Yoko and I met with Dr. Lunin today to discuss what the next steps should be with respect to treatment. I will give you the bottom line and then tell you how we arrived at this conclusion.
We are going to continue the chemo using a drug called vinorelbine together with cisplatin. (I could never be a doctor as I can not pronounce the names of half the drugs on the market... ) The consolidation treatment is going to go for 16 weeks. We plan to follow the regiment of a study that was published in the New England Journal of Medicine in the June 23, 2005 edition. If you want to read the details: http://content.nejm.org/content/vol352/issue25/index.shtml or let me know and I will e-mail you the article as a pdf file.
We will start the new regiment on Friday, February 15th and continue every Friday until May 30th. According to Dr. Lunin, the biggest side effect from the new drug regiment will be nuropathy (loss of feeling) in the extremities, which happens in about half the cases. The longer the chemo goes on, the more likely it is that I will experience some nuropathy. Other than that, as far as side effects, we would not expect that this course of treatment would be much different than the initial round. That is good news because it means that I should be able to continue on without any obvious outward signs that I am being treated for cancer. I should be able to keep working, doing seminars, etc. as long as the status quo remains and that was one of my goals. (As long as I can tie my shoes, button my shirts, etc. we would continue treatment. Nuropathy would be expected to come on slowly and only become noticeable as time goes on. Anyway, it would be something we would be looking for.)
Now how did Dr. Lunin arrive at recommending this course of treatment? Well, I think Scott would be the first to say that we are in un-chartered waters. The fact of the matter is no one knows what will work for someone like me. In fact, we can't even say with certainty what caused my tumor to shrink...the radiation, the cisplatin/taxol regiment, or the two modalities in combination. In fact, from what I have gathered so far, it appears to me the treatments being used on lung cancer patients today have developed on a hit or miss basis (i.e. constantly trying different things to see what works). So, having said that, one could argue that there is no "right" answer and there is no "wrong" answer regarding the treatment regiment following definitive chemo radiation.
Here's what we do know. If I do nothing, it is very likely that I will, sooner or later, see a recurrence. How likely? Perhaps a 70% or 80% chance. f I do have a recurrence, I am not likely to survive it. Another way of saying it is I could do nothing and have a 20 - 30% chance of never see any cancer again....in fact my cancer may already be dead and gone and any further treatment might be unnecessary. The sad fact is that there is no way to know that for sure. We have to assume there are still some live cells floating around in my system and that I am in danger of recurrence. The goal, therefore, is to kill these other remnant cells (or keep them from reproducing) where ever they may be lingering using a systemic treatment.
We think the cisplatin/taxol doublet worked to kill my tumor, so why not just do more of the same at even higher dosages? The issue here is that my body can only take so much toxins before I begin to develop problems and too much exposure to the same chemical may make the cancer resistant; we might want to keep some of this ammunition dry for another fight down the road.
Scott's thinking in making the recommendation is why not treat me as though I had surgery to successfully remove the tumor? If you read the New England Journal Article, you will see that the regiment he proposes was tested on a population of early stage non-small cell lung cancer patients who had their tumors completely resected -- that is to say, the drug combination was tested on patients who had surgery to remove the cancer. There were a total of 482 patients in the study. On a random basis, half the patients were selected to receive the treatment and half did not. The median age of the patients in the study was 61 and the performance status (general health) was 0 or 1. (My performance rating is zero; i.e. general good health.)
What the study found was that overall survival was prolonged in the chemotherapy group in comparison to the observation group by about 20 months (94 vs. 73 months). Five year survival rates for patients with surgery and then the chemo regiment was 69%. The study found that vinorelbine plus cisplatin has an acceptable level of toxicity and prolonged disease free and and overall survival rates.
These statistics are significantly better than what I have been reading about tarceva and other consolidation drugs, where the "extended survival" was only one or two months -- hardly worth the trouble. Of course, we can't know exactly the role vinorelbine/cisplatin play in overall survival compared to surgery alone, but clearly it had a positive impact with relatively little downside. I think Scott's suggested course is about as elegant a solution as you are going to find in the circumstances.
Vinorelbine apparently interferes with cancer cell division; no one knows exactly why cisplatin works, but it seems to interfere with the DNA of cancer and causes the cells to die. So, I guess if you can kill whatever living cells are still in my system and keep these cells from reproducing, you are going to be better off. At least that is the hope.
There is a lot more to talk about...unfortunately, as usual, I am out of time. Tomorrow I have Rotary in the morning and a seminar in the evening. Maybe if I get back early enough from the seminar I can make another contribution.
Tuesday, January 29, 2008
Monday, January 28, 2008
Surgical Strike Out
We had a fitful night of sleep last night, so neither Yoko nor I were well rested when we set off for The Moffitt Cancer Center at 6:50 this morning. Our appointment was for 9 AM and we were required to check in by 8:30. We got to the place just on time.
Unlike our last trip up to Moffitt, we were in and out quickly. We met with Lary Robinson, who reviewed my most recent CT and Pet Scans with us, comparing these with the scans done in October. The conclusion, as I expected, is that, despite the tumor shrinkage, surgery is still NOT possible. Dr Robinson explained that the tumor goes from the right lung into the central chest and almost extends into the left lung. He said I was classified as Stage IIIA. However I would be Stage IIIB if the tumor went only a little further and entered my left lung as well.
The radiation and chemo have done as good a job shrinking the tumor as could be expected. In fact, the lung tumor by itself could be removed, but the part of the tumor involving a central chest lymph node can not be removed, making surgery altogether useless. The good news is that the shrinkage in my central chest relieved the superior vena cava, which was being closed off and might have done considerable damage. Robinson believes that consolidation chemo is the best course of treatment going forward and is currently my best chance for a cure.
Robinson explained that the removal of the right lung, if it could it be done, has a 30% mortality rate. I asked why the mortality rate was so high and the explanation I received is that the operation requires pinching off the bronchial tubes. In many cases, post-operative complications arise because radiated bronchial tubes do no heal well and a bronchial fistula (leakage) develops.
Actually, I spent a good part of the day yesterday researching and reading about the proposed procedure and the more I read, the more apprehensive I became -- ergo my sleeplessness. Besides the 30% chance of dying from the operation and loosing a lung, there would also be the possibility of loosing your voice entirely, having a heart attack or having other coronary problems. The procedure is also a very painful requiring a long (2 - 3 month) recovery period and there is no guarantee that you would enjoy a good quality of life following such a procedure. (Frankly, I am more afraid of pain and becoming disabled than I am of dying!)
There is also the possibility that the surgeon would get in there, decide it could not be done after all, and simply close me up. This would be the worst of all worlds because I would still suffer all the pain of the surgery with none of the benefits and have to go through all the recovery and rehab while at the same time postponing consolidation chemo! All in all, while having surgery might statistically give me the best long-term prospects, I feel confident we can beat the cancer without it. In fact, Dr. Robinson said I am just the kind of patient (young and healthy with good initial response) that is cured.
I asked Dr Robinson what kind of chemo he thought I should do. He did not have an opinion, but he spoke with a medical oncologist (Dr Williams) at Moffitt about my case and Dr Williams seemed to think that, given my good performance status (i.e. general good health) more of the same (taxol and cisplatin doublet) at double the dosages (400 mg) might be in order for the consolidation phase.
On our way home from Moffitt, Scott Lunin called to see what Lary had to say and I relayed all the above. Yoko and I will meet with Scott tomorrow to decide on the next steps. Scott has been thinking about what the treatment should be. He pointed out in our phone conversation that we don't know what treatment modality has had the positive effect on the tumor -- was it the radiation, the chemo, or the combination of both? There are different schools of thought on what the next step should be; some people advocate changing the chemicals used; others would argue for more of the same -- emptying both barrels, so to speak, on the cancer.
Emotionally I like the "empty both barrels" approach. The problem is that we have to fight this the cancer like a chess game -- thinking several moves ahead and not just making the emotionally satisfying decision. Scott points out that we should consider what our options will be if the cancer pops-up elsewhere down the road. If we use all our ammunition now Cisplatin/Taxol) there is the possibility that we won't be able to use it later (because of toxicity) or it won't be as effective (because the surviving cancer cells have adapted). This might lessen the chances of fighting future cancer. (On the other hand, if we unload on it now and kill every remaining cell, there would be less of a chance of tumors returning.) I would also argue that "other chemicals" (keep the cancer guessing approach) would always be there as a "Plan B."
Anyway, after tomorrow we will decide what the next steps should be. Scott is an excellent doctor and I am an excellent patient. Together we will figure out the best way forward. In the meantime, Yoko and I are planning our June trip to California for Paula's wedding and a September cruise in the Mediterranean. My plan is to be cancer free by April.
Unlike our last trip up to Moffitt, we were in and out quickly. We met with Lary Robinson, who reviewed my most recent CT and Pet Scans with us, comparing these with the scans done in October. The conclusion, as I expected, is that, despite the tumor shrinkage, surgery is still NOT possible. Dr Robinson explained that the tumor goes from the right lung into the central chest and almost extends into the left lung. He said I was classified as Stage IIIA. However I would be Stage IIIB if the tumor went only a little further and entered my left lung as well.
The radiation and chemo have done as good a job shrinking the tumor as could be expected. In fact, the lung tumor by itself could be removed, but the part of the tumor involving a central chest lymph node can not be removed, making surgery altogether useless. The good news is that the shrinkage in my central chest relieved the superior vena cava, which was being closed off and might have done considerable damage. Robinson believes that consolidation chemo is the best course of treatment going forward and is currently my best chance for a cure.
Robinson explained that the removal of the right lung, if it could it be done, has a 30% mortality rate. I asked why the mortality rate was so high and the explanation I received is that the operation requires pinching off the bronchial tubes. In many cases, post-operative complications arise because radiated bronchial tubes do no heal well and a bronchial fistula (leakage) develops.
Actually, I spent a good part of the day yesterday researching and reading about the proposed procedure and the more I read, the more apprehensive I became -- ergo my sleeplessness. Besides the 30% chance of dying from the operation and loosing a lung, there would also be the possibility of loosing your voice entirely, having a heart attack or having other coronary problems. The procedure is also a very painful requiring a long (2 - 3 month) recovery period and there is no guarantee that you would enjoy a good quality of life following such a procedure. (Frankly, I am more afraid of pain and becoming disabled than I am of dying!)
There is also the possibility that the surgeon would get in there, decide it could not be done after all, and simply close me up. This would be the worst of all worlds because I would still suffer all the pain of the surgery with none of the benefits and have to go through all the recovery and rehab while at the same time postponing consolidation chemo! All in all, while having surgery might statistically give me the best long-term prospects, I feel confident we can beat the cancer without it. In fact, Dr. Robinson said I am just the kind of patient (young and healthy with good initial response) that is cured.
I asked Dr Robinson what kind of chemo he thought I should do. He did not have an opinion, but he spoke with a medical oncologist (Dr Williams) at Moffitt about my case and Dr Williams seemed to think that, given my good performance status (i.e. general good health) more of the same (taxol and cisplatin doublet) at double the dosages (400 mg) might be in order for the consolidation phase.
On our way home from Moffitt, Scott Lunin called to see what Lary had to say and I relayed all the above. Yoko and I will meet with Scott tomorrow to decide on the next steps. Scott has been thinking about what the treatment should be. He pointed out in our phone conversation that we don't know what treatment modality has had the positive effect on the tumor -- was it the radiation, the chemo, or the combination of both? There are different schools of thought on what the next step should be; some people advocate changing the chemicals used; others would argue for more of the same -- emptying both barrels, so to speak, on the cancer.
Emotionally I like the "empty both barrels" approach. The problem is that we have to fight this the cancer like a chess game -- thinking several moves ahead and not just making the emotionally satisfying decision. Scott points out that we should consider what our options will be if the cancer pops-up elsewhere down the road. If we use all our ammunition now Cisplatin/Taxol) there is the possibility that we won't be able to use it later (because of toxicity) or it won't be as effective (because the surviving cancer cells have adapted). This might lessen the chances of fighting future cancer. (On the other hand, if we unload on it now and kill every remaining cell, there would be less of a chance of tumors returning.) I would also argue that "other chemicals" (keep the cancer guessing approach) would always be there as a "Plan B."
Anyway, after tomorrow we will decide what the next steps should be. Scott is an excellent doctor and I am an excellent patient. Together we will figure out the best way forward. In the meantime, Yoko and I are planning our June trip to California for Paula's wedding and a September cruise in the Mediterranean. My plan is to be cancer free by April.
Friday, January 25, 2008
Happy Endings
I don't have time to write anything of length. I just wanted to let you know that I received word today that the MRI did NOT turn up any more cancer. I was concerned that if I have a metastases in the liver, lung surgery would definitely be off the table. I think that Dr Robinson will probably come back and say that his original view (that surgery is not possible) is still the same. We are scheduled to meet with Lary on Monday morning at 8:30 AM at Moffitt. If he thinks surgery may be possible, they will take my case to the "Tumor Board" at Moffitt where all the experts weigh in with their opinion(s). I should have an answer on surgery no later than Wednesday of next week.
This surgery, should it happen, is a big deal and kind of scary to think about. I am reading about it and the more I read the more apprehensive I become. I said to Yoko last night that it would be like jumping out of a plane -- scary to contemplate, but if you close your eyes and step into the air, there is no going back!
Anyway, the fact that there are no mets in the liver is the bit of good news I wanted to share.
This surgery, should it happen, is a big deal and kind of scary to think about. I am reading about it and the more I read the more apprehensive I become. I said to Yoko last night that it would be like jumping out of a plane -- scary to contemplate, but if you close your eyes and step into the air, there is no going back!
Anyway, the fact that there are no mets in the liver is the bit of good news I wanted to share.
Wednesday, January 23, 2008
The Poseidon Adventure
Do you remember the 1972 movie The Poseidon Adventure with Shelly Winters, Ernest Borgnine and Gene Hackman? If not, let me remind you of the storyline. A passenger cruiser transiting the ocean is suddenly capsized by a gigantic wave. Many of the passengers survive the initial trauma and then try to make their way to the surface in the upside down ship. Of course, most of the passengers tragically die in the process and there is unexpected trouble and disappointment along the way. The route to the surface is debated and different paths are chosen. Only a few ultimately survive, but we learn a lot about the character of each victim along the way.
It seems to me that my cancer experience thus far closely follows the storyline of the Poseidon Adventure. Yoko and I had just begun to enjoy our "cruise" toward retirement, looking forward to the next long and uneventful passage in our lives, when suddenly everything is turned upside down by my unexpected diagnosis of lung cancer. The diagnosis was like getting hit by a gigantic wave. After the initial shock and confusion, the panic subsided and we settled down to think more clearly. It is a crisis that tests our faith in God, but we have come to realize we are not in immediate danger of drowning and that we can manage our lives in an upside down ship for quite some time. Just as we began to get our bearings and make our way to the surface, there is another event and more turmoil and we are again having to face life and death decisions. Luckily, we have Scott Lunin, playing Gene Hackman's role as Reverend Frank Scott, the compassionate character guiding us to safety!
Why are you telling me all this? Well, I learned today from the Reverend Scott that the PET scan turned up something that is a potential hot spot on my liver. Lung surgery would be off the table if the cancer metastasises and shows up elsewhere. The "hot spot" the radiologist found may just be a remnant from the radiation (let's hope) but, Dr. Scott, in an abundance of caution, wants to do an MRI to find out for sure. So tomorrow I will have an MRI done. The radiologist will be able to get a better look at what we are dealing with; if in fact is is cancer, the course of treatment (our route to the surface) will have to change.
For me, making it to the surface would be a diagnosis that there is no evidence of disease. (i.e. the cancer is in remission.) That might happen after surgery or consolidation chemo; a metastasizing disease ("mets") will be roadblocks in getting there. It is part and partial to lung cancer and is to be expected. After all, the ship is upside down ...we have to expect a setback or two. I am confident the MRI will prove the spot to be nothing-- but we'll know one way or the other in short order.
I must tell you I feel very comforted to know so many people praying for me and if asked, would do anything to help. I have had any number of friends who know about this) stop by the office, come for lunch, invite Yoko and I out to dinner, etc. and offer words of encouragement and support.
Unfortunately, there is a sea of capsized ships out there; many lives are turned upside down. Unfortunately, many many people are not as lucky are we are. Millions of other people may one day get the diagnosis that I have today. How can they be helped?
There needs to be more awareness and funding for lung cancer research. People simply don't know about the devastating effect this disease is having on millions of Americans and their families. Did you know Suzanne Plechette (Bob Newhart's TV wife) died this week at age 70? Her death was publicly attributed to "respiratory failure", but the cause, in fact, was lung cancer. She is one of 163,000 people who will die from lung cancer this year. Think about the enormity of that number. That is the equivalent of a fully loaded jumbo jet crashing to the ground every day of the year, year after year, and not being reported anywhere in the news. There are more deaths from lung cancer than all other cancers combined and yet the Federal government spends next to nothing on research to fight the disease.
We need to change that to save lives. Lung cancer awareness must be increased and research aimed at early detection has got to be funded. Finding the disease at an early stage will be the key to survival for millions of Americans (both smokers and non-smokers) who have not (yet) contracted the disease. There is promising technology out there. Friends and family of victims are the ones who will have to carry the flag, since lung cancer victims themselves have their hands full trying to survive.
I will have more to say about this in future blogs, but e-mail me if you would like to help get the word out!
It seems to me that my cancer experience thus far closely follows the storyline of the Poseidon Adventure. Yoko and I had just begun to enjoy our "cruise" toward retirement, looking forward to the next long and uneventful passage in our lives, when suddenly everything is turned upside down by my unexpected diagnosis of lung cancer. The diagnosis was like getting hit by a gigantic wave. After the initial shock and confusion, the panic subsided and we settled down to think more clearly. It is a crisis that tests our faith in God, but we have come to realize we are not in immediate danger of drowning and that we can manage our lives in an upside down ship for quite some time. Just as we began to get our bearings and make our way to the surface, there is another event and more turmoil and we are again having to face life and death decisions. Luckily, we have Scott Lunin, playing Gene Hackman's role as Reverend Frank Scott, the compassionate character guiding us to safety!
Why are you telling me all this? Well, I learned today from the Reverend Scott that the PET scan turned up something that is a potential hot spot on my liver. Lung surgery would be off the table if the cancer metastasises and shows up elsewhere. The "hot spot" the radiologist found may just be a remnant from the radiation (let's hope) but, Dr. Scott, in an abundance of caution, wants to do an MRI to find out for sure. So tomorrow I will have an MRI done. The radiologist will be able to get a better look at what we are dealing with; if in fact is is cancer, the course of treatment (our route to the surface) will have to change.
For me, making it to the surface would be a diagnosis that there is no evidence of disease. (i.e. the cancer is in remission.) That might happen after surgery or consolidation chemo; a metastasizing disease ("mets") will be roadblocks in getting there. It is part and partial to lung cancer and is to be expected. After all, the ship is upside down ...we have to expect a setback or two. I am confident the MRI will prove the spot to be nothing-- but we'll know one way or the other in short order.
I must tell you I feel very comforted to know so many people praying for me and if asked, would do anything to help. I have had any number of friends who know about this) stop by the office, come for lunch, invite Yoko and I out to dinner, etc. and offer words of encouragement and support.
Unfortunately, there is a sea of capsized ships out there; many lives are turned upside down. Unfortunately, many many people are not as lucky are we are. Millions of other people may one day get the diagnosis that I have today. How can they be helped?
There needs to be more awareness and funding for lung cancer research. People simply don't know about the devastating effect this disease is having on millions of Americans and their families. Did you know Suzanne Plechette (Bob Newhart's TV wife) died this week at age 70? Her death was publicly attributed to "respiratory failure", but the cause, in fact, was lung cancer. She is one of 163,000 people who will die from lung cancer this year. Think about the enormity of that number. That is the equivalent of a fully loaded jumbo jet crashing to the ground every day of the year, year after year, and not being reported anywhere in the news. There are more deaths from lung cancer than all other cancers combined and yet the Federal government spends next to nothing on research to fight the disease.
We need to change that to save lives. Lung cancer awareness must be increased and research aimed at early detection has got to be funded. Finding the disease at an early stage will be the key to survival for millions of Americans (both smokers and non-smokers) who have not (yet) contracted the disease. There is promising technology out there. Friends and family of victims are the ones who will have to carry the flag, since lung cancer victims themselves have their hands full trying to survive.
I will have more to say about this in future blogs, but e-mail me if you would like to help get the word out!
Monday, January 21, 2008
To Cut or Not to Cut...That is the Question
I just returned from my appointment with Dr David Rice, who is the radiology-oncologist that has been treating me thus far. I brought the CT Scan and PET Scan photos with me to the appointment. Dave's view was pretty much the same as mine; that I had about as good a response to the treatment as one could hope. The question now is what comes next.
What I learned from Dave is that there appears to still be metabolic activity within the primary tumor, but thus far it does not appear that the cancer has spread. (Dr Thomas Fabian, the radiologist who did the CT and PET, will be providing a report with a more detailed analysis, but that is Dave's best (albeit cursory) read from the pictures.)
Dave believes that the course of action to give me the best long-term prognosis would be to remove the remaining tumor, if that is possible. While I was there Dave called the thoracic surgeon, Dr Lary Robinson, at Moffitt. I am going to have another appointment with Dr Robinson ASAP and have him look to see if his view (about surgery) has changed. From Dave's conversation, it sounded as though the option of surgery still remains in considerable doubt. The issue appears to be the location and size of the tumor and now scaring. The fact that we did definitive radiation (7 weeks) vs a less intensive 5 weeks makes surgery more difficult. If we are going to do surgery at all we have to do it soon; otherwise scar tissue (from radiation) will be the deciding factor.
Dave's opinion was that I may currently be a borderline surgery case, so it is worth pursuing. We are going to set up an appointment to see Dr. Robinson ASAP. If he decides after all to do the surgery, we would do it right away right at Moffitt. In my case we might have to remove the entire right lung, rather than do a partial re sectioning. Removing the entire lung, according to Robinson, is high risk with high mortality from post-operative complications. (Although that is mainly true for patients who are elderly and have complicating medical conditions.) Moreover, surgery would entail a prolonged (two or three month) period of recovery (assuming you survive the initial trauma!) and would result in significantly reduced breathing capacity.
The other thing Dave said was that, they could go in to do the surgery and decide, after seeing what's what, that it can't or shouldn't be done! Then I would have to go through all the pain and recovery for nothing!
Frankly, all this does not get me excited to run out and have surgery, especially since I am feeling so well right now! Dave believes that, whether I have surgery or not, I should proceed with the consolidation chemo. The only problem I have with that recommendation is that I wouldn't want to be in a rundown condition (i.e. anemic or prone to infection) when I go under the knife. I would want to be in excellent shape, which I think would rule out consolidation chemo until we have a final decision on surgery.
Anyway, where we left it is that I will make an appointment to see Dr Robinson at Moffitt ASAP. My appointment with Dr Lunin is next week. I would like to see Dr Robinson after I have seen Scott so I know what questions to ask.
We should have some answers shortly about where we go from here. In the meantime, I am going to relax at home, eat, read, and generally enjoy my current good health! I definitely want to wait on proceeding to next steps until after the Giants beat New England on February 3rd.
What I learned from Dave is that there appears to still be metabolic activity within the primary tumor, but thus far it does not appear that the cancer has spread. (Dr Thomas Fabian, the radiologist who did the CT and PET, will be providing a report with a more detailed analysis, but that is Dave's best (albeit cursory) read from the pictures.)
Dave believes that the course of action to give me the best long-term prognosis would be to remove the remaining tumor, if that is possible. While I was there Dave called the thoracic surgeon, Dr Lary Robinson, at Moffitt. I am going to have another appointment with Dr Robinson ASAP and have him look to see if his view (about surgery) has changed. From Dave's conversation, it sounded as though the option of surgery still remains in considerable doubt. The issue appears to be the location and size of the tumor and now scaring. The fact that we did definitive radiation (7 weeks) vs a less intensive 5 weeks makes surgery more difficult. If we are going to do surgery at all we have to do it soon; otherwise scar tissue (from radiation) will be the deciding factor.
Dave's opinion was that I may currently be a borderline surgery case, so it is worth pursuing. We are going to set up an appointment to see Dr. Robinson ASAP. If he decides after all to do the surgery, we would do it right away right at Moffitt. In my case we might have to remove the entire right lung, rather than do a partial re sectioning. Removing the entire lung, according to Robinson, is high risk with high mortality from post-operative complications. (Although that is mainly true for patients who are elderly and have complicating medical conditions.) Moreover, surgery would entail a prolonged (two or three month) period of recovery (assuming you survive the initial trauma!) and would result in significantly reduced breathing capacity.
The other thing Dave said was that, they could go in to do the surgery and decide, after seeing what's what, that it can't or shouldn't be done! Then I would have to go through all the pain and recovery for nothing!
Frankly, all this does not get me excited to run out and have surgery, especially since I am feeling so well right now! Dave believes that, whether I have surgery or not, I should proceed with the consolidation chemo. The only problem I have with that recommendation is that I wouldn't want to be in a rundown condition (i.e. anemic or prone to infection) when I go under the knife. I would want to be in excellent shape, which I think would rule out consolidation chemo until we have a final decision on surgery.
Anyway, where we left it is that I will make an appointment to see Dr Robinson at Moffitt ASAP. My appointment with Dr Lunin is next week. I would like to see Dr Robinson after I have seen Scott so I know what questions to ask.
We should have some answers shortly about where we go from here. In the meantime, I am going to relax at home, eat, read, and generally enjoy my current good health! I definitely want to wait on proceeding to next steps until after the Giants beat New England on February 3rd.
Sunday, January 20, 2008
Before and After CT Scan
I thought you would be interested in seeing the results of the CT Scan. Here is a view of the tumor at its largest before chemo radiation. The dark area is my lung and the gray matter on the left side is the tumor.
The following picture is a view of the same tumor at its largest after chemo. As you can see, the tumor is significantly reduced in size. You've got to admit this is pretty amazing.
Wednesday, January 16, 2008
Keeping Busy or Slowing Down
One problem I don't have is finding things to do with my time. I seem to run from one thing to the next. I would much prefer to have the time to do the things I enjoy. I am working 12 hour days (on the days that I work) and I still can not seem to get caught up. The long work days leaves me little time to do the things I would really like to do. I just wish I had more time for myself.
I have conversations every day with people who make cavalier remarks that irk me. Someone I was meeting with today (who is roughly my age) said "I want to use my last dollar on the day I die." (With the market down 300 points yesterday, that day may be sooner rather than later!) Anyway, it got me to thinking what a crock this statement actually is... Look at me! I would STOP working if I knew I am going to die soon. The fact is, I may die this year or next year, or I may live five or ten years. Since I don't know, I have to go on living life the same as I always have and try to maintain and/or grow my bank account. If I get sick, I won't be well enough to spend my last dollar. If I don't get sick, I'll have to keep working. Ugh.
Anyway, all week I have complained to Yoko about having to go to work . Fact of the matter is I feel as well as I ever have and my demise is a long way off, which means I will probably work until I can't work any longer. What a depressing thought!
My lack of enthusiasm for work these days means I take my sweet time to get into the office. Yesterday morning I was just sitting down to breakfast at around 9 AM when Advanced Imaging called to say that the CT/ PET machine was had unscheduled maintenance this coming Tuesday. They offered to take me today (if I had not already eaten) or reschedule. Since I had not eaten and had nothing pressing at work, I decided to go in for the CT and PET scan. I got to Advanced Imaging by 10 AM and had an injection of radioactive particles. You have to wait about an hour for these to circulate. Next I had the CT Scan, where they inject iodine for contrast and then take a series of high resolution x-rays. After that I had the PET scan. All I had to do was lay still with my arms above my head while the machine scanned my entire body. Sounds easy, except that they were having trouble with the machine, so instead of 25 minutes I had to lay motionless for nearly an hour. This has never happened to me before but I started to panic. Staying in that machine and not being able to move for that length of time was like torture. My arms went to sleep and I literally began to feel something akin to drowning or choking. It was really difficult to complete the test, but, with coaching, I made it through. (This experience does not make me want to go through it again, however.)
I was done with the testing by 12:30 and took a disc home of the CT pictures, since I did not want to wait to hear the results. There has been obvious dramatic shrinkage of the tumor in my right lung. I will have to wait until Monday (when I see my radiology oncologist, Dave Rice) to know what he thinks of the pictures. Dr Lunin will see them next week; I have an appointment with him on the 29th. No wonder I am feeling so good!
The big question is whether the cancer cell metabolism has slowed. My guess is that it must have or we would not have seen such dramatic shrinkage. I am fully recovered from the first round of chemo. I am golfing in the low 80's again and I have regained weight (now 150 lbs), so I am ready to go on to the next "consolidation" round.
The shrinkage is so dramatic that it does raise a question in my mind as to whether surgery may now be possible. I will be anxious to ask that question at my next appointment. I'll try to get the before and after pictures on this blog so you can see the difference.
The only bad thing about all this good news is that I may have to work for a long time yet. Oh well, I guess that is the price of success? Maybe they will be able to operate and I will get two or three months off work. Let's hope.
I have conversations every day with people who make cavalier remarks that irk me. Someone I was meeting with today (who is roughly my age) said "I want to use my last dollar on the day I die." (With the market down 300 points yesterday, that day may be sooner rather than later!) Anyway, it got me to thinking what a crock this statement actually is... Look at me! I would STOP working if I knew I am going to die soon. The fact is, I may die this year or next year, or I may live five or ten years. Since I don't know, I have to go on living life the same as I always have and try to maintain and/or grow my bank account. If I get sick, I won't be well enough to spend my last dollar. If I don't get sick, I'll have to keep working. Ugh.
Anyway, all week I have complained to Yoko about having to go to work . Fact of the matter is I feel as well as I ever have and my demise is a long way off, which means I will probably work until I can't work any longer. What a depressing thought!
My lack of enthusiasm for work these days means I take my sweet time to get into the office. Yesterday morning I was just sitting down to breakfast at around 9 AM when Advanced Imaging called to say that the CT/ PET machine was had unscheduled maintenance this coming Tuesday. They offered to take me today (if I had not already eaten) or reschedule. Since I had not eaten and had nothing pressing at work, I decided to go in for the CT and PET scan. I got to Advanced Imaging by 10 AM and had an injection of radioactive particles. You have to wait about an hour for these to circulate. Next I had the CT Scan, where they inject iodine for contrast and then take a series of high resolution x-rays. After that I had the PET scan. All I had to do was lay still with my arms above my head while the machine scanned my entire body. Sounds easy, except that they were having trouble with the machine, so instead of 25 minutes I had to lay motionless for nearly an hour. This has never happened to me before but I started to panic. Staying in that machine and not being able to move for that length of time was like torture. My arms went to sleep and I literally began to feel something akin to drowning or choking. It was really difficult to complete the test, but, with coaching, I made it through. (This experience does not make me want to go through it again, however.)
I was done with the testing by 12:30 and took a disc home of the CT pictures, since I did not want to wait to hear the results. There has been obvious dramatic shrinkage of the tumor in my right lung. I will have to wait until Monday (when I see my radiology oncologist, Dave Rice) to know what he thinks of the pictures. Dr Lunin will see them next week; I have an appointment with him on the 29th. No wonder I am feeling so good!
The big question is whether the cancer cell metabolism has slowed. My guess is that it must have or we would not have seen such dramatic shrinkage. I am fully recovered from the first round of chemo. I am golfing in the low 80's again and I have regained weight (now 150 lbs), so I am ready to go on to the next "consolidation" round.
The shrinkage is so dramatic that it does raise a question in my mind as to whether surgery may now be possible. I will be anxious to ask that question at my next appointment. I'll try to get the before and after pictures on this blog so you can see the difference.
The only bad thing about all this good news is that I may have to work for a long time yet. Oh well, I guess that is the price of success? Maybe they will be able to operate and I will get two or three months off work. Let's hope.
Sunday, January 13, 2008
Free Marion Jones! Thoughts about Right and Wrong
I have been thinking lately about "being right" and "doing right." There are no easy answers to the questions I have. The funny thing is that I am 52 years old and still struggling with issues of right and wrong. Here are a couple of recent examples:
Yesterday we are playing golf at Verandah and the guy I am playing with hits an awful shot into someones back yard. It is not "out of bounds" because there are no white stakes at Verandah, so technically, anything is "in play." Anyway, we found the ball and the guy could take a swing. I did not want the guy to play from some one's back yard, so I told him he could take a free drop (no penalty) so that he was not hitting out of the back yard and he said to me, "I don't think the owner is home." In other words, he would play it from where it lays and only take a drop (and technically a penalty) if the owner can see him. The thought occurred to me that this guy knew it was wrong to be playing the ball from some one's back yard-- especially since I told him he could have a free drop -- but he would do it as long as he would not be caught. This guy was formerly a CFO of a very large and well known public company. I had to wonder what ELSE he did when no one is looking.
Today I was playing golf and hit the ball to the edge of a water hazard. The ball was actually partially in the water but I decided I could play it out, rather than take a one stroke penalty. Now technically you can not touch your club to the ground (ground your club) or touch the water when you are addressing the ball in the hazard. The guy I was playing with was Doug Bowers -- a real stickler for the rules. (To his credit I have to say that Doug also holds himself to a high standard when it comes to following the rules of golf.)
Anyway, I walked into the hazard and addressed the ball. I was obviously being careful not to touch the water. As I was addressing the ball I inadvertently grazed the bottom of the club to the water (barely enough to even cause a ripple). Before I actually swung at the ball Doug said, "That's a two-stroke penalty." He was right, but no one I play with would ever call a two stroke penalty for what I did, let alone do it before I had hit the ball. (The edicate (not a rule) in golf is that you call penalties on yourself and you don't talk when someone is addressing the ball. ) I made the saving shot and took an 8 (triple bogey) instead of the 6 (bogey). After the hole was over, I told Doug that it is a disadvantage to play with him (since no one else follows the rules as closely as he does). His response was "The rules are the rules" and while that is true, it is also true we are not playing in the PGA Championship and the other 25 guys in this league are not abiding by Doug's standards... So I AM disadvantaged by playing with him.
So here are two situations in two days on the golf course that are kind of similar. In the first situation I GAVE the man a free drop (even though he is not entitled) and he choose to do the wrong thing (because no one was watching and he could get away with it.) I think I was "doing right" by offering the free drop (even though technically it was not allowed.) HE was being right (not touching or moving the ball) and doing wrong (by hitting the ball from some one's back yard.)
In the second situation, I called a two stroke penalty on myself primarily because Doug WAS watching and I could not get away with NOT calling myself on it. Doug was technically correct that I had made an infraction, but I think he was "wrong" in calling me on it before I had hit the ball or declared my score. If the roles were reversed I would not have called a penalty on Doug.
So what is my point? I guess the point is that the world does not work if we try to run it by rules alone. Rules and laws are broken and sometimes it is RIGHT to break the rules and sometimes it is WRONG. Judgements have to be made about right and wrong and when the rules should apply. The Japanese seem to have figured this out and the society runs very smoothly as a result. In many ways I wish Americans were more like the Japanese.
The other thing that got me thinking about the use of judgement and right and wrong is the case of Marion Jones, the Olympic athlete accused of using performance enhancing steroids. Did the judge that put Marion Jones in jail for six months do right by giving her such a severe sentence? Her reputation as an athlete is ruined and her endorsement career is ended. She lost five gold metals. What is the point of a six month jail sentence? How is it right that Marion Jones gets six months for lying about whether she took steroids and Scooter Libby, a high government official, gets no jail time for lying about whether he outed a CIA agent?
Yesterday we are playing golf at Verandah and the guy I am playing with hits an awful shot into someones back yard. It is not "out of bounds" because there are no white stakes at Verandah, so technically, anything is "in play." Anyway, we found the ball and the guy could take a swing. I did not want the guy to play from some one's back yard, so I told him he could take a free drop (no penalty) so that he was not hitting out of the back yard and he said to me, "I don't think the owner is home." In other words, he would play it from where it lays and only take a drop (and technically a penalty) if the owner can see him. The thought occurred to me that this guy knew it was wrong to be playing the ball from some one's back yard-- especially since I told him he could have a free drop -- but he would do it as long as he would not be caught. This guy was formerly a CFO of a very large and well known public company. I had to wonder what ELSE he did when no one is looking.
Today I was playing golf and hit the ball to the edge of a water hazard. The ball was actually partially in the water but I decided I could play it out, rather than take a one stroke penalty. Now technically you can not touch your club to the ground (ground your club) or touch the water when you are addressing the ball in the hazard. The guy I was playing with was Doug Bowers -- a real stickler for the rules. (To his credit I have to say that Doug also holds himself to a high standard when it comes to following the rules of golf.)
Anyway, I walked into the hazard and addressed the ball. I was obviously being careful not to touch the water. As I was addressing the ball I inadvertently grazed the bottom of the club to the water (barely enough to even cause a ripple). Before I actually swung at the ball Doug said, "That's a two-stroke penalty." He was right, but no one I play with would ever call a two stroke penalty for what I did, let alone do it before I had hit the ball. (The edicate (not a rule) in golf is that you call penalties on yourself and you don't talk when someone is addressing the ball. ) I made the saving shot and took an 8 (triple bogey) instead of the 6 (bogey). After the hole was over, I told Doug that it is a disadvantage to play with him (since no one else follows the rules as closely as he does). His response was "The rules are the rules" and while that is true, it is also true we are not playing in the PGA Championship and the other 25 guys in this league are not abiding by Doug's standards... So I AM disadvantaged by playing with him.
So here are two situations in two days on the golf course that are kind of similar. In the first situation I GAVE the man a free drop (even though he is not entitled) and he choose to do the wrong thing (because no one was watching and he could get away with it.) I think I was "doing right" by offering the free drop (even though technically it was not allowed.) HE was being right (not touching or moving the ball) and doing wrong (by hitting the ball from some one's back yard.)
In the second situation, I called a two stroke penalty on myself primarily because Doug WAS watching and I could not get away with NOT calling myself on it. Doug was technically correct that I had made an infraction, but I think he was "wrong" in calling me on it before I had hit the ball or declared my score. If the roles were reversed I would not have called a penalty on Doug.
So what is my point? I guess the point is that the world does not work if we try to run it by rules alone. Rules and laws are broken and sometimes it is RIGHT to break the rules and sometimes it is WRONG. Judgements have to be made about right and wrong and when the rules should apply. The Japanese seem to have figured this out and the society runs very smoothly as a result. In many ways I wish Americans were more like the Japanese.
On my way home from golf today some guy in a white Lexus pulled out in front of me (from the Racetrack on Sandhill Road) and proceeded to do a u-turn in the middle of a Sandhill without using any turn signal. I was trying to pull into the car wash while he was doing his u-turn. He clearly made an illegal and dangerous move. If I was a cop, I would have pulled him over and ticketed him. Instead, I raised my two hands and shrugged my shoulders in a gesture of "what the hell are you doing?" Instead of a gesture of "I'm sorry", I was greeted with a middle finger. In the interest of social harmony, a Japanese would at least have said "I'm sorry" while making an illegal u-turn. But here people in the wrong have an "in your face" attitude. No wonder there is road rage and senseless violence in America.
Yoko and I are both amazed by how much American Christians talk about Jesus and God and then flip the bird to their neighbors. Is that was Christ was teaching? Screw thy neighbor before he screws you?
The other thing that got me thinking about the use of judgement and right and wrong is the case of Marion Jones, the Olympic athlete accused of using performance enhancing steroids. Did the judge that put Marion Jones in jail for six months do right by giving her such a severe sentence? Her reputation as an athlete is ruined and her endorsement career is ended. She lost five gold metals. What is the point of a six month jail sentence? How is it right that Marion Jones gets six months for lying about whether she took steroids and Scooter Libby, a high government official, gets no jail time for lying about whether he outed a CIA agent?
Saturday, January 12, 2008
Go Rudy!
It has been a while since I have made a contribution to this blog. Frankly, it is hard to write something every day and say something new each time. Now that a week has gone by since my last contribution, there is lots to report. Let me bring you up to date.Last Sunday morning I played golf in my normal league game. I got up early (6:30 AM) to play and played badly on the front (47) and a little better on the back (45) for a 92. I was so unhappy with my game overall that Chris Maher and I decided to go out again after lunch. On the second 18 I shot 40 on the front and 41 on the back for a total of 81 -- much better. A couple of bad chip shots cost me at least 6 strokes, so I played well the second time around. Maybe my bad morning game is related to being sleepy? Anyway, I was glad to have enough energy to play 36 holes. First time in a while I have felt like playing all day.
I worked a full week this past week. That's actually been pretty rare in the past three months. I was taking off every Friday for chemo and then I had time off during the holidays. It may be the first full week I have worked since September. There is nothing too exciting to report about work, except to say that business is good and the current market volatility is keeping me busy. I expect to have a record (sales) month in January and February is already shaping up to be a pretty good as well. I am lucky to have a job that allows me a flexible schedule. Even better, I have not been hurt financially by only being able to work 4 days a week.
This fall we had a sales meeting set for every Tuesday morning from 9 AM. Of course, while I was undergoing radiation I could not attend, so the meeting kind of fell by the way side. (I have not told people in the office about my diagnosis so all they know is that I had a scheduling conflict.) Anyway, the weekly sales meeting was re-instituted this week for every Tuesday. A week from Tuesday (January 22nd) I have my CT Scan and PET Scan and blood tests. I am planning to take the entire day off, so I will miss the scheduled meeting again. I guess one of these days soon I will have to tell the office out my medical condition or they'll think I am purposely snubbing them!
I have flying ants in my new office that seem to come out of the woodwork as soon as it gets dark. They are into everything after 6 PM, so lately I have not been able to stay late in the office. The ants drove me out of the office on Tuesday evening, so I decided to go home at six. When I got home I changed into pajamas and a bathrobe (which I never do) to spend a leisurely evening reading and writing. As I sat down to check my e-mail I realized that I was suppose to attend a Project Graduation meeting at the high school. I quickly changed back into street cloths and went to the meeting, which did not end until 8:30PM. I was home for dinner by nine.
I was suppose to get up for Rotary on Wednesday morning, but I was too tired to make the 7 AM breakfast meeting, so I slept in and went directly to the office instead. I don't remember what I did on Wednesday evening, but whatever it was, it was not too exciting.
I came home early on Thursday, only to discover that Yoko was out with her friend Kazue Anderson, They went to watch Kazue's son wrestle for Charlotte High. Yoko had a really good time and came home all excited about high school wrestling. Yoko enjoys high school and college sports. This year she marked the calendar with all the college bowl games she wanted to watch. Last year we spent a lot of time going to high school football games, mainly because Yoko knew some of the kids who were playing. I am glad Yoko has developed a taste for spectator sports. I wish she would develop a taste for golf!
On Friday night after work we joined the Mahers and Rowes for drinks at the Maher home and then went together to Harpoon Harry's to listen to Mike Riley's band, the Bogiemen. We haven't been dancing in a while, so it was fun. Riley's band is very large (about 1o people) and has a sound that is a lot like Chicago or Santana. They play hits from the 70's and 80's that are dance tunes. I had four drinks during the night, which is more than I have had in a while. Thankfully, there were no ill after effects.
I was up at eight this morning to play golf at Verandah. I played with Fred Taylor, Jim Mathews and Tom Loop. I played with Taylor last week; Mathews and Loop were people I had not met before. I am glad to report that I shot 40 on the front and 43 on the back for an 83. I was grateful to have played much more like my old self.
Tonight Yoko and I attended a Republican Club dinner in honor of Mayor Rudy Guiliani. He is campaigning hard in Florida and is spending time this week in Charlotte County. I really like Guiliani and his message of lower taxes, smaller government, tort reform, health care reform, victory in Iraq, strong border security, etc. He makes sense and he has executive experience in government. Of all the candidates, I like Guiliani the best.
Tomorrow morning I am planning to play golf in my weekly league event. We tee off at 7:30 AM. In the afternoon we will be watching the NFL playoff games. Tomorrow night I have a Rotary board meeting and then it is back to work on Monday again.
My big complaint these days is that I don't have the time to do things that I want to do. Work and other commitments keep getting in the way. I want to read. I want to write more. I need time to plan travel. These are things I really want to do. Time is flying by and even with the sudden realization of how short life can be, I still don't seem to have the time I want to do the things I want to do. All I can do is keep trying.
Saturday, January 5, 2008
Family Photos
The photos from Christmas that were taken by Paula Kennedy are now online at http://www.paulakennedyphoto.com/ You can look at the online proofs by clicking where it says Online Proofs, selecting Cappiello, and typing in the secret password (Capp08). I like the one shown here! Let me know by e-mail (tecappiello@gmail.com) which ones you like! There is no real news to report. I decided to take the afternoon off yesterday and went golfing with Chris Maher at my club, Verandah. It was practice for the round I played there today (Men's Day). I shot 86 yesterday (43/43) and 89 today (49/40). Despite the higher score, I played much better today. I just had some bad breaks and did not putt well on the first few holes. I played golf with three guys I had not met before: Dick Murphy, Fred Wolf, and Gary Douglas. All three were new to the club. (Golf is a great way to meet new people and most of the people at this club have an interesting background.)
After golf today I went to Ft Myers to get measured by a tailor. (Paula needs the measurements to order my tux/suit for the wedding.) Yoko also happened to be shopping in Ft Myers for leftover holiday decorations, so we met up at Books a Million for coffee. I bought the Holy Bible, which I have never read cover-to-cover. I thought it might be time to actually read the Bible.
Tonight the plan is to eat out. We have not had prime rib in a while, so we are heading to The Captain and the Cowboy for dinner. The remainder of the weekend will be more of the same. Tomorrow morning I play in my normal Sunday morning league. In the afternoon we'll be watching football. I plan to read and write; Yoko plans to put away Christmas decorations.
I would like to take Yoko on a special trip. The earliest we could do something is August, after Paula's wedding. Andy Dulay introduced me to a travel agent that is selling tickets to a three legged cruise (46 days -- two legs of 15 days and a third leg of 16 days) that departs from Florida January 4, 2009 and goes between South America and Antartica before arriving in LA. Apparently the ship (Mariner of the Seas) is being repositioned to operate from LA and is too big to go through the Panama Canal, so this "repositioning" cruise is being planned. The cost is actually quite reasonable, about $7500 per person for all three legs, including port charges. The ship stops in St Martens, St Kitts, Rio De Janerio, Buenos Aries, Strait of Magellen, Montevideo (Uraguay), Chille, Lima (Peru), Costa Rica, Mexico, etc.) I think this would be quite an adventure, but Yoko would rather see Europe. If you have an interest in taking this winter cruise with us next year, let me know!
Thursday, January 3, 2008
New Year's Starts
New Year's is an important holiday in Japan. To celebrate the Japanese traditionaly have a dish at midnight called toshikoshi soba (New Year's buckwheat noodles). June purchased the special noodles for Yoko in Hawaii and gave them to her for Christmas, so that's what we had for dinner on New Year's eve. I have not had toshikoshi soba in years but they are good once a year. (I have to be careful about saying I like soba or, the next thing you know, I'll be having soba once a week!)
Around 10 PM Yoko and I went to Andy and Jan Dulay's home for their annual party. (Andy is one of my clients and a good friend. He just retired from UPS where he was a 747 captain.) Every year the Dulays host a real traditional New Year's party with hats and noisemakers The noise builds all evening and crescedos on the countdown to midnight. We toast the New Year with champagne and fireworks. Yoko and I are ususally home and in bed by 1 AM.
It is aways fun to visit Andy's house on New Years Eve. The same people (mostly Andy's neighbors on Suzi Street) come to the party every year. Yoko and I have gotten to know most of the people in attendance over the years, even though we only see them once a year! Actually, Andy's New Year's Eve party has been a good source of new clients. Andy and Jan go around introducing me to their friends as "their moneyman." There are usually 30 - 40 people at the party and invariably someone wants to talk with me about managing their assets.
Jessie was invited to the Dulay party but instead decided to spent New Year's eve at her roommate's home in Boca Grand. She did not come home until noon on New Year's day. Yoko and I slept in late but we were up by 11 AM and spent the day lounging around watching football.
Tuesday January 2nd I went back to work and the market promptly took a 220 point dive. Welcome to 2008! I hope the opening day of trading does not portend how the rest of this year is going to develop. After work we had the year's first Rotary dinner meeting. Jessie was invited to the meeting to speak about S4TL (Seminar for Tomorrow's Leaders); I was the speaker for the evening and made a Morgan Stanley presentation on "Planned Giving." The presentation was pretty dry. It might have been a better had the powerpoint I prepared been working. Unfortunately, due to technical difficulties, we ended up having to "wing" a presentation that really requires visual aids. Oh well...I hope the rest of the year is better!
Around 10 PM Yoko and I went to Andy and Jan Dulay's home for their annual party. (Andy is one of my clients and a good friend. He just retired from UPS where he was a 747 captain.) Every year the Dulays host a real traditional New Year's party with hats and noisemakers The noise builds all evening and crescedos on the countdown to midnight. We toast the New Year with champagne and fireworks. Yoko and I are ususally home and in bed by 1 AM.
It is aways fun to visit Andy's house on New Years Eve. The same people (mostly Andy's neighbors on Suzi Street) come to the party every year. Yoko and I have gotten to know most of the people in attendance over the years, even though we only see them once a year! Actually, Andy's New Year's Eve party has been a good source of new clients. Andy and Jan go around introducing me to their friends as "their moneyman." There are usually 30 - 40 people at the party and invariably someone wants to talk with me about managing their assets.
Jessie was invited to the Dulay party but instead decided to spent New Year's eve at her roommate's home in Boca Grand. She did not come home until noon on New Year's day. Yoko and I slept in late but we were up by 11 AM and spent the day lounging around watching football.
Tuesday January 2nd I went back to work and the market promptly took a 220 point dive. Welcome to 2008! I hope the opening day of trading does not portend how the rest of this year is going to develop. After work we had the year's first Rotary dinner meeting. Jessie was invited to the meeting to speak about S4TL (Seminar for Tomorrow's Leaders); I was the speaker for the evening and made a Morgan Stanley presentation on "Planned Giving." The presentation was pretty dry. It might have been a better had the powerpoint I prepared been working. Unfortunately, due to technical difficulties, we ended up having to "wing" a presentation that really requires visual aids. Oh well...I hope the rest of the year is better!
Subscribe to:
Posts (Atom)