the Torisel.

Not that that is going to be a problem for me. I'm not a grapefruit guy. But it is amazing how something so innocuous could be such a serious threat. All of this has to do with chemistry. It's amazing, and kind of scary, how chemotherapy is all about mixing up the regular chemical balances of your body.

Tomorrow I go for my second Torisel session. That's another needle in the arm. By the end of the month I expect to have enough needle marks to look like a heroin addict.

My oncologist is reportedly back from his hospitalization, caused by complications that arose from his summer kidney transplant. I'm glad he's doing well enough to be back at work.

My family doctor called yesterday to report that he has talked to my oncologist. He added that the oncologist wanted to handle all referrals. That comment stemmed from my family doctor taking charge and finding local interventional radiologists, something my oncologist said didn't exist in Lancaster.

I'm not exactly sure what my oncologist's motivation is in "claiming" me as his own. I know my family doctor is a stand-up guy who would want to follow rank-and-file, and I can understand that. But I only hope that my oncologist is not reacting to his own self-interest rather than mine.

We'll talk on Friday. He's not going to prevent me from seeking out all possible treatment options. I'm anxious to see how he's posturing himself.

Dreams

Photo of the Day
Trying to look chemo cool

I was dreaming this morning that Barb and I lived in a warehouse that had been renovated into a loft-style home, in a little surf community north of San Diego.

We had a successful graphic design business in a separate building we owned in this small communities' business district.

I surfed every morning before going to work. We were so incredibly happy.

Barb and I stood above the cliffs one evening, which were just a short walk from our loft, watching the sunset over the Pacific, each enjoying a glass of Merlot.

Suddenly I heard a loud "MEOW!"

Awwwwwww. Freckles!!!!!

I had slept in and Freckles didn't like it. He came into our bedroom this morning and let out a couple loud "Meows" to wake us up. He stirred me right out of San Diego - silly cat.

Why San Diego? I don't know. I guess the scenery from golf's U.S. Open this past weekend sunk into my head. Plus I just sent a print job to a printer in San Diego yesterday.

People have often told me that with my laid-back surfer style demeanor I'd love California. I really can't imagine it though. Pennsylvania is my home. I love "Penn's Woods," the rolling countryside, the back roads that suddenly make 90-degree turns along very old property lines.

Pennsylvania may not be very progressive, and I've often loved to dance along the cutting edge of art and music and culture in general. Growing up I couldn't find anyone who was listening to the Velvet Underground, reading Hunter S. Thompson, or following the exploits of Andy Warhol.

But I've always been a man of old-fashion values, who believed in family and faith and the strength found in small communities, and that fit the spirit of Pennsylvania well. This is, and always has been my home.

After college I took the first job I could get, which happened to be in Northeast Philadelphia. I spent almost four-years in the big city, saturated by cutting edge music and art and culture. But I never felt comfortable, never felt like I was at home. Eventually it wore me down and I returned home, and stayed home in Central Pennsylvania, back to the rolling countryside where I belonged.

I always remember a friend of our family telling me, "You're just like me. You think you need to go chase your dreams. But then you realize that everything you ever needed was all around you all along."

Feeling Out the New Chemo

Photo of the Day
The broken into FJ Cruiser

There just is no such thing as chemotherapy without side-effects. So as I move through my first week on the new chemo drug Torisel I wait and watch to see what side-effects will present themselves.

So far, in general, overall, I feel better than I did on Nexavar. Fourteen-months of Nexavar really began to take its toll on me. So I've wondered the past couple days whether I feel better because Torisel side-effects just won't be as severe as Nexavar side-effects. But it's really still too early to tell.

Since I've begun Torisel I have had headaches. Mainly, outside of Saturday's monster, marathon, severe headache, the headaches have been very small. But I've still had headaches. The past two mornings I've woken up with small little headaches.

My appetite, also, has not been great. I'm eating small portions without difficulty. I get full fast. Overall the digestive system doesn't feel quite right. But it feels better than it did on Nexavar.

I do feel that my body is in a transition. Not only did I stop taking Nexavar, but I've also stopped taking all the supportive drugs that were used to control the Nexavar side-effects.

So, I'll continue to wait and see. I'll report everything to the oncologist on Friday before being hooked up to the Torisel again.

I'm a little concerned about my oncologist, in more ways than one. We did hear yesterday that he is coming back to work on Thursday after being hospitalized for complications that developed from his summer kidney transplant. I was praying for his return to health, and hopefully he is doing OK.

I'm also worried that his personal health battles have left him a bit unfocused on his work - when I need him most.

I enlisted the help of my family doctor last week because of this concern. I heard from him yesterday and he found me a doctor within Lancaster General Hospital that performs ablation procedures to remove tumors. The ablation procedure is a minimally invasive procedure that is meeting great success. It's so easy on the body patients are back to normal activity as soon as the next day.

My oncologist had told me previously that no one at Lancaster did this procedure. Huh? That's when he sent us on the wild goose chase to Philly. So...I'm a bit concerned about how much he's really going to be able to help me. I'll discuss it with him more on Friday. But I'm certainly keeping in touch with my family doctor on everything.

Quick Update

I had a rough night Saturday night. I'm not sure why. A bad headache dogged me most of the day, and then kept me up through the entire night. I finally fell asleep early Sunday morning and after a few hours woke up feeling OK.

I'm tentatively going through the drug transition here. My body has become accustom to the daily dose of drugs it's been fed over the past 14-months. When I started the Torisel on Friday I immediately stopped all other drugs, not just the Nexavar, but also all the other drugs I took to help control side-effects.

I'm sure it's putting my body through a bit of a roller coaster. And it's hard to say at this point exactly what the Torisel may have in store for me. But it's all a transition that I'm riding through.

This weekend we had some great visits with my brother and sister on Saturday, and Alyssa and Charlie on Sunday.

Today a potential client is stopping by with his big boss to discuss developing a web site.

And thanks Bill for all the work on our front window. Getting a "real" window for that space has been long on the to-do list for us, ever since we bought the house. And no worries Susan, we have plenty more to do to help keep your husband out of trouble. LOL

So Far So Good

I started the Torisel chemotherapy yesterday and so far I'm feeling good. So far I'm feeling strong.

I'm not counting my blessings quite yet though. I'm not naive. I'm sure the Torisel will have some cumulative effects on me as it works its way into my system, week after week. It is chemotherapy afterall, the medical term for poison.

I do think I'm feeling stronger because I'm off the Nexavar chemotherapy. After 14-months it wore my body down. I lost more than 40-pounds. It dried out my skin and convinced most of the hair on my body to fall out. And it drove my digestive system nuts. That's not mentioning the fatique, tremendous fatique, that would ensure that I did everything in slow motion, or not at all.

Late Thursday we did receive word that my oncologist has been hospitalized. He had a kidney transplant in late summer of 2007. He had been doing well, but complications apparently developed. His prognosis is unknown but our thoughts and prayers are with him. We knew something was wrong because his behavior had changed and he seemed to stop caring about his patients, or at least this one. Now we know that something was going on.

So we started the Torisel Friday under the direction of an oncologist we never met before. He was a good guy, looked like he was about 25-years old though. But as a surgeon once told me when all this started, "Find a young oncologist because they are more in tune with the latest treatments."

Lancaster General Hospital does not put "ports" in place for the IV drip until your veins leave no other option. So they stabbed me in the forearm and hooked up the IV. That's fine with me. I'm going to get stabbed by needles a lot in the upcoming months it seems. Besides the weekly IV I will have to get a weekly blood test to ensure that the Torisel isn't creating trouble.

Barb kept me company in the chemo room. She's such a sweetheart. I'm so fortunate.

We were the youngest patients in the room. I always notice that most of the cancer patients at the cancer center are 20-years our senior.

First they set me up with a bag of Benadryl, which helps offset any allergic reactions. Then I got a bag of saline solution. And then they hooked up the big bag of Torisel. I figured the Torisel would be some neon purple color or something. I don't know why. But it just looked like harmless water.

Barb and I did a couple crossword puzzles, taking turns, we finished 'em all. (We buy easy crossword puzzle books. It makes us feel smart.)

I was even allowed to eat a Baby Ruth bar, while the chemo dripped into me! This was novel. On Nexavar I had to leave at least three-hour windows around my treatment time without any food. The stomach had to be empty, or there was a price to pay.

This morning the alarm clock did not go off at 5 a.m. like it has every day for the past 14-months. I slept until 6:30 a.m. 6:30! Can you believe that?

And yesterday, just because I could, I ate some snack mix at 3:30 in the afternoon. I haven't had food between 3:00 and 6:00 p.m. in 14-months.

To some extent I feel like a prisoner who has just been set free.

But as my oncologist once said, if your feeling bad and suffering from symptoms then that's how we know the chemo is working.

Goodbye Old Nemesis, Hello New One

Today is my last day of the chemotherapy pill Nexavar. Tomorrow morning I start the new chemotherapy Torisel.

I have been on Nexavar for over a year. Nexavar required me to take two doses per day, 12-hours apart. I could not eat for two-hours prior to taking the pills, or one-hour after. I figured the best course was to take pills at 5 a.m. and 5 p.m., so I could at least preserve a decent dinner hour.

There is a little good in everything. Tomorrow will be the first morning in more than a year that Barb won't have to set the alarm for 5 a.m.

Tomorrow I will be able to eat if I want to at four in the afternoon, uh huh, if I want to, I can, for the first time in more than a year.

But then again, Torisel may make me so sick to my stomach that I can't eat a thing, or go to sleep. Chemo can be funny, affecting everyone a little differently in its own way. But I'm feeling positive.

The Kidney Cancer Association operates a forum for patients to talk with one another. There was a pretty good conversation on the forum between a few folks who made the switch to Torisel. Most reported feeling much better than when they were on Nexavar, ate better, and gained weight. So I've got my fingers crossed.

I had to take the FJ out this morning to get stuck by the needle for more bloodwork. It was ordered "fasting" so I was motivated to get it done so I could have breakfast.

I only had to jump on a great back road and travel a few miles to get to the Lancaster General Hospital satellite office. Cool morning temperatures, sun rising over one-foot high cornfields, passing chicken farms, music turned up loud, open roads, it was a great morning for a little drive through the Pennsylvania country side.

Barb and I will be staying busy around the home and office today, riding out the last day on Nexavar, and readying for the first day on Torisel. Wish us luck!

A Break in the Heat

Freckles is happy. So we're all happy.

The brutal heat of the past few days finally broke last night with some good rumbling thunderstorms. It got so dark around dinner time last night I thought I was Dorothy. I guess that would make Freckles Toto. Barb as Auntie Em?

Going to take Barb out for her driver's permit test this morning. I know she'll pass it. I know she'll be a good driver. Still I worry about her all the same. Those roads can be crazy.

I made an appointment with my primary doctor for tomorrow. Today I'll print out all the information I can find on potential surgical and potential radiation procedures today and take it to him for a head start. I believe there are four options out there that could work for me, all with pluses and minuses.

Otherwise, life goes on. I REALLY need to get back into the exercise routine. The more I have thought about my current situation, the more I realize that there really are no options but just get up and keep on living. I've known two kidney cancer patients now that have passed away. And in both cases the disease just tore their bodies down slowly until one was in a wheelchair most of the time and the other couldn't get out of a chair without help. So I take that as a sign to keep living, to keep active, to get back to exercising. And that's what I'll do my very best to do.

Torisel It Is

Well low and behold two doctors actually took the time to talk to one another. The Lancaster oncologist and the University of Pennsylvania kidney cancer specialist agreed that the best next step for me was to start on the chemotherapy Torisel as soon as possible.

So this Friday morning I will start on the IV-based Torisel in Lancaster. I will need to go in for a treatment every Friday morning, and treatments should last for about an hour.

Considering that the tumor in my liver grew so incredibly fast, I've concluded that the Nexavar indeed had run its course and was no longer working. So I welcome the switch to Torisel. I'm not fond of the idea of having to go in every Friday to get hooked up to the "juice." But, it is what most cancer patients face. Most aren't as fortunate to have a pill that they can simply take at home. And I rode that one out for more than a year.

I'll be trading in the side-effects from Nexavar for the side-effects of Torisel. So I don't know exactly what I'm in store for yet. To many extents chemo side-effects are similar since all chemo attacks fast-dividing cells, whether they be healthy cells or cancer cells. But I did do a lot of reading this weekend on a forum for kidney cancer patients, and many patients now on Torisel were reporting feeling better than they had on Nexavar or Sutent. So . . . we'll see.

We're going to put this all in the hands of Torisel for a month. Then we'll do follow-up scans and check if the new chemo has been able to shrink, or at the very least, stabilize the tumor growth. I'd love to see the largest tumor, at 2.4-inches, shrink to 2-inches or below since that seems to be the mark for whether new, minimally invasive techniques can be used over traditional surgery.

My oncologist did garner an additional surgery idea from the specialist in Philly. It's a technique close to the ablation technique. But it involves a catheter run through a vein, into the tumor, for direct application of high dosage chemo right to the tumor.

I figure I have a month of Torisel to explore all my other options, and ready myself for anything.

I am feeling well. I mean I still have all the wonderful side-effects from the Nexavar - fatique, anorexia, tough digestion. But I feel good. That's a lot different from how I felt a month ago. It makes me feel fairly confident that the tumor growth has at least stabilized for now.

That's the latest from here. Barb and I are off to the butcher and the grocery store this morning before the thermometer hits the 90s again today. It's been brutal in PA the past few days. But thunderstorms are on the way today and a new weather front should bring temperatures back to normal for this time of year by tomorrow.

Anyone need a smoked sweet bologna stick from Groff's?

Taking Charge and Never Giving Up

One thing that I have to emphasize to every cancer patient is to never be satisfied with the opinion of just one doctor.

Doctors work within the auspices of hospitals or medical organizations. Their knowledge of advances in medicine or technology is often limited to what the overall organization offers.

Just through the weekend I have researched doctors who perform the ablation surgical procedure, which inserts a needle into a tumor and freezes it or burns it, on an out-patient basis, and is very minimally invasive.

I've also found a new radiation technique called tomography, that incorporates a CT scanner into a machine that delivers radiation with pin-point accuracy to spare healthy tissue from radiation harm. The closest hospital using tomography is in Chambersburg.

And there is a Phase II clinical trial in process for a new pill-based kidney cancer chemotherapy named "Radd."

My oncologist in Lancaster doesn't have knowledge of any of these things. And if I was content to have his opinion, and his opinion alone, I'd be limiting myself to all of the treatment possibilities.

For today, Barb and I still wait to hear from the Lancaster oncologist who is expected to confer with the kidney cancer specialist at the University of Pennsylvania.

What we expect to hear is the verdict on what chemotherapy to switch to. We're expecting the IV-based Torisel, and we're OK with that. Most reports from patients on Torisel indicate less side-effects than Nexavar, and effectiveness in slowing cancer growth. Although Torisel can come with its own ideas of chemo "fun," everyone is their own snowflake and I won't know how exactly it will effect me until I start taking it.

There is a chance that the oncologist here and in Philly will never talk. If that's the case we do have an appointment in Philadelphia set for Thursday. But we are really hoping that doctor can talk to doctor (what a novel concept) and save us the tough trip to the big city. I did originally try to set up a phone consultation with the Philly specialist, but he refused. It's against his policy.

OK.

Maybe I need to start developing some policies. What do you think?

Our family doctor is great. And I'm hoping that after the chemo decision I can get together with him and pow wow on all the treatment options I discovered this weekend. I'm hoping he can help me track down the best options, the best treatments, at the best places.

It's going to be a tough one, I'm sure. But what hasn't been tough along this journey? And that's why I call it a fight.

A Million Questions

Barb and I met with my oncologist yesterday and had a pretty good sit-down talk.

Again, we heard another doctor tell us that the spread of the cancer is not good. But we already knew that.

The concern is that the Nexavar, which I've taken for just over a year, has stopped working. It is a known characteristic of the drug, after awhile the cancer learns to overcome it. Kidney cancer is a tough one.

There are two other chemo choices to try, Sutent and Torisel. The oncologist feels that Sutent is too similar to Nexavar. So he's recommending Torisel.

But the oncologist wanted to send me to Philly again to talk to the kidney cancer specialist. The only reason he wanted me to see him was to get his opinion on what chemo drug to switch to. I asked him if the doctors could just talk to the doctors with a simple phone call and save me the trip. He agreed.

So we wait until we hear word back from the oncologist. And then I'll start on the new chemo. The plus side is that the chemo side effects could be better. And the down side is that the chemo side effects could be worse.

As far as surgery possibilities go? They won't touch me in Lancaster. The Lancaster hospital's position on cancer surgery is to not do it if the cancer is metastic, or already spread throughout the bloodstream. The theory is that you just put the patient through risk, and two-months of pain and recovery, to remove tumors that are just going to return.

My overall perspective on our local hospitals is that they're very organized, friendly and successful. But they are not keeping up with a lot of the latest techniques and medicines in an industry with rapidly advancing technologies.

A new procedure called ablation has been around for some years and is practiced in many areas now. But not our area. It's an out-patient procedure where a needle is guided into a tumor by an ultra-sound or CT scan and then burnt or frozen. It's been reported to be very successful. Cancer patients can have a tumor killed and be back at work the next day. Really!

I have three "lesions" in my liver. Two of the tumors are eligible for an ablation procedure. The other - the amazing 2.4-inch tumor - is too large for the 2-inch maximum size requirement for ablation.

So I don't know.

I do know that Lancaster hospital won't touch the idea of surgery, and doesn't offer ablation.

I do know that my family doctor will help me anyway he can, including finding the right out-of-town surgeons, if necessary.

I'll start with work on the new chemo drug, and cross my fingers that the side-effects aren't worse than the Nexavar.

A follow-up CT scan will be done in a month with more blood work. And that will give us a month to examine surgical options.

And we'll hope that the big tumor isn't growing at the same speed that took it from nothing to 2.4-inches in 2-months.

I'm still going about my everyday living. Started the weekend with a Friday afternoon his and her haircut, provided by Father and Son. Steve and Charlie gave us haircuts (well Barb was styled, I was just cut) side by side. They have a great shop, in a great location, with great personnel, it's no wonder they're a success. And it didn't hurt that Steve was showing off his new accordian. And Charlie gave me the best cut I've ever had, no fooling. And that's saying a lot considering my blonde, baby, chemo hair.

Here We Go

I can't tell you how or why, but I knew that something was brewing and it wasn't good.

I guess the pains I had through my right side for a month tipped me off that something was up. And when the ultra-sound earlier this week picked out a "bright spot" in my kidney I accepted right away that the cancer had spread. Plus, when you've been in a position such as I for more than a year, you come to accept the reality that a spread of the cancer could happen at any time.

So when I talked to my doctor yesterday and he gave me the news that there were three "lesions" in my liver I really took it in stride. Of course it's not what I wanted to hear. But I almost expected it.

My reaction wasn't, "Oh no! How could this happen?"

My reaction was, "OK. So what can we do about it?"

Some of my doctors have been very disappointing the past month. I virtually begged my oncologist to pay attention to the pains that were inflicting my right torso (pains that are now completely gone). He suggested that maybe I should go to the emergency room or see my primary doctor. I took that as showing no interest, and really just blowing me off.

Barb and I meet with him today and I'm going to politely push him for explanations of his sudden disinterest. It's certainly obvious now that he should have gotten involved.

And the kidney specialist at the University of Pennsylvania sent me to see a surgeon, a "friend of his," who he knew was doing a procedure known as "ablation." Ablation is a relatively new procedure where needles are inserted into the middle of a tumor and then the tumor is burned or frozen. It's a minimally invasive procedure that can be done on an out-patient basis. Hospitals have been too slow at integrating this technique. And when I met the surgeon in Philly, who I was told had done dozen of ablations with great success, he told me that he had never done an ablation procedure.

OK.

So I'm putting my foot down, politely, with my doctors now, no more screwing around.

My primary doctor is awesome. And it's become obvious to me that he should really be my point-man, my go-to-guy.

Today we'll give the Lancaster oncologist a chance to really get involved again. But if he shows little interest, then I'll be going right back to my primary doctor.

It's disappointing to see how little doctors talk to doctors. In this age of specialists, though, it's crucial that doctors communicate, and communicate well.

I have a strong feeling that my oncologist today is going to pass-the-buck and simply say, "I want to send you to Philly."

But I'm done with wild goose chases in Philly. I'm going to ask him to forget about Philly, and tell me what he thinks, and tell me what he would do. If he wants to consult with doctors at the University of Pennsylvania I think that's great. I think he should. Just don't send me down there to wait for four-hours to see the wrong doctor, and discuss medical treatment plans that I'm not qualified to discuss.

I've been explaining to people that when the cancer spread to my brain in March of last year that it was serious. It was life threatening. We treated it and it was rough. But I made it and pulled through strong in the end. And the brain has been clear ever since.

I expect now to take the same approach to the cancer in the liver. Be aggressive, go after it, and knock it out of there. As long as I can convince the doctors to take the same approach.

Kidney cancer still has no cure, at least not yet. But there are two FDA approved chemotherapies I've yet to try. Plus there are two more chemotherapy drugs currently before the FDA for approval, one has already been approved for treatment in two other types of cancer. There are also surgery options for the liver, including ablation and traditional surgery, or possibly a combination of both considering the sizes and locations of the tumors.

So, giddy-up, let's go. As of this morning my full-time job is attacking this thing.

Waiting for Word

I went for my CT scan yesterday of the chest, abdomen and pelvis. The scan was around noon time yesterday. We received no afternoon call from the doctor, which is a good sign. The earlier they contact you, typically the worse the news.

My primary doctor ordered the scan. I'm guessing he wants to discuss the results with my oncologist, probably before he discusses the results with me. And yesterday is my oncologist's typical day off. So I expect to hear results sometime during the day today, probably after the two doctors discuss the results.

The scan went quick. The technician didn't mess around. She did take some extra shots in the upper chest (expected due to the nodule in the upper lobe of my left lung) and some extra shots through my mid-section (expected due to a cyst in my left kidney).

The only kink in the day was my stop at the Burger King drive-through.

To prepare for a CT scan of the chest, abdomen and pelvis, you must not eat for four-hours before the scan, and can have nothing but clear liquids (water). Also, you must drink two bottles of CT prep, which is a milky, chalky, shake-like, chemical mixture. It came with a bendy straw!

By the time the scan was over I was starving and my tummy was begging for food. Burger King happens to be on the way home from the medical center in Columbia so I breezed through the drive-through and got myself a whopper with cheese and onion rings.

Man that whopper hit the spot. But the second I finished it, right when I took my last bite, my stomach went into an uproar. The whopper and the CT prep drink did not get along. They did not get along at all.

All day my stomach tossed and turned and tumbled and growled, worst I can ever remember. But I should remember better, because I do this to myself everytime I have a scan. This was just the worst result I remember.

Today everything is settled back down and back to "normal."

We'll wait for word from the doctor today and stay busy around the house.

My parents are off on their trip to Michigan and I hope they have a safe and relaxing trip.

Barb's busy spying on a cat and her four kittens who have sought shelter under our neighbors back porch - the simple amazing feats of nature.

The Fight Continues

I went for the ultra-sound of my abdomen yesterday. I could tell something was up just by the way the tech went about her business. She focused on a few areas quite a bit. But I knew something was going on with all the pain I've gone through the past month. It was just a matter of getting the doctors to take action and stop treating me like I'm nuts.

When the phone rang just two hours after the ultra-sound and the doctor said "Hello," on the other end - I knew I was in some trouble. The doctor never calls that fast unless there is some concern.

The doctor explained to me that the ultra-sound showed a "bright spot" on my liver. He said that the radiologist called it "fuzzy" and "indescript." But it was also noted at six centimeters, which is really large in size. The doctor felt that the size had to be wrong, especially since there was nothing there just two-months ago.

Well there was actually something there in March. It was a tiny, little dot. The radiologist report said it was so small that it was inmeasurable.

My theory is that when I went on half doses of chemotherapy April 8th, after consulting with the specialist in Philly, that the tiny, little dot in the liver started growing like a wild fire.

By April 29th the pain in my shoulder had moved to my right abdomen and right side and I decided it was time to go back on full doses of chemo. In the meantime I was trying in vain to have a doctor pay some attention to this.

Through May, now back on full chemo, the pains in my right side continued to lessen, more and more. Now I only rarely feel a twinge, no pain, and the lymph node that had swelled on the back of my neck has now shrunk to barely anything.

So, I'm not a doctor, but I play one on the internet. And I think that the cancer had already made its mark in the liver before I moved to half-doses, then grew out of control, before I went back to full-doses and the chemo attacked it and shrunk it.

That's the latest. It's not the news I wanted to hear. I just never wanted to hear about liver involvement in all of this. But then I never wanted to hear about brain involvement either and I managed to slosh through fighting that off.

So the fight will likely continue. I think we should all wait to hear Wednesday's CT scan results before jumping to any conclusions.

I told Barb yesterday that I'm not afraid to die, and it's true. But I do want to hang around, so I can hang around with her. I've been looking for her my whole life, and now I finally found her. It's not my intention to give up being with her very easily. And my family, my friends, such super people, I want to be around all of them for a long time too. And that is my plan.

Monday Morning Tests

After a month of wondering what's been causing me so much pain in my right side, tests officially began this morning to try to find out the culprit.

I should mention that the pain has gone down substantially, almost completely gone away. And the lymph node on the back of my neck has shrunk considerably also. So I hope the tests aren't too little too late. I really want to know what this was the past month, because I certainly have never felt anything quite like it.

More needles this morning, and two viles of blood drawn, for more blood tests, which have almost become a monthly thing for me. I also had the first ultra-sound of my life. It's strange stuff, warm gooey gelatin on my belly, and rubbing the world's biggest computer mouse (at least that's what it looked like) over my abdomen for a good 40 minutes.

I did notice this morning that the ultra-sound technician was spending a lot of time, and taking a lot of pictures, of my left kidney. To confirm this I said, "I do have a cyst in my left kidney." The nurse said, "I know. I'm measuring it right now."

This let me know when she was focusing on an area and when she was not.

And she focused a lot of attention on my gall bladder. And she focused a lot of attention on the base of my breast bone. So? We should find out tomorrow what was found, if anything.

Now it's up in the attic to pull down a couple rolls of old insulation that was installed improperly.

More updates tomorrow . . .

Back to the Village

I do think that our social and economic structures will someday move back to the village concept. I think it's already heading in that direction.

When I was growing up we had a milk man, a produce cart, a local butcher, a local baker, everything was right there in the "village." We had carpenters and builders and a foundry. We had local banks, local grocery stores, local eateries. The village was pretty self-sufficient with the exception of the most specialty of specialties.

Then in my time everything was nationalized and all the local businesses conceded to Wal-Marts and shopping malls.

I think that's really starting to end.

I think people will stay home more, or at least closer to home, and start looking local once again.

Why?

Well, for one, the cost of gas. It's much easier to run to the end of town then to the mall downtown. And with the cost of gas I think people will be more and more willing to pay more to have goods delivered. So I think the day of the milk man may someday come back.

Also, there's more natural trust and accountability in doing business locally. A local businessperson knows they'll see you in church, at school functions, around town. Doing business locally demands working hard for a solid reputation. Doing business nationally is anonymous.

We try to do as much business locally as possible. It just seems to make simple sense. Why do to the national chain pharmacy when we have a locally-owned pharmacy? We get to build business and personal relationships with people, our neighbors, not a national branding identity.

More and more I see and hear in local people this same desire to stay at home. I think we're coming back to the village model. As populations continue to grow and resources continue to dwindle, I think we'll find life in the village our solution.