The Return

Back from Mayo. I guess I was secretly hoping that Dr, Hunter, one of the world's foremost experts on this particular type of cancer, would say positive things -- possibly make me feel better about the staging of my cancer... or that Dr, Ungawa had somehow overstated or exaggerated my condition. He didn't. The news is bleak, honestly.

Dr. Hunter's recommended course of action is more extreme and more invasive than Dr. Ungawa's. Dr. Hunter does laparoscopic surgery but wouldn't in this case as he wants to see and feel the lymph nodes in the area and the bladder. He's done about 100 bladder cystectomies (exactly the same kind he would do on me) this year alone, so he is definitely the guy for the job if I can get in to see him for the surgery. On another note, I am the youngest he's personally seen with bladder cancer, usually not even affecting lifetime smokers until they're 60 or more. He says whatever is going on with me is very aggressive so he recommends aggressive action to make sure it doesn't recur or spread.

The game plan changes somewhat after talking to Dr. Hunter: He recommends chemo *first* (3 to 4 months worth, the same regimen and drugs as the oncologist I met with) and then surgery *after*. Ungawa's current plan has me doing surgery first and chemo and radiation afterward. The chemo can be done wherever, and doing it at Mayo would be needlessly far away -- adding a 2 hour drive onto each side of a 6-hour treatment sounds pretty horrible to me. I'll just do it in Minneapolis at my oncologist's. Dr. Hunter doesn't recommend radiation at all, as that apparently permanently changes the bladder tissues, making any further procedures that might be needed impossible.

What this all means is that I will have time before the surgery (as much as 5 months) while I undergo chemotherapy, so I can do everything possible to get my coverage changed to a network (like UCare) that will cover Mayo. Even if this isn't possible (and I'm now worried about Dr, Ungawa's abilities based on the contrasting courses of action each had) I will follow Dr. Hunter's advice on doing the chemo first.

Though this was a sobering visit that put things into very clear perspective, I am extremely glad that I met with him. He was knowledgeable, personable, and patient.

I have some hard decisions to make, but at least I don't have to feel rushed into them.

Waiting for Dr Hunter.

Represent.

Mayo Monday, Color Rant

Its been a nice weekend off -- no phone calls or plans to make,
nothing really to be decided or planned, so I've been giving myself
permission to take it easy.

I went to benefit yesterday for Ed M, Minneapolis Irish music
forefather, who passed away unexpectedly from undiagnosed liver cancer
a few months ago. When they caught it, the docs gave him 6 months and
he lasted 30 days. It makes me glad that mine was caught as early as
it was. The benefit was held at the old Kieran's Irish Pub (A
Minneapolis Irish Music landmark for 20 years). Kieran's just recently
moved to be closer to the new baseball stadium, but the old pub is
still open under the clever name of "The Old Pub" for lunch and happy
hour. They opened on a sunday just for this, all proceeds from alcohol
and food sales was donated by Kieran (who still owns it), all
waitstaff worked for tips only, there was a very nice silent auction
and a raffle with thousands of dollars of donated prizes. Several
bands donated their time, including the new Tim Malloys, minneapolis
music legends boiled in Lead, and a Van Morrison tribute band 5-piece
called (for some reason that I've never been able to figure out) St.
Dominic's Trio. They're decent, but the problem with being an
authentic tribute band is that no one would ever buy your album if you
made one.

A and R -- Ed's widow and 8 year old son -- were also there, of
course. She has clearly lost a dangerous amount of weight but I can
tell has great support through this. She seems to be hanging in there
very well and was very glad to see the big turnout.

Among the fundraisers was a guy selling armbands. I knew that breast
cancer was yellow, but I never really realized that (someone) has
decided on a color scheme for ALL of the cancers. Lucky me, this is
the color I get:

http://www.choosehope.com/product/cancer-sucks-wristband/1226?cancer_color_id=Uterine+Cancer+-+Peach

Peach? Peach?! How about black, mofos. Or at least yellow. Breast
cancer should be pink, colon cancer should be brown, *uterine* cancer
should be yellow. Or perhaps all cancer should just be black. Other
color options I can think of: testicular cancer should be blue, bone
cancer should be white, brain cancer should be grey -- and it is,
thankfully.

I got one of the "Cancer Sucks" armbands in memory of Ed and also for
myself. Though the color is kelly green (liver cancer), it also makes
sense for a Irish musician who has cancer, so that's what I'm telling
myself. But I think I'll get a zillion of the black ones and give them
out. Take back black, I say. Who says the melanoma peeps get to have
all the cool stuff?

Today I head out to Mayo to see Dr. Hunter. To Review, I do have
health insurance, through HeathPartners, and I'm well covered for the
surgery and chemo, etc. But Mayo is out of network for them, so I
chose to do my second opinion with perhaps the best guy on the planet
for this exact type of cancer. His consult fee will be out of pocket
but then (assuming he gives the green light to Dr. Ungawa and his
plan) I'll be back in HealthPartners fully covered for everything else.
Another recent development speaking of insurance, though:
MinnesotaCare (which is who I get my coverage through) has slightly
changed their tune: They originally said no, there's no chance to
switch from HealthPartners to UCare until open enrollment in the fall.
Upon hearing my arguments last friday on the phone -- the Mayo
procedure will be less invasive and involve less hospital and recovery
time (read: cheaper) -- they have now said, "maybe" I can switch
before fall. This is an exciting maybe, because if so it would mean
that all of my current docs would still be covered... PLUS ALL OF MAYO
CLINIC, at 100%. UCare the is the way to go, for anyone who has the
option. So I'm hopeful.

Anyhow, Mayo today with R and G, another painful uroscopy (its a 3
foot long hose with a camera at the end and is the diameter of a
pencil, people) and then hopefully some good feedback. Once again, its
unlikely I'll be able to do the surgery with this guy, but his opinion
is worth it.

And yes, Cancer sucks. Right now I feel like I should be billing
someone for my time and the time of everyone who is helping me. If you
let me know where I can send the bill, I'd be much obliged.

Friday (?!)

Has it only been one week since I got the biopsy results back and was told the Big News? Seems like a huge amount has happened since then.

Last night was difficult. I was out of Ambien and decided (partially for lack of other options) to try sleeping normally. Bad idea. I ended up laying awake until at least 3 am, then slept fitfully until about 8, waking up well before my alarm (set for 9). I was up at least 10 times during the night. Called Dr. Larry and got him to give me a scrip for another 30 Ambien first thing.

Sleep, it does a body good.

I have been getting notes from other Cancer Survivors that I know on FB with unusual little tidbits of advice, all of which are fascinating and helpful. I think this is the reason for support networks. People can pass the torch, so to speak, helping out other Brothers and Sisters with their own experiences, observations and revelations.

SL, a FB friend and Cancer Survivor, recommended that I take strong smelling cleaners, etc out of my house. This was interesting timing, since I had already started to realize the need for this. One of the questions Dr. Frodo (the current oncologist) asked me yesterday was whether smells bothered me now. I thought about it for a second and was surprised to find myself answering yes. When R and I were at the Apple store the other day I was overwhelmed by what smelled like some sort of new brand of Axe body spray gone very wrong: the entire genius bar smelled like armpit. Looking around, I eventually found the culprit: one suburban knowledge-seeker's unfortunate bag of leftovers from California Pizza Kitchen. I have also noticed that the last veggie delite sub I had from Subway (usually a reasonable, quick, healthy-ish option) tasted like bleach and chemicals to me. This morning, my toothpaste tasted incredibly strong and the smell of soap after my shower was not unpleasant but almost overwhelming, as if I was holding the bar of soap to my nose constantly. My dog's fur smells faintly like cologne or perfume, but not my cologne. Possibly I'm just smelling the last person other than me that petted her. Maybe she's seeing someone else on the side.

I have been working the phones again this morning. I have decided to go ahead and schedule the surgery with Dr. Ungawa for the week of the 5th, if possible. I haven't met with Mayo but even if Dr. Hunter recommends someone else, I need to get on the schedule with Dr. Ungawa. The procedure is a 2-surgeon procedure so scheduling is tricky. I also need to get blood tests done at Dr. Larry's office today (CBC, LDH, possibly one more), pick up the Ambien from the pharmacy, meet with my brother, and then I want to see J tonight before she heads out of town tomorrow morning for a week-long trip that has been planned for nearly a year.

Despite all of this drama going on, the 4th of July weekend will be happy, social, and filled with gigs. If all goes as planned, I'll be in surgery on Monday or Tuesday, July 5th or 6th, so I'm living it up while I'm still at 100%. We are playing on Thursday (mostly likely, still to be confirmed) in Stillwater, and on Friday, Saturday and Sunday at CONvergence.

I haven't really talked about my trial in Boulder, which is scheduled for mid-July. This is the long-awaited (5 years) lawsuit against the dude that hit me on my motorcycle in 2005. I may be still recovering from my surgery when I fly out for that. Either one of these things would be enough excitement for the summer, but to have them both hit the fan in the same month is a little much.

Motorcycle, Your Time Has Come

Many have asked if there's anything they could do to help. I truly appreciate this and I have just realized that there is something that people *could* help with, if they're so inclined. Its hard to ask for help, but occasionally it is necessary to realize that one cannot do it all themselves and to call for backup.

What I'd like to ask for is a little networking.

I'd like to sell my motorcycle since its an easy source of cash. It's not a necessary vehicle and its worth as much as $5,000, so its seems like a no brainer that it would go.

If you're so inclined, please pass the CraigsList link on to any people, networks or groups that you think might be interested.

http://minneapolis.craigslist.org/hnp/mcy/1829618543.html

Thanks very much!

Oncologistics

So I met with the oncologist today. Actually I don't know if it's *the* oncologist, this was just the first doc that could fit me in on 24 hours notice. I may have another, long-term.

Going into an Oncologist's office is a bit of a downer, as you might imagine. People are pale, quiet, tired-looking. No doctor's office is a happy place, but this is downright moribund. You can tell that the staff are pretty numb to serious illnesses, since that's all they see all day, every day. Tell them you have pain, nauseua, bleeding, loss of appetite and they'll just make a note of it and wait to see if you're going to list anything else. They've seen it all before. They care, of course: but you won't shock them with this the way you might with your primary care physician.

The place is huge and mazelike. All that Edina has to offer with calming art and many, many treatment rooms. I got lost finding the bathroom, and then again on the way back, and then again on the way out.

So anyhow, the oncologist: he's middle eastern, youngish, quiet. Seems like he's mainly just absorbing information from me at this point. I'll call him Dr. Frodo. Mostly just because its a comforting image rather than from any overt resemblance. He is kinda short, though. And I suspect that he may have hairy feet.

We asked all of our questions and had them answered. How much chemotherapy? (4 rounds: 2 weeks on, 1 week off, treatments to take up to 6 hours each). When would chemotherapy start? (About 2 weeks after the surgery). What drugs would be used? (He told me and my mother wrote it down, but I can't remember - perhaps she can fill in the blanks here). Will I lose my hair? (most likely yes, with this type of chemotherapy). Will I have enough energy to work? (Maybe, it depends largely on how nauseated I am during the chemotherapy: anti-nausea drugs can wipe you out). What stage am I at? ("at least stage II, we'll know more after the surgery"). Will there be a PET scan? (Yes, if insurance covers it). When should the surgery be? (Within a few weeks, though a few weeks more won't make a huge difference).

So: surgery within a few weeks, recover for a few weeks, then about 3 months of chemotherapy. Best scenario, that's the end of it except for checks and scans for 5 years or more. It sucks, but is doable.

I got some cool brochures and numbers of financial and support people.

Lots of stuff to look through. Another tiring day but at least there's really only one more appointment (at Mayo on Monday) before I get in to the Decision Making phase.

Oh, and the cost of my Mayo deposit has been covered, now. This was surprising and huge. Thanks so much, K and C. I truly appreciate it. You are amazing.

Mayo

I talked to Mayo's billing department and, largely due to my awesome negotiation skills, I was able to talk them down from a $5,000 deposit to a $3,000 deposit, refundable within 30 days. Since HealthPartners doesn't cover out of network providers at all, Mayo needs a guarantee. I reasoned with them that since the exam is only going to cost $650 tops, $5,000 seemed a little excessive. They grudgingly agreed. Perhaps they're worried that I'm going to start trashing the place and therefore need a deposit against me throwing a TV through a window.

But we agreed on 3k, which felt like a small victory.

But they confirmed my appointment on Monday with Dr. Hunter, so there is movement there.

Regardless, the financial stuff is my next hurdle.

Ambien

This Ambien is strong stuff. I took my last one last night and perhaps
I could have taken 1/2 after my long day. I set the alarm for 10 am
just to make sure I wouldn't sleep all day and was surprised that I
was still sleeping like a log when it went off.

My friend S has a connection to some high-powered herbal sleep stuff
-- that he gets from a chiropractor -- that works so well that one
needs to be careful with it. I took some on a motorcycle trip (one of
those endurance rides where you have an 8-hour window to sleep and you
really need to be asleep for all of it) and was groggy and probably
unsafe to ride all the next day. And I think I took 1/2 of one. So
maybe 1/4 of those if I take it again.

Today, as mentioned, I actually got to sleep in a little. I will take
the Poor Doggie, Kaia, (who spent most of yesterday inside) for a walk after
I talk to Mayo, and then head off to get Mom for the Oncologist's appt.
Some of the main things that I hope to find out today: how serious is
it and how soon should I have surgery? What will MY course of chemo be
like? Will I need radiation? From my extremely limited experience,
which is the guy that I finally start getting some answers from -- the
person that starts to tie it all together and direct my care.

I am interested in working with a nutritionist, but I am aware that
most dietitians are trained based on 1950's food pyramids. As an
example, the very first meal they game me in the hospital aver my
diverticulosis experience (where all of my nutrients came via IV for
several days afterward) was essentially beefy hamburger helper. Fat,
red meat, tomatoes and refined flour. Yum. A balanced meal for anyone.
I know that there are good dietitians / nutritionists out there, but
sifting through the pile will be challenging.

I did not succeed in being vegetarian yesterday, mostly because all
the salad options that looked halfway decent at dinner all had chicken
in them. So at least I'm off red meat, Baby steps. I managed to have
just one drink at dinner (a margarita: I was told that water and
citrus are good for me, so that's my excuse). And I had had a hard
day. But I passed on the beer later, twice. So that's something.

R waits for Nuke Med with me.

 

R provides moral support -- and catches up on trashy magazines at the same time.

Long days, long nights.

A productive day today:

Up at 0730, pick up R by 0900, at the imaging place in Edina by 0945,
injection of radioactive isotope at about 1000, drop of prescription
at about 1045, pick up medical records including CT scan CD from
Ungawa at about 1055, meager (lack of hunger for both of us) breakfast
at the Huis at about 11:15, wait in line to return long-overdue un-
needed accessory at the Apple Store at SouthDale (note: wait until
after the iPad and new iPhone newness has worn off -- was like a day-
after-Thanksgiving sale) back to Imaging place by 1345 for bone scan,
done by 1500, meet J, drive with J and R to Mayo to drop off records
with Dr. Hunter's people, "Italian" dinner in scenic Rochester, back
to cities by 1900; much-needed quiet time with J.

Some very good news: they called me at about 1600 with news of
*negative* bonescan results. In brief, this means that the cancer has
not spread to my bones as far as anyone can tell, which is widely
regarded as a good sign.

Other good news: I have an appointment for Monday with Dr. Hunter at
Mayo, though insurance does not cover Mayo at all so the consult will
be out-of-pocket. This sucks, but its good to get the best guy on the
planet's opinion if you're able, I feel.

Further good news: I have an oncologist, whom I will meet for the
first time Thursday (tomorrow) afternoon.

p.s. my mom, who is fabulous, came and let my poor dog out in the
middle of the day. For those who were keeping track, I was gone 15
hours straight. I would not have been gone this long had I not had
someone to let her out, of course.

p.p.s. no superpowers as of yet, but I'm still hopeful.

RadioactiveMan

Waiting

I am currently radioactive. Seriously. They injexted me with a radioactive isotope that will settle in my bones and illuminate any areas of concern. It is disconcerting when someone tells you what the half-life of the medicine is 6 hours. Apparently I should not fly or visit the White House in the next day or so, as the dosimiters would go off.

I am hoping to get cool super powers from this. Laser beam eyes or super stretchiness would be some of my first choices.

- M

Nuclear Medicine Bone Scan, Pt. 1

Dr. Ungawa

Some of the players in this story are merely 2-dimensional at this
stage. I will endeavor to fill them out.

Dr. Ungawa (not his real name) has a likewise hard-to-place ancestry.
I'm guessing his family was possibly from Spain originally, but he has
a quality to his voice that leads me to believe he grew up in southern-
rural USA. His suits are just a shade flashier than might be expected,
favoring pinstripes, double-breasted coats and silky shirts with
subtle stripe patterns in them and french cuffs. He appears about 50,
but in denial of his age. He has medium-length, black, swept-back hair
(the hairline and color of which are too perfect to be original) and a
short beard that is clearly dyed black. The snakeskin cowboy boots
complete the ensemme and are everpresent, even underneath his surgical
scrub booties, I noticed. I have a feeling that he is straight and I'm
guessing that he dates women far younger than him. In all, he looks a
little like a sideshow barker or a depression-era roadside Unguents
peddler or perhaps Satan.

Despite the failings of communication, he is a very nice guy and is
known in the area as being one of the most communicative urologists in
the cities (I realize that's relative) and perhaps the best urological
surgeon in the area. His resume is hugely impressive. For whatever
that's worth. I could possibly be in better hands, I could definitely
be in worse hands.

Kaia

This is by far the most trusted and valued member of my daily support network and therapy team.

Meetings

Okay. So I just got back from a long meeting with Dr. Larry. Really
good information. He thought it was strange that Dr. Ungawa did some
of the things he did. Among them:

1) Rooming me with the pathology report sitting on the table for me to
read and peruse as my introduction to cancer before he came in (I know this wasn't intentional, but is a huge professional gaffe).

2) Not giving me any information about what to expect next.

3) Not referring me to an oncologist.

4) Not giving me as much as a "So You Have Cancer" pamphlet.

5) Not talking about the urgency of my situation (all that I now know
I learned myself from the internet this weekend).

All that aside, Dr. Larry says Dr, Ungawa is still the guy in the city
he'd want cutting into him. So that's something. It looking like I
won't really have another option than him and -- bedside manner aside
-- apparently he's a great surgeon that is very highly regarded in his
field.

So I will have another couple of docs on the list, soon. Among them a
therapist. This was a great suggestion that I hadn't thought of.
Someone to help you talk through stuff is very helpful, I can see.
Today I'm starting to be reminded of my 2005 post-crash doctor
followup cycle, and hating the feeling of being a "sickie" that spends
more time with doctors than with friends (and is so tired out from it
that I don't have the energy to see friends). Hopefully this will get
into a sort of routine after the surgery and I won't have to feel like
all I do is talk to and see doctors.

Oh, and I did have something to eat. I'm still 1,860 calories under my
daily limit though, so perhaps I'll have something more.

Setbacks and discoveries, not all bad.

So some frustrating news today. Apparently I can't switch to UCare
until November (MinnesotaCare only gives you one time a year to
switch). Though apparently my primary care physician can write a note
to HealthPartners asking them to consider covering me. But that takes
2 weeks to get through the system over there at HP. And there are no
guarantees.

I may not have any option other than Dr. Ungawa and HeathPartners. It
would be almost completely covered through HP, but Ungawa wouldn't do
the procedure laparoscopically (where they make only a small
incision). The Mayo doctor, whom I shall call Thompson S. Hunter can
do laparoscopic surgery. Doing the incision traditionally will be
nearly a cesarian-size scar and a longer recovery.

The last item means that there is a case in favor of using Dr. Hunter.
Today on stolen breaks from teaching I coordinated with Dr. Ungawa's
office to send my original pathology slides to Dr. Hunter, which they
agreed to do. So they're winging their way to Rochester even as I
write this. I had to lie about my hard deadlines in order to get them
out today. I don't feel bad about that.

Tomorrow I will drive to Dr. Ungawa's office in Edina, get the CT scan
CD and written report and then drive it to Rochester myself, since Dr,
Ungawa's office has no way of overnighting things. At all. Ever.
Apparently. So a trip in the convertible to Rochester is on the
docket, immediately after I get my bone scan done tomorrow. Hopefully
its sunny, at least.

Off to see my primary care physician. This is the first chance I've
had to see him since this avalanche began, its hard to believe it was
just last Friday that I got this news.

This health stuff is a full time job!

Strange

It is 2:29 pm here in central time zone and I still haven't had
anything to eat today. Mostly because I forgot before heading to work,
but I still don't feel hungry at all. I'm making some stuff now. Don't
worry.

Minutes

I have used 965 minutes this month so far. Averge usage for me is
about 200. Night and weekend social calling now recommended!

Psychosomatosis

I'm feeling almost no hunger these days. I think it would be very
early for the cancer to be causing this, and I tend to link it to
stress. Though there is a dull pain in the lower stomach area
occasionally. It serves one of the very few daily reminders that that
there is Something Going On. In general my energy level and spirits
are surprisingly good. The support is hugely helpful in that regard.
I find my body is already speaking up as far as when food is good,
though. I had some brown rice and broccolini the other night and it
was one of the best tasting things I've had in a while. Clearly, just about
every dietitian on the planet would agree that brown rice and
vegetables are good for everybody, and that's not exactly news to me
either. But I find that body craves certain things and listening to
those cravings is difficult at first.

As an example, when I broke my leg in the 1991 motorcycle crash, they
put a rod in my femur. This is a big bone, and in order to make space
they took out the marrow. The rod is hollow and it has grown back now,
surely. But right after that surgery I intensely craved steak and
broccoli, two high-iron foods. I never cared for steak and I hated
broccoli so that was odd to me at the time.

I was vegetarian for 7 years (and vegan for 3 of those) and I find of
all the varied and variously wacky food plans I've followed the best
diet for me is a vegetarian + fish diet, what I call Fish-atarian. I
learned the other day that breast cancer is nearly unheard of in
Japanese women and this linked sometimes to their nutrition, as
Japanese tend to eat a diet rich in fish. Whether this is a
coincidence or not remains to be seen, but most people would tend to
agree that fish is good for you regardless.

Further statistics: bladder cancer usually affect urban, white males
over 50. I'm not 50 yet, but the rest applies. I guess all that clean
mountain air wasn't quite enough to cleanse the system. Maybe the 8
years of high altitude (9,000 feet) deprived the cells of oxygen and
thus weakened the system. I dunno. Other risk factors (compiled from a
variety of sources) for bladder cancer include smoking (I occasionally
smoke a tobacco pipe but Dr Ungawa brushed that off as not
significant) working with certain chemicals such as Benzene, and
having had too much artificial sweetener or caffeine. I did work with
Benzene though not for very long, and I definitely have been
unhealthily hooked on caffeine in my life. I also pounded the Diet
Coke for years. I'm now off caffeine altogether, have been since my
diverticulosis episode, where the iv-fluid/feeding bag was rudely
caffeine free, so I went through the Caffeiene withdrawal in the
hospital and decided to just stay off it.

I have been having some difficulty sleeping and that could be stress
as well. I have resorted to the Ambien the last few nights. My
prescription bottle is nearly empty and they are loathe to refill it
since it can become habit-forming. The last 'scrip of 20 pills lasted
me about a year, but I've been burning through them the past few weeks.
What I'm really missing right now is going to the gym. I don't want to
overdo it, but the last few times I was there (before the biopsy) I
had intense lower abdominal pain and had to stop. This was just doing
the elliptical, which is a very common machine for me. So I'm walking
now, which seems to be fine. The bicycle for some reason is also not
good right now, which sucks.

Off to teach at Big Box Driving School, though this will be my last
day for the next while. I have enjoyed the distraction and I'm happy
to have finally gotten in with a school that seems well-managed with a
good curriculum that I can get behind. Definitely the best program
I've found yet. Hopefully I'll be able to come back to it after all of
this.

This post seems a little somber. Mostly its just morning.

- M

m sent you a lol

Something positive, or at least entertaining:

http://engrishfunny.com/2010/06/21/engrish-funnycrap-your-hands/

Mondaze

The phone, she is going off. And the video games, they are going on. I
deserve it.

Project Management 101

Years ago I took a project management seminar when I was working at a small ad agency in Boulder, which I will call Sho' Nuf advertising. My boss, whom I will call Dick, sent me to a 2-day project management seminar in Denver (which he often reminded me after the fact had cost $1,000). As a notoriously disorganized person -- but yet someone who needed to track big projects -- it seemed like a good idea. It was, though I did not emerge the next day a project management whiz-kid. I did learn a lot and I retain some of that to this day. Thanks, Dick.

I was reminded of all of this today when I realized that this stage of the Condition involves making phone calls, going to meetings, appointments, weighing information, getting better information, comparing conflicting information, weighing it all and eventually making decisions based on possibly substandard information becuase time marches on. Scribbled notes, promises to one hand based on the other hand's ability to deliver. Financial considerations. Budget constraints. Time constraints. Weighing completion time v. price. Bids. Schmoozing. Some insincerity with people that I need information from regarding the hard deadlines. Followup with stragglers. Fudging of deadlines. "Begin With The End In Mind, they said. A great idea. And I have. I'm also identifying stakeholders and obstacles and getting buy-in, but the project scope is undetermined. Unfortunately, there really isn't a lot of time-padding in my deadlines. I need it all yesterday. Just like every other project manager.

As I was saying to a friend earlier today, the actual medical process may be a welcome relief.

My life.

Thanks be for rollover minutes.

I don't use my phone as an actually phone much these days, but since I got the diagnosis last Friday my phone has been in use nearly constantly. I'm burning through my AT&T rollover minutes in a hurry. I still have a bunch left, but still.

Today I've been feeling the push-pull of different people who want me to make decisions, ASAP -- and balancing that with lack of information. I finally talked to Mayo directly and am making progress towards getting in to the the guy that I want to see.

It appears that if I stay with Healthpartners, they wouldn't cover any of the cost of mayo -- 100% out of pocket. But apparently UCare would cover Mayo fully with only a miniscule copay -- including hospitalizations, etc. I missed the window to talk to the MinnesotaCare colks today to see about changing my provider. I feel that they might make me wait until the end of the month for it to be effective, or perhaps longer. The good news is that UCare also covers my primary care physician (Dr. Larry) and the original Urologist, Dr. Ungawa (not his real name), who h is apparently one of the top men in his field, but definitely lack some in the communicating-with-patients department.

Tomorrow I go back for another day of teaching at Big Box Driving School. I taught today and I love the curriculum, the students, my new boss is great and very understanding. It keeps me focused and from feeling useless, which otherwise I'm sure I would do. Too much time off, as I know well, can be very toxic.

I was reflecting today that this is not my first major life changing medical event. My motorcycle crashes in 1991 and 2005 were significant. My diverticulosis episode is still a recent memory. So While some may say that I have a grey cloud hanging over my head or 10d6 of Unluck, at least I'm better than most (I flatter myself) at dealing with catastrophes. I'm good at compartmentalizing things, mentally shelving things until the next day and taking it -- to use a well-worn phrase -- one day at a time.

I've had so much support from family and friends that I am feeling that I may never be able to repay this debt of gratitude. Everyone has been hugely helpful, most noteworthy my mother and brother, R, J, G, the McMasterson's.

I really appreciate all the little notes too. It means a huge amount just to get the texts and FB notes that say "hang in there" or what have you. Its easy to feel alone in this time and everyone has been very good at keeping in touch and distracting me.