Catching Up

I have actually been writing quite a bit, I just have not posted everything I have written. I have been in a bit of a funk this past week, for no reason that I can discern easily. I skipped going to Project Graduation on Tuesday night and Rotary on Wednesday morning. Its been hard to keep going this week for some reason.

It started with my feeling sick over the weekend. After chemo last Friday I was nauseated. I did not work the air show, as I normally do, because I did not want to be exposed to thousands of people while my WBC count is low. On Saturday I had the first of three neupogen shots. Saturday afternoon I played golf with Chris and Kirby at a Kingsway. I was feeling nauseous during golf and finally lost it in the bushes around the 7th hole. I blame it on the chemo, but truthfully it might have been the golf. (I shot over 100 for the round that day.) I was not feeling much better on Sunday and my golf only improved slightly. (Yoko and I did finally get all our tax stuff together on Sunday before golf and I delivered it all over to my tax accountant on Sunday afteroon.)

On Monday I had a neupogen shot in the morning. In the afternoon Yoko and I went to sign our estate documents. There is a lot of work I need to do to get our affairs in order. The primary culprit is the fact that Yoko is not a US citizen, which complicates things. She not entitled to the "unlimited marital deduction" that married US citizens are entitled to receive. As a result, any amount over $2 million today that I leave to her as part of my estate (which includes life insurance proceeds) is subject to the estate tax, at 45%. I am entitled to gift Yoko up to $125,000 per year, so our plan is to gift the things in my name or in joint name to her. In the meantime, we will try and get her citizenship. She is my healthcare surogate and visa versa. Yoko also has my power of attorney. John Mizell, our estate attorney, warned that should she ever need to sign consent forms at the hospital for any procedure on my behalf, she should sign for me "as surogate". Otherwise, the hospital could become a creditor of my estate for any bills insurance does not pay and all our carefully layed estate plans could be ruined. (Any of you readers who might be with her at the time take heed!)

All the discussion of death and taxes did not lift my spirts. On Tuesday I got my third shot of neupogen for the week. At lunchtime on Tuesday I attended the Charlotte County Estate and Tax Planning Council, where I listened to more discussion of death and taxes. Afer the luncheon, which was also held at Kingsway Country Club, I was still not feeling great, so I decided to go home and go to bed. I did not leave bed until late Wednesday morning. Mostly I just slept. (Tuesday night I did finally finish "Team of Rivals," the book on Lincoln that I started when I began chemo last October.)

I decided to take myself off lyrica (nerve pain medication), with Dr. Lunin's permission. If I have nerve pain that comes back, I can always go back on medication, but I am not in the habit of taking drugs unnecessarilyand this paricular drug affects the brain. I am down now to taking just one pill a day for acid reflux. I have been off lyrica since Tuesday and feel no worse for it. In fact, I am wondering if the lyrica could be some of the reason I was feeling depressed.

I started feeling better when I went back to work on Wednesday and I was able to put in a full schedule on Thursday. Right now it is Friday and I am back in treatment and feeling fine once again. This week, I am prepared for nausea, should it occur. I asked Scott for a prescription, which we had filled. If I am not feeling well after chemo at least I will have something on hand to take.

Now for the good news. In my meeting with Scott today, he told me that my CEA(carcinoembryonic antigen) (which is a marker in the blood commonly associated with lung cancer -- like the PSA is associated with prostate cancer) was back to normal range. When the cancer was discovered in October, my CEA level was 77 (normal is the 4 - 6 range). In December the CEA was 12 and it is currently 5. That is a good indication that treatments are working. This week I will have three more neupogen shots and on Wednesday I will have both a CT Scan and PET Scan to see what progress we are making. I am not looking forward to the PET Scan because of my bad reaction last time. Hopefully, we will find that the cancer is under control.

I asked Scott what I should expect going forward in terms of what we are going to do. After this round of chemo, assuming my scans come up clean, the only thing left to do will be to monitor my condition. The most likely site of recurrance will be the brain, because the "blood-brain barrier" does not allow chemo to work its magic in the brain as well as below the neck. I asked Scott whether we should consider using whole brain radiation as a preventative measure. He was not adverse to the idea and we will pursue this with David Rice at a later date.

The other bit of good news is that I was invited (expenses paid) to the Lung Cancer Advocate Summit in Chicago. The problem is it happens the week before Paula's wedding and is in conflict with Project Graduation, which is May 29th. Maybe next year? I was also invited to go to Washington DC to lobby for lung cancer research. I think Yoko and I will plan to make that trip in July.