First Anniversary

I had a Dr Appointment today with my radiation oncologist. He mentioned that it is my first anniversary. I officially started cancer treatments on August 15, 2007.

It doesn't seem like it has been a year. Time keeps on slipping...

Anyhow, I am still doing just fine. I have gained 10 lbs, so that means that I am about 90 lbs down from when I started the adventure a year ago. I find that this weight gain is weighing heavily on me...about 10 lbs to be exact...so I am making a conscious effort to try to lose a little bit. I liked hovering around 200 lbs!

Mum and dad will probably want to celebrate. The best way that I can think of is ordering a pizza and watching TV. I guess I have still retained the lazy streak that I had pre-cancer. Radiation and chemo can only do so much!

An image for your consideration:

Random Stuff...

Snow
The snow from my last post is almost completely gone. There are a few piles of filthy, black snow lying around in the shadows of buildings. However, with the warmer temps...it was 63° yesterday...they won't last long. It is supposed to be in the 50's today with rain, which will further beat down the remaining slush.

Time
What is the deal with this daylight savings crap? Now when I get up in the morning, it is dark! At 7 am! I don't know why we even bother changing the clocks. It seems to me that it would be better just to shift all our zones forward from standard time by 30 minutes and be done with it for good. You know, split the difference. But, who am I?

Car
On two of the coldest days last week I awoke to my car not able to start. You want to talk about being ticked off! I've never had a problem with my car ever, so I thought this quite unusual. I got new tires weekend before last and it figures that would be the first day this all started. They checked out the alternator and battery and said both were good, but that there could be a flaw in the battery that only showed up when cold. After the last time I had to jump it...by driving my mother's car around my house through my backyard to get to the front of my car...I went and bought a new battery. Haven't had any problems since...knock on wood.

Water Heater
OK, I spent some of my tax refund on a new water heater. The happiness was short lived as I discovered in my research that I have to have a special flue dedicated just to the tankless heater! I was intending to vent it up through the existing chimney with some of the special stainless-steel "type III" vent tubing, but you can't do that. The county would not approve a permit for a new heater installed in that manner. So much for lower gas bills.

I sent it back and should get the refund soon. Then I will go out and buy a regular gas water heater. They are quite a bit more efficient these days than my existing 25 year old heater, so the gas bills should still be lower. And I intend on getting a fitted insulating blanket to make it even more energy efficient. I tell you, it is always something!

Cancer Update
I am holding steady around 200 lbs., which is very nice. I actually had to move my seat in my car up a little bit because I was so far away from the wheel. I have long legs anyhow, so I can't be too close to begin with, but I feel so small in such a large car. That's OK by me!

I am now on passive monitoring, which means I will have a CAT scan and checkups every three months for about a year. Then I will be looked at every six months for about five years. And I will have a PET scan about once every year, too. So, things are looking up!

Films
I don't usually recommend films to people because I have such an eclectic taste, but my friend Chris turned me on to one lately that is one of the best I've ever seen. It is called Hot Fuzz. I initially thought it was a porno, but it isn't. It is about a British cop in London that is so good at his job his colleagues decide to have rid of him an promote him to sergeant and ship him out into the countryside. It gets better from there, with lots of twists and turns, conspiracies and a good bit of comedy. It is pretty gory on occasion, but I have to say it is one of the best cop movies of all time. You must see it!

British entertainment is so much better than our American crap.

Cancer, Part VI: Major Update

First off, let me say that I am now down to 200 lbs. That makes 96 lbs lost so far. I feel great! Other than still having few clothes that fit.

In other news, I had a doctor's appointment today with my E, N & T doctor to go over the results of the Contrast CT that I had last Thursday. He examined me, looked over everything from my ears to my throat. Then gave me copies of the reports from the radiologist.

Nothing.

The pictures indicated there were no abnormalities visible that were of concern. Therefore, as Dr. S put it, "no weird surgeries for you!" LOLz!

Mother is taking me out to dinner tonight to celebrate. I go back in three months to see the doctors for the next round of checkups. It is kind of annoying, though, since my insurance changed and now my co-pays are higher. Thankfully, I won't have to go as often now that everything is under control. I expect the phone to start ringing off the hook any second now, since mother is probably spreading the news far and wide.

So, this may be the last of the cancer postings. That is unless someone has a question or wants more details about something that I would be willing to provide.

This, though, won't be my last posting in the blog. I just have to think of more things to write about...

Cancer, Part V: Minor Update

I had a doctor's appointment today with Dr. M2. You might remember him as the "medical oncologist", the one responsible for my chemotherapy treatments.

This was just a short follow-up to go over the PET scan results again, and go over the information that he received from my E, N & T doctor, Dr. S. Dr. S has me scheduled for a contrast CT coming up next week, which I am not looking forward to. The contrast injection burns from the inside out. I cannot stress this enough...burns from the inside out!

Let me restate this for clarity's sake...BURNS FROM THE INSIDE OUT!

For you Star Trek fans, you might remember the Next Generation episode "The Most Toys". This is one of my very favorite episodes. In it, a shady black-market-smuggler-used-car-dealer type person just happens to have enough of a certain chemical to counteract the poisoning of the water supply on a planet. In retrieving said chemical, Data's shuttle blows up. The intrepid crew thinks he is dead, but the "proprietor" of the chemical business...one Kivas Fajo...invented this elaborate ruse in order to add Mr. Data to his collection of unique, one-of-a-kind items.

Another one of the unique items Kivas has is called a Varon-T disruptor, a weapon banned by most of the civilized universe. Kivas has four of the five made, of course. This weapon is brutal...it painfully and relatively slowly dissolves the body from the inside out. In the end, he uses it on his consort, Varria, for her disobedience in helping Data try to escape.

This is what the contrast media feels like as it courses through your veins. You can feel the heat...or at least the perception of heat...building up inside your body as if a fire has started inside you. The expect you to lay still on the CT's tray while they put you through the doughnut and the imager whizzes around, all while you are on fire. It is not painful in a sense, but totally and freakishly unusual, unpleasant and uncomfortable.

In other news, I am still losing weight, though slowly. I am now down to 205. That means a loss of 93 pounds so far. So, there have been some benefits to all of this. My blood pressure is down, too, since the time before cancer...or "B.C.". My BP was in the 140/90 range...borderline worrisome. My BP today...even after the aggravation at work...was 127/72. Pretty good, that! Another benefit!

Cancer: Part 4 - PET Scan Results

I got the results from the PET scan I had a week ago. I, and my mother, met with Dr. M2 this afternoon.

The scan results indicate that the three tumors in my neck, all lymph nodes, have reduced in size significantly. The also have much less "uptake" than before. The "uptake" reading indicates how fast the cells are eating up the radioactive sugars. Mine were listed as a "3" on the scale of 0 to 9. 0 is dead, 3 is normal and 9 is a very aggressive tumor. There is also a small indication of something in my right side neck, and a nearly invisible micro-spot on my right lung.

Some of this sounds good, some bad. I assure you, the news is pretty good! The indication is that the tumors are now nothing more than scar tissue-filled lymph nodes, which will often show normal on a PET scan but still be visible on the adjoining CAT scan. Scar tissue is oftentimes more dense than normal tissue, so it is more visible on CAT scans. Due to the normal uptake of the glucose, there is a great chance that the cancer has been eliminated. The spot on the right side of my neck is most likely damage from radiation, and the spot on my lung is related to an incident of severe pneumonia I had back in 1989. The largest tumor started out at 1" in size, it is now less than ²/₃ of an inch, so the treatments have had a definite effect.

I am to get in to see the E, N and T doctor, Dr. S, sometime next week, and he will make a determination whether to operate and remove the nodes, or if they think waiting it out and seeing if they reduce even more is an option. Either way, as of now there will be no more radiation or chemotherapy. The plan in the beginning was to try to reduce the size of the tumors, and if they are not completely gone, then at least surgery to eliminate them will be considerably less invasive.

I have also lost more weight, I am down to 210 lbs. As a friend of mine said today, this was both a blessing and a curse. I now, officially, have no pants that fit. A visit to JCPenney's is in order!

Radioactive Man: An Addendum

While I was getting radiation treatments, a number of people asked if I was still radioactive after the treatments.

No. I don't glow in the dark, either, though it would be cool if I did!

There are quite a few different methods of radiation treatment. The most common and typical treatment, which I underwent, is x-ray therapy. This involves a machine, not unlike an overgrown x-ray machine, that shoots x-rays at you. These are, of course, hundreds of times more powerful than what is used to generate an x-ray image. Similar to this is a treatment called HDR, or High-Dose Radiation. This is similar to what happens in the typical radiation therapy, excepct it is even stronger. These machines are computer controlled and can deliver a precise dosage of radiation to specific areas in three dimensions.

Another type of treatment is the implantation of radioactive seeds around the affected area. They insert little tubular reservoirs down to the affected location, then drop in the seeds...oftentimes particles of material suspended in a liquid...for a predetermined amount of time. This type of therapy allows a higher dose of radiation in a shorter amount of time. This is generally used in areas that need more localized treatments, such as prostate cancer.

X-rays are, essentially, photons...radio waves...electromagnetic radiation just like light. Think of it as a microwave oven, just much stronger, more specifically directed and of a much higher frequency. Any form of electromagnetic energy can cause problems to a body, just ask any ham radio operator that has gotten an "RF Burn"...they'll tell you right quick.

For interests sake, it is important to know that microwave ovens operate in the 2.4 GHz band. This is because water molecules oscillate at 2.4 GHz...thus causing heating. Other items in this area: cordless phones and 802.11b, g and n wireless network devices. This is one reason that the FCC has limits on the field strength of both licensed and Part 15 unlicensed transmitters in this frequency range. Your wi-fi could be cooking you! Not really, though...the power is so low that it wouldn't really affect anything. Now the internet flowing through the wi-fi just might kill you, however.

You may have heard in the news about people being exposed to antennas or something similar and being hurt or killed. I seem to remember hearing a story a while back about a security guard that worked somewhere where there was a microwave transmitter...like a telecommunications microwave link tower or TV station link. This dingleberry found out that they could stay warm if they stood in front of the antenna. Of course, this is true, it will keep you warm...you stay warm because it is cooking you like a morning bowl of oatmeal! They supposedly found him dead on the ground, and exploded beer cans next to the antenna. This may be an urban legend, but could happen. It is not just the frequency that can determine the safety of a generated signal, but the power of the transmitter and the distance to the antenna and type of antenna. This is why the FCC has, and enforces quite severely, rules pertaining to radiation exposure from transmitter antennas...both licensed and unlicensed.

Interestingly enough, my engineer friend McA has a complete set of 6 GHz radios from an AT&T microwave relay station that was upgraded. Now tell me he's not planning something...

With regular radiation therapy, there is no residual radioactivity. Once the beam is turned off, the radiation is completely gone, just like turning off a light switch. Other than the side effects that develop over time, no one would be the wiser that you were getting any treatment at all.

With therapy using radioactive seeds, these are highly radioactive materials and they stay radioactive. If the seed materials are not handled properly, there could be radioactive particles left to float around in the facility where the treatment happens. Of course, any radiation technician that is good will take all required and necessary precautions.

So, don't be afraid of anyone getting radiation therapy. They won't radiate you, they won't fog your film, they won't erase your credit cards, they won't mess up your TV...

Now, someone that just had a PET scan...yes, they are radioactive for a short time after the treatment, usually about 18-24 hours. The radioactive materials are not dangerous, and are eliminated quickly through pee-pee. The radioactive materials are such a low level emitter that only really sensitive detectors would know, like the ones at a nuclear power plant or a nuclear-materials-enrichment facility. If you didn't have a "get out of jail free" card, like in my last post, they would go all Silkwood on your ass.

There is a very slim chance, however, that they could fog camera film. I came across a website about a guy that experiments with a variety of low-emission radioactive sources to make "x-rays" using Polaroid film. One of his subjects was a person that had a cardio stress-test, and this poor guniea pig walked around with a Polaroid film cartridge strapped to him for hours. It was all in the name of science, after all. You can read more about this here: http://www.omnimatter.com/2007/12/making-your-own.html. This is pretty cool stuff. Just be careful with anything radioactive, otherwise you may just need that stuff to give yourself some do-it-yourself cancer treatments!

Here is a tip from an amateur photographer who still loves film, and used to manage a photo lab. When traveling, use a lead lined bag to hold your film. In the US, the x-ray machines are pretty powerful, but won't really hurt any film lower than 800 speed. In foreign airports, the x-ray machines can be much, much "hotter" and can ruin film as low as 200 speed. I had a relatively expensive roll of Kodak T-Max P3200 black-and-white film completely fogged by the newer x-ray machines at the Dayton airport. Specialty films, like black-and-white and infrared-sensitive films, can be especially sensitive.

So there.

Radioactive Man

I just now got back from my post-treatment PET scan. This one seemed to go faster than the last one, which was very nice.

My appointment was this morning (January 8, 2008) at Miami Valley Hospital, our premier humongous hospital just outside downtown Dayton. My office is about 1/2 mile from here. There is always a lot of activity around the hospital, not necessarily medical-wise...but construction-wise. There is always something under construction here.

Fig. 1: Main Hospital Entry Courtyard

They have a pretty good system to get people registered for outpatient procedures. You go to a central registration area and get a pager. Then, when your pager goes off, you are sent to one of fourteen private niches to get your information taken. Then the registrar directs you to where you need to go.

After registering, I made my way to the Medical Imaging department.

Fig. 2: Orders and ID stickers.

Before the PET scan, they install an IV so they can administer the radioactive glucose. The syringe is a typical plastic syringe, but it is jacketed in a thick, heavy lead liner.

Fig. 3: Nuclear medicine at work.

After getting the radioactive injection, you are left in a comfy recliner for nearly an hour to rest in a darkened room. This is to allow the glucose to spread throughout the body. The idea is that since cancer cells take up sugars quite rapidly, they will take in the radioactive materials. The PET scanner detects the particle emissions of the radioactive material. The greater the concentration of radioactive particles, the more likely the area is cancerous.

This stuff is seriously radioactive. On the way out to where the PET scanner is located, there is a Geiger counter on a little shelf with a sign that instructs employees to check themselves to make sure they aren't "hot". As I passed by, the little machine went bananas.

Fig. 4: The GE Discovery PET/CT Scanner

You lay on a long table, and have a CT scan first. The front 2/3 of the scanner is the CT scanner. The CT spins around an takes x-ray images of thin slices of the body. This gives information as to what is where. The CT takes only about a minute or two.

The PET scan take a lot longer. Strapped down to the same table, you stay aligned just as with the CT scan, then pass through the rear 1/3 of the donut. The PET scan I had today took about 40 minutes. This is because it takes a while for the detectors to receive enough particles. During all of this, you have to remain still. Because they wanted to make absolutely sure of everything, they had to do an additional precision "neck study", which is a slower CT scan to get clearer, more detailed images, then another 20 minutes in the PET scanner.

The scans are then sent to a radiologist that scrutinizes everything. The PET scan is overlaid on the CT scan, so the actual locations of any tumors can be discovered. They will then submit a report to my oncologist.

The hospital's PET scanner is in a trailer outside the hospital, so you have to pass through a tunnel to get there. The machine costs about $1.2 million. I suspect that since the machine is in a trailer, the bank can come and get it real easy if they miss a payment.

Fig. 5a: The front of the "Get Out of Jail Free" card.

Once the procedure is complete, they give you a little card that tells that you received a medical dose of radiation. If I were to go to an airport, the air force base or a Department of Energy facility today (none of which are likely), then I would set off every alarm they have. Without the card they would ship me off straight away to Guantanamo Bay, where I would never be seen or heard from again.

Fig. 5b: The back of the "Get Out of Jail Free" card.

The text in the box on the lower half states:

Michael received a medical dose of radioactive material (18FDG) on 1-8-08. This person poses no risk to the public. The release of this patient is allowed by the U.S. Nuclear Regulatory Commission and meets the required regulations of the State of Ohio. If you have questions, call the Nuclear Medicine Department at (937) 208-2220. This card expires 1-9-08.

The radioactive material will be gone by the morning.

18FDG is actually, in scientific jargon, 2-deoxy-2-[¹⁸F]-fluoro-D-glucose. Originally developed in the '70s for brain imaging, but discovered to be useful in detection of cancerous cells in the '80s, leading to PET scans being the norm for many cancer patients.

Brookhaven National Laboratory has a short article about "FDG" at http://www.bnl.gov/pet/FDG.htm.
Harvard Medical has a great website that outlined pretty much everything about the PET/CT procedure, located at http://www.med.harvard.edu/JPNM/chetan/.

The radiology techs were amused that I took pictures of everything. They had never had anyone do that before. They were all very nice and friendly, as per usual. The first PET scan I had, I did not know what to expect, and they all made me feel quite at ease. This go around I knew what was going on, so I wasn't apprehensive or nervous and could be a great deal more chatty.

So, I will get the results late next week at my next oncology appointment!

Huge Television

I am such a ridiculously lazy person. It is pretty disgusting, actually.

I initially had my beloved great big TV in my living room, because that is supposed to be the central locus of the typical home. In the living room, one is supposed to entertain visitors and generally use it to relax. The bedroom is supposed to be used to sleep, period.

Many people argue that the bedroom is for sleeping only. You are not, under any circumstances supposed to have a TV or other entertainment devices in your bedroom since it can interfere with sleep patterns.

Bah, I say.

Last night, I retired my old, little 13" analogue Sony TV from my bedroom and moved my beloved 40" Sony LCD digital TV in. Now, 40" is not that big of a TV, really...there are many, many larger TVs...Panasonic has a 103" set for goodness sake. I never realized how big this TV was. It takes up nearly my whole dresser. I got rid of my old home theatre receiver and tiny little speakers that flanked the miniscule 13" TV and only connected up my satellite receiver and old DVD player. The speakers built in to the big TV actually sound great, and the picture is superb.

Fig. 1: Huge TV

I love my big TV, and now I will enjoy it more. I am considering removing all the stuff from my living room (my good, fairly new home theatre receiver, my satellite DVR and good DVD player) and putting it all in my bedroom. I would mount the TV to the wall opposite my bed, and I would just have to get some little speakers, like the Bose Acoustimass 16s or similar, to enhance the experience. There isn't really room for the big speakers I have in the living room in my bedroom, since my bedroom is rather small. Just do I want to spend the money? Not really, but I might, I just haven't decided yet.

In the winter I rarely use the dining room or living room because they stay rather cold. My bedroom stays toasty and comfortable, so I spend most of the time in my bedroom. Not to mention that I would rather lie down and watch TV than sit up on the couch.

My goodness I am lazy.

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Cancer Update

My afternoon snack consists of two tabs of Ibuprofen and two Vicodin. Yum.

Fig. 2: Pills (Left: Ibuprofen, Right: Vicodin)

It does help, really, my severe jaw pain. My oncologist, Dr. M1, prescribed an anti-inflammatory arthritis medication that I have to take regularly to try to take care of my jaw pain once and for all. Its side effect is overproduction of acid, so I have to take Zantac as well.

[sarcasm] Oh, I just love being sick! [/sarcasm]

My weight is now steady at 220 lbs., and Dr. M1 is still pleased with his skill at being a radiation oncologist. The remaining scar tissue in my mouth is slowly going away, though I still have problems with my tongue. Other than the dry mouth, tongue sensitivity and jaw, I feel great!

I should be hearing any day now about when my PET scan is scheduled for, so I will update everyone once I get the results!

Jerk

I was a jerk this morning.

I left work to go to speech therapy. My speech therapist is a very nice, younger lady whom we will call "J". I pulled into the parking lot behind the doctor's offices (same building as my E, N & T doctor, Dr. S) and tried to maneuver into a parking space that was close. There was one that I wanted, but I was not in a good position to pull into it. I drive a full-size car, so maneuverability in tight areas can be tough.

I went further into the lot, pulled in, backed out and went to the space I wanted. I pulled as far to the left as I could so I could turn into the space easily. Another driver entered the parking lot and pulled up pretty much nose-to-nose with my car, obviously wanting by...on the proper side.

I made a somewhat rude gesture, as if to say "Can't you see I am trying to get into this space?!" I managed to get into the space awkwardly, and had to back in and out a few times to straighten up. Had the person backed up, went around on the right (there was plenty of space) or just plain not been there, I could have pulled in just fine. I mumbled a few "choice" words under my breath about the other driver, and went on my way.

On the way across the parking lot, the lady driver from the offending car spoke to me, and said "Good morning!" I said "Good morning!" back as pleasantly as I could and smiled at her.

I didn't realize until I got to the elevators that the lady was none other than MY SPEECH THERAPIST! Now I really felt like a prick; she is one of the nicest people I have ever met. She has such a disarming quality about her personality. And she has the prettiest green eyes, almost a yellow-green.

I did not want to go to my appointment, because I didn't want to face her. I was afraid of the possibility of confrontation, which is new and different, too. I did go to my appointment, and it was ok, no problems and no mention of anything that happened in the parking lot.

I may have explained it to her, in not so many words, that my jaw has been hurting me quite a bit lately. Every time I move my jaw, a sharp pain jolts from my cheek up to my ear. Quite painful, actually. On the way to work this morning, I sneezed and nearly lost control of my car because of the severe pain.

One thing that I have noticed since the cancer is that I have mellowed out. Back in the day (cliche, no?) I would have just stopped my car and flipped the bird and maybe even kick the door of the offending car in and start a fight or something. I used to be in a perpetual bad mood, but now I don't really talk out loud to other drivers as I am driving along or make commentary on how stupid every other driver is. You know how it is, you are driving along and another driver does something stupid and you holler to no one in particular a few choice words. I find that I don't really think bad thoughts about other drivers, or other people, anymore either.

I am coming to think that getting cancer may be a blessing in disguise. I don't need any more blessings like that, thank you very much! I would like less painful, less invasive blessings, if you please.

Update: I am now 227 lbs., loss of 71 lbs. so far.

Friends and Family

As an addendum to my previous posts, I neglected to state the importance of my friends and family. I am not sure how I would have survived if it was not for them thinking about me and looking after me. I know this sounds sappy, blah, blah, blah. But, it is true. I did not leave the house except for medical appointments (and work in the early days) for about three months total.

It is, unfortunately, typical for cancer patients undergoing treatment to shun visitors. We are tired and fatigued and all we would want to do is sleep. Even the desire to watch TV...for a TV addict like myself...was gone.

My mom and dad were especially important. Mom, incessantly demanding and pleading that I eat, was a blessing. We have been through so much together over the years, I could not normally survive without her. Some would say I am a momma's boy, and they would be right! This is why I moved into "This Old Crack House" next door. More on this in a future blog entry.

My dad, the best dad in the entire universe, told me recently that he was so proud of me. He said that I took my disease in stride...that I took it like a man. That comment from him made me feel so good, I could not tell because I didn't have the words. He has told me similar things, like after graduating from high school and college and other events throughout my life, but this seemed to have special meaning.

It is helpful when you are going through a problem...any problem...that you have a kindred spirit to help guide you. My friend Beverly, a nurse at the nursing home where my mom works, was a cancer patient also. She guided me through some of the toughest times and made herself available to me whenever I needed it. I didn't call her, but a number of times I should have. Of more importance, she served as a counselor to my mother, helping her though this time and telling her what to expect. She, thankfully, is now cancer free.

I also have to mention my boss, Hank, who donated some of his ETO time to me so I could enter into EPI for the 6 weeks off. He actually recommended that I take time off, bless him!

And thanks to my friend Chris, with whom I work, for taking a lot of the load off of me during my illness. He bears the brunt of many of the issues people have at work, but he suffered doubly so during the time I was gone.

But I have to admit one thing...there is a certain truth that we have learned at my company. If one of us is gone, any of us, nothing happens. Nothing. There are no major problems whatsoever. My boss has gone on vacation, no problems. Chris takes off a day, no problems. I was off for 6 weeks, no problems. That is to say no MAJOR problems like servers dying, computers exploding, etc. It is a nice feeling, really!

And to the many people out there that were thinking of me and praying for me, thank you so much. It really helped.

Cancer, Part 3

The aftermath...

Yes, I am done with my treatments and I have gone back to work. I still have a few lingering problems, though. I have no appetite still, and my tongue is very painful. I cannot eat bread or anything heavy like that, lest it become stuck in my throat.

I've been living on macaroni and cheese, and other assorted pasta-and-cream-sauce dishes as these go down the easiest. My mother constantly pesters me to eat more, but I cannot. Though I am eating more than I did during treatments, I am still losing a little bit.

My skin has healed, and the acne is gone. I still have a lot of fatigue, but I am able to put in a full day at work as long as I take it easy. It was not easy to be off for those six weeks, I began to go stir crazy. You can only watch so much daytime television before you become insane.

It was surprising when the bills started coming in. The company I work for has great insurance, thankfully. Lots of people at work bitch and moan about the piddly amount we have to pay on our checks for insurance. Every two weeks, we pay something like $17 for a single. This is not much considering that insurance rates constantly increase. Our company has to pay over $5 million dollars per year for insurance premiums to cover all the employees.

I received the bill for the radiation treatments. Each treatment cost $1,291. The total was $38,400 for the radiation alone. I have yet to receive the bill for the chemotherapy, but Dr. M2 stated that the seven doses I took would cost about $40,000. The total I had to pay for everything, with copays and prescriptions and the like, was about $150.

This was, I think, the most shocking part. I knew that it would be expensive, but my goodness. How can someone without insurance handle this? This shows the state of health care in this country. The doctors have to charge so much because insurance companies only pay a fraction for the services rendered. Doctors have to make a living, too. And don't start about the obvious well-to-do nature of most doctors. They invariably have lots of patients, so they are bound to make good money...and they should.

People say that the answer is to offer socialized medicine like in Canada. That is a good idea, in theory. If you go to Canada and see how things operate, you'll discover that it is not very good in practice. People wanting surgeries now are coming to the US and paying our exorbitant prices.

And don't get me started on Medicaid and Medicare.

Cancer, Part 2

If you have stayed with me so far, then you should be up to speed...so I shall continue...

I had my first appointment with Dr. M1. He examined me and looked at all the data and recommended radiation therapy daily for about eight and a half weeks. I didn't know what this entailed, but then he explained it. They will be using some advanced medical systems that are fully computerized to direct the radiation to the specific areas needed to prevent damage to other areas that do not need to be treated.

There are side effects, however. Severe sunburn. Fatigue. Lethargy. The radiation would probably kill one or more of my salivary glands, or at least damage them, causing thick and nasty saliva. My throat would become raw from the radiation. I might lose my hair in select areas.

I'm here to tell you, they aren't kidding.

I went to an appointment with the medical oncologist, Dr. M2. We spoke of the chemotherapy regimen that I was to take. He decided to put me on a new drug that is approved for head and neck cancers called Erbitux. This is a different form of chemo in that it is a drug rather than chemical. You see, with traditional chemotherapy, they load you up with poisons that will hopefully kill the cancer before it kills you. The side effects were that I would get acne. Severe acne. But I won't lose my hair. I immediately said OK, and got on the schedule. I would be taking one dose every Friday afternoon for seven weeks.

One thing that Dr. M2 told me that I found really interesting was that this drug, Erbitux, is what got Martha Stewart in trouble. You may remember back a few years ago, Martha was sent to jail for insider trading of her ImClone stock. Apparently Erbitux had not gotten FDA approval for treatment of something, and she found out and sold her ImClone stock before it took a dive.

My first appointment with Dr. M1 was to get pictures, x-rays and a CAT scan so they could program the computers for proper targeting of the radiation. This entailed fitting me for the mask. What a weird experience that was! They laid me down on a moving table, the same they use for the CAT scan, on a special backboard. In a heated unit, they pulled out a plastic mesh board which they placed directly over my face and attached it to the backboard. It molded to my face and hardened in an instant. This mask would be used in the radiation to make sure everything was aligned properly. They used lasers built in to the walls and ceiling to set the targeting.

So, thus began the adventure. I would go to the office and they would put me on a backboard and attach the mask. It was a little bit disconcerting for the first few times, I felt trapped. But, the device that delivered the radiation was not enclosed like a CAT scanner or MRI, but it was large. It would go around me 360 degrees, stopping occasionally and whirring and buzzing. In about 10 minutes, it was done.

I thought that I strong enough to work through this ordeal, and I did for a while. I would steal away in the early afternoon and go to treatment and come back and finish working. This worked out great for a while.

Then the side effects caught up to me. I fell asleep at work quite often. My friend, Chris, who works at the same company I do (what would I do without him) would cover for me with phone calls and such to take the load off. My boss, Hank, suggested that I take leave, but I thought that I could make it. As time went on, and I started taking heavier and heavier drugs. I decided to take Hank upon his offer.

I did not have enough ETO, or Employee Time Off, to cover the five days before the EPI, or Extended Personal Illness, would kick in. I had almost 400 hours of EPI available. Thankfully, Hank donated me about 27 hours of ETO to get me to the EPI stage. I decided to take off six weeks and Dr. M1 agreed. So, I gathered up my work laptop, so I could keep in touch and monitor some of the projects that were going, and went on leave.

On the first day, my mother insisted that I move back in to her house. I could sleep in the spare bedroom. I would not have my little house, my little sanctuary. It was comfortable, though, and reminded me of the years that I lived there. I still had satellite TV and my iPod, and I could still go wherever I wanted...as if I really cared to.

My throat was raw. My skin was going to break down, and it did. I had severe sunburn symptoms on my neck and face. My throat was raw and I could barely swallow. I could hardly open my mouth. I was constantly tired. The acne was starting to take hold pretty badly...my dad called me a little spotted pup. Hardy, har, har!

I was put on a number of drugs, including an opiate-based pain patch which worked quite well. I was also taking copious amounts of Vicodin for acute pain relief. I felt like House. Cancer patients are in the catbird seat where good drugs are concerned...they will pretty much give you anything you want.

When I started this ordeal, I was 298 pounds. I was definitely not a little guy. Since I had no appetite at all, and I could not taste anything due to damage on my tongue from the radiation, and when I did try to eat it was excruciatingly painful and I usually threw up everything, I started to lose weight rather quickly. Dr. M1 demanded that I have a feeding tube installed into my stomach. After reading about it online and discussing it with my mother, I said "Hell, no!" Dr. M1 was not happy at all, but there was nothing that he could do.

Dr. M2 was less shocked about my weight loss. He said since I was big to start with, and healthy, that it was less of a problem to lose weigh quickly. He said, specifically, "if you weighed 74 pounds soaking wet, then we would have to take measures."

I am now down to 230 pounds. This is a weight loss program that I would not recommend.

Cancer, Part 1

A few months ago I was diagnosed with cancer.

Imagine you are a guy (or girl) sitting at work and getting a call from a doctor saying that they have found cancer in a biopsy. What would you initial reaction be? I just sat in the "pink chair" in stunned silence. I didn't know how to react, since I had never been truly sick before. I called my boss and told him the story and he sent me off for the day.

I did not know what to do next. So, I drove to where my mom works, since I handle their computer network, and talked with her and caught up on some nagging issues with their system. Needless to say, she was devastated.

The whole reason I got cancer to begin with is, in itself, unusual. Years ago, my wisdom teeth had grown in, and I was going to have them removed. The problem was I had no insurance and didn't have the $750 to have it done. Mom said that she would pay, but I told her no, that I should pay. My wisdom teeth were not bothering me so I left them alone. Needless to say, big mistake.

Fast forward to 2007...I had a nagging sore in my mouth. One of my wisdom teeth had grown in crooked and I was literally chewing on my cheek. It was really bothering me, so I made an appointment with my dentist. He referred me to an oral surgeon, Dr. K. At the first appointment, he felt sorry for me and removed the offending tooth, and the remainder would be removed two weeks later.

At my next appointment, Dr. K was shocked. The lesion in my cheek had doubled in size. This concerned him, so he removed it and sent it off to a lab for checks. This is when I had gotten the call. It was cancer, but the margins were clear which is supposed to mean that they got it all. So, it may not be a problem but he referred me to an ear, nose and throat specialist, Dr. S, for follow-up.

At the follow-up appointment, Dr. S checked me out and got me signed up for a CAT scan, but determined that everything seems to be OK, for now. He recommended several follow-ups to make sure nothing was happening abnormal. At the next appointment, they told me that they discovered in the CAT scan three places in my neck and jaw that were suspect.

Dr. S sent me to a local hospital for a "ultrasound-guided needle biopsy" of a tumor in my neck. This, in and of itself, was an intriguing experience. I was able to watch the whole thing on the computer monitor...the same monitor that the doctor was using to direct the needle. He showed me where the tumor was and the needle as it collected cells in the tumor. Interestingly enough, this was a painless procedure. The most painless of the whole ordeal, to be sure.

The results were returned. It was indeed cancer. So, Dr. S referred me to a radiation oncologist, Dr. M1, as well as a medical oncologist, Dr. M2.

Needless to say, mom is hysterical. I, on the other hand, seem to be calm, cool and collected. I decided to go into this thinking that it is an interesting and unique experience. I have to say, that it was and still is interesting. I never knew how high tech the medical community was for cancer care. I was, however, unprepared for the things to come.