Friday, November 13, 2009

Back so soon?



I'm back in Montana...and unemployed for the second time in 2009. Wow, I must really suck. Perhaps I have a future in a job where I wear a name tag. Quite a few people have asked me what happened. I'm not going to try to explain it on Facebook...and I'm not even going to attempt to explain it here either. Because:

1) I'm not 100% sure myself. Really.

2) Trying to explain it would take me an hour to write and you 10 minutes to read. And it would just make me look (and feel) like a victim. I refuse to go there.

3) There's great people that work at that station and I would never do anything that could possibly hurt anyone there or reflect badly - even indirectly.

I will say this much. I committed to them (at great sacrifice to myself, not to mention great hardship to my wife). And I disagree vigorously with the (very weak and Catch-22ish) reason given for my termination. The dismissal was awkward and botched. Hell, I'm pretty sure I have given more thought to what socks I should wear on occasion than the thought that went in to my exit.

And I'm proud of how I embraced Milwaukee...I went to several concerts (indoors and outside) and several Brewers games...to the Domes and the Milwaukee Art Museum...saw movies at 4 different "neighborhood" theatres....went to the Rep Theatre...participated in Aids Walk....even volunteered regularly at Animal Control. I enjoyed eating at Italian, Vietnamese and German restaurants. I walked (and rode my bike) miles and miles through various neighborhoods. I joined a great health club. Oh there were times when I sat in my puny apartment (furnished as if I was back in college) and wondered what the hell I was doing there...but I clearly embraced my new city and never would have simply bailed out on the company that hired me just a few months ago and moved me across the country.

So yeah, I feel a bit silly about the very things I said here a few months ago. Comparing non-profits to corporations and all that. Well, I'm not going to get too down on myself for being excited about a new job in an era of 10% unemployment. Just another lesson learned by a guy who keeps thinking that he's too old to learn new things and keeps getting proved wrong.

Finally...it feels great to be back in Montana...as I have also said on these pages before - my wife and I have made sacrifices to get here and to (try and) stay here - so I'm going to enjoy Montana. Again.

Thursday, October 15, 2009

Q3 Report


I'm just a bit late with this, but I was waiting on some lab results. I recently had my first PSA test since my Proton radiation. I'm 3 months out of my treatment and my PSA has fallen from 3.01 to 1.0. I also had my cholesterol checked and it has fallen from 217 to 185 over the past 6 months.

Each of those numbers were just about what I would have predicted. Maybe they are what I would have optimistically predicted as I'm pretty pleased with the progress. The PSA should continue to fall to (hopefully) below 0.5 over the next 6 months.

I'm probably more proud about the cholesterol drop. The PSA was the result of the radiation, but I'm responsible for the cholesterol number. I think I can take another 15-20 points off of it in the coming 6 months. I've managed to hold the weight down after nearly 3 months in the land of beer and brats. This week I joined a very nice health club about a mile from where I live...I think that will be key to not regressing through a Wisconsin winter.

I really had to stop and appreciate my health results today. It's pretty easy to get caught up in the day-to-day stuff, but it doesn't mean anything without your health.

Sunday, September 6, 2009

The Neighborhood



(This is not my home)....but it is within a few blocks of where I'm living. I'm finally getting very familiar with my neighborhood in Wauwatosa, WI. With the exception of roughly a year back in my mid-20's when I lived on Grandin Rd. in Roanoke, I've never lived in a city setting. It has either been suburbs or rural. What I'm about to write may will likely seem so simple and uninteresting to many...but I've never lived in a setting like this before and I find it all very interesting. My apartment is nothing special...maybe 600 square feet. It fills the need for now while our house in Montana is on the market (and not drawing any interest).



Wauwatosa is immediately west of the city of Milwaukee. It has three business districts...the 'Tosa Village, North Avenue and the Mayfair Mall area. I can walk to the first two areas in minutes. I can even walk to work...it's just in the Milwaukee city limits a mile away. Big deal? Well, I've never lived anywhere where I could walk to work, grocery stores, restaurants, movie theatres, etc... So, that's all great, but I'm more impressed by the diversity and the character of the neighborhoods within a few blocks of my rental. Specificially how they change from block to block.



Milwaukee is one of the most notoriously segregated cities in the US. The radio station is located in one of a handful of areas where you may actually see blacks and whites living side-by-side. Go a few blocks to the east, and it's all black....a few blocks to the west, and it's pretty much all white. And as you walk block to block, you notice something else - the significant changes from one block to another. One block may be mostly duplexes and the next single family homes. One may be full of 1,000 square foot cottages and the next could have larger homes with the next having mansions. One block is brick homes...the next siding....One block has upstairs porches, the next does not. In addition, no single home on any block is like another. The 1900 block of N. 64th street feels different than the 1900 block of N. 65th street. The 2000 block of N. 72nd feels different than the 1900 block does. In most of east Wauwatosa, huge trees canopy the street. I've been caught in the rain a couple times and barely gotten wet as I stayed under the cover of 100 year-old trees.


You can find cottages and fixer-uppers for under $200,000. Most of the homes in east 'Tosa would sell for between $225,000 - $350,000...but get into the Washington Highlands or Milwaukee's adjacent Washington Heights neighborhood and many of the homes are on the National Historical Registry and sell for up to $ 1 million. Property taxes are very high (by my standards) even the cheapest homes have taxes in excess of $4,000 annually...the homes in the Heights that may sell for $500,000-750,000 have annual taxes between $12,000 and $15,000. You don't want to get homeowners here started in a property tax conversation!

So, I'm here for now...I love the character of the neighborhoods...I love walking to dinner and a movie in 15 minutes...or the grocery store in 5. I didn't see myself in my mid forties living like this, but it's up to me to make the best of it until something more permanent can be worked out.

Saturday, August 15, 2009

A pretty good day




This blog has been a bit neglected. I've been dragging. I'm in a period of a couple weeks where I feel so uncreative. Not sure if I've had a good idea all August. What's behind it? I think I was due. May, June and July were so intense - so much was on the line - I could not afford a let down. It was manic at times. I basically moved 1,000+ miles two times. Made three trips to California and three more to Milwaukee. Arranged and completed a regimen of medical treatment and simultaneously found a new job and a new place to live. Now the pressure is off...there's no more gun to my head, so I guess this has been the decompression. There's also a bit of frustration because the last puzzle piece is out of my hands. I could be proactive about my medical treatment and I could be actively looking for a job... but I cannot do much to help sell our house back in Montana (short of listing it for a price we cannot afford to accept)...and that eats away at me as I'm anxious to truly move on with my life.


Today started with no plans and no expectations, but ended up being filled with a lot of very small things that went well. It was just what I needed. Shortly after I woke up I remembered that RadioMilwaukee had a booth this morning at the East Town Farmer's Market. I headed downtown to Cathedral Square Park and the Market. My co-worker Theresa handles most of the station promotions...many of which are at evening concerts and festivals. She made a great point noting that people at early morning farmer's markets are so happy and friendly...especially compared to the often-inebriated crowd you'll find at other events. And a steady stream of shiny, happy people stopped by our booth this morning. They had their fresh veggies, colorful flowers and sticky pastries and many made a point of saying how much they loved 88Nine. One woman even overheard me talking and said: "Oh wow!, You're Dave...I listen to you!" I like to think my ego is small (as radio egos go) but the recognition was nice...especially since I've been on-air here all of two weeks.


I stayed downtown at the market longer than I expected and then I decided to explore another part of town I had yet to see - I headed for Brady Street. Brady street is somewhat Bohemian. Full of bars, restaurants, thrift stores and the like. They were shooting a movie there today (I understand it's set in roughly 1920 New York and that David Strathairn stars), but I saw little specific evidence...just a bunch of guys with two-way radios and many equipment and personnel trailers...yes, a few had stars on the doors. I walked all over and checked out the "cool record store" (Every "Brady Street" has a "cool record store", though this one is about a half block off-Brady) and then I ducked into a Thai restaurant and had a great green curry for lunch. I drove north from Brady street and quickly stopped to walk off my lunch at Lake Park. Old Italian men dressed in white were playing Bocce ball on an immaculately groomed field. A wedding party was posing for pictures. It was a sunshine and lollipops kind of day. As I was driving to Lake park, I passed the ginormous Whole Foods store and couldn't help but think of the remarks their CEO made this week...He basically said that we are a country of obese people who need to take personal responsibility for their own health - and that if we finally did so, government health care would not be necessary. He's right, America is on a terrible nutrition path. However, he came across as an insensitive elitist and his comments certainly do not align well with the stereotypical Whole Foods shopper....thousands have already joined the "boycott Whole Foods" Facebook group that mushroomed this week. I laughed...and then drove straight to Trader Joe's.

On my way to Trader Joe's I drove through the heart of Milwaukee's highest-dollar neighborhoods...the lake-front homes of Shorewood and Whitefish Bay. Amazing. Trader Joe's is part of a newly refurbished mall that feels more like a city street than a sterile mall. I love Trader Joe's...some of their stuff is so inexpensive I'm sure it must have fallen out of the back of a truck or be tainted in some way. I try not to think about it as I load my cart with yummy, healthy stuff (and very cheap wine). While it's clear across town from where I live, I'm glad that I live in a city that actually has a Trader Joe's...and it's only 15-20 minutes away.

After I put the groceries away I still had time for a lengthy bike ride. Milwaukee has an excellent system of bike trails...the best being the Oak Leaf Trail that connects most of the city's parks in some fashion. I biked through Jacobus Park (where an adult Raccoon ran out of the underbrush right in front of my bike, scaring us both equally) and then to Doyne Park. I took note of the par 3 golf course at Doyne as these are pretty much the only type of golf courses I can play with out major performance anxiety and embarrassment. I snapped this picture of Miller Valley. Schlitz, Blatz and Pabst breweries are closed, but Miller still employees 2,200 workers here. From there I biked to the Wisconsin Humane Society...I didn't realize how close it was to my apartment. It's a very nice facility...I took this picture of three Pit Bull pups cuddled in one of the kennels.


So that's it...a series of tiny and mundane things made up this Saturday. No single one worth blogging about, but - taken as a whole - a pretty good day.

Thursday, July 30, 2009

DOH! - Keys!


I've got to get used to these things. For the last 14 years I didn't even carry house keys. When I lived in Bozeman I didn't even have house keys...in fact, I think that when we sold the house in Bozeman we had get new locks installed.


It's not that I feel unsafe in Milwaukee (I don't)... but I've acquired many more of these key things. There's two keys just to my house (a key to get in and then a key to my upstairs apartment)... In fact, my apartment door automatically locks behind me. I am so not used to grabbing keys before I leave the house. In Montana, my (few) keys just stayed in the (unlocked) car all night. It's just a matter of time before I lock myself out. I'm pretty sure that day will coincide with the coldest day this winter. Hope the landlord is handy.


Meantime, at work, I've got another door that locks automatically behind me...and I've got keys for both the studio office and the annex office across the street. After losing 25 lbs. recently, I'm pretty sure that my extra key weight could drop my pants to the floor at any time. Who knew that keys would be near the top of my list of challenges when adapting to a new city?

Monday, July 20, 2009

*sigh*



Take my word for it...that speck in the center of the side-view-mirror is the "Welcome to Montana" sign. A few minutes past 10am this morning I saw Montana disappearing behind me and there was a lump in my throat and an empty feeling in my stomach. I arrived in Montana 18 years ago and never really thought I would leave. I was 27 then. Single. I found someone to sublease my apartment in Virginia...and when I arrived in Montana I already knew quite a few people...aunts, uncles and cousins. Today I'm off to my new job in Milwaukee (a place where I really don't know anyone) and I'm leaving behind my wife...and my mom...my friends, my cousins and my former co-workers.


People my age shouldn't have to "start over" again. It's a lot harder now than it was in 1991...but hell, if it was easy everyone could do it. I'm so fortunate to have a very cool job in Milwaukee...one I believe is a perfect fit for me. There's a couple of guys I have "met" on the prostate cancer message boards that just cannot find a job. They're not that much older than I am. One has been unemployed for a year - the other has just given up on finding a job...he's trying to settle on a treatment while his COBRA is still active and he and his wife are selling their house and most of their possessions and moving into an apartment. I really have it pretty good.


I worked pretty hard in Montana and in the last couple years I missed out on much the state has to offer. I didn't much ski/fish/camp/visit relatives. In one of my earliest posts I lamented the fact that I was too scared/busy/stressed to take all my vacation time in my previous jobs. Well, my new job at Radio Milwaukee comes with a generous amount of vacation time. I'm sure I'll spend a lot of it in the "Last Best Place"...

Thursday, July 2, 2009

I have been Hypofractionated

I just completed the last of my Proton Beam Radiation treatments. Tomorrow morning I'll get in the car and head north on I-215. As I climb through San Bernardino I'm sure I'll sneak a glance over my shoulder (or in the mirror)...one final peek at the structure that dominates the community of Loma Linda below. The Loma Linda Medical Center can be seen for miles and I'm sure I won't be able to resist one last glimpse.





I'll miss my comfy, little cottage...I'll miss my very cool neighbors-Mary & Marty. I'll miss my walks all over town...especially down Huron Street which offers great homes, landscaping and a view of the town below. I'll miss the crew of Gantry 3...especially Ken and Jessie. It's not like we exchanged emails and will remain friends; however those guys were awesome every day and their level of care and concern for the patient was appreciated. I'll miss the Drayson Center...especially its huge pool on a 100-degree day. I'll miss the Vietnamese and Thai restaurants. I'll miss the amazing smells of the flowers all over town (I will not miss the awful smell of the automatic air freshener in the changing room...I thought of disarming that thing nearly every day)...I'll miss the huge variety of produce and healthy food available at a great price from Clark's or Trader Joes. I'll even miss the helicopter traffic at all hours. In between the balloons and the beams and the 3am trips to the bathroom, I stood on a mountain and surveyed the desert below...I stood in the ocean...I drove all the way into LA (like a big boy) three times and I rode a cable car in San Francisco.





It can't (and certainly shouldn't) last forever...but I found myself thinking the same thing as Dana Jennings expresses here: http://www.nytimes.com/2009/06/30/health/30case.html?_r=2&ref=health Dana has been blogging about his Prostate Cancer for the New York Times for some time. He has a MUCH more serious situation that I did...a more aggressive cancer, failure of surgery to remove all the cancer and the subsequent hormone and radiation treatment. Dana makes an interesting point about the odd fact that the daily routine of treatment can be a comfort in and of itself...and that some people feel at a loss when it's over. I think I understand, and I'm thankful that I have a new, exciting and challenging job to jump right into after treatment.





I'm glad I made this treatment choice, and I'll be happy to recommend Loma Linda to prospective patients, but I'd like to be a year removed before I do so. I really want to see if the clinical trial (the hypofractionated part) I chose proves to be as effective as the standard protocol...and I want to see if I get a year past treatment without side effects cropping up. I will agree with one thing that I was promised prior to treatment: Loma Linda (both town and medical center) is a magical place that has a lasting effect on all who spend any significant time here. So long, "beautiful hill".

Tuesday, June 30, 2009

Q2 Report


"I wouldn't say I've been missing it, Bob."

So my period of unemployment pretty much lined up exactly with Q2...and you may have noticed, I have been missing a lot of work.

Well, I certainly haven't missed the passive-aggressive, condescending head games that accompanied the home stretch of my previous job. But, it's June 30th and Q2 deserves at least one summary report. Sorry that it's not in spreadsheet form.

2009 Q2 vs. Q1

weight..... down 13%
waistline..... down 10%
sit-ups in 2 minutes..... up 100%
new friends made..... up 400%
stress..... down 50%
PSA..... down ??% (will know soon)
Cholesterol..... down ??% (will know soon, too)
salary (adjusted for cost of living)..... flat (new job)
annual vacation time..... up 150% (new job)
number of people I fired..... down 100%

Not a bad quarter...too bad I was my own boss for the past 90 days...no one to impress with these strong numbers. I think I'll print them off and put them on the refrigerator. With a gold star or smiley face. Or both.

I miss a lot of the people I used to work with. Last week brought some great news for the programming staff of my former stations. The ratings were up significantly. I believe that 6 of the 7 stations (possibly all 7) went up in the just-released ratings (unheard of). I may have had a small impact on that. Also my old group had 6 first-place winners (out of only 11 categories) this past weekend at the Montana Broadcasters awards. No other radio cluster in Montana had even 3 nominees. Angel, Shawn, Peter, Craig, Aaron, Erik, Denny, Jannette and others...a great bunch of talented people who I didn't spend much time with because I was focusing on the "other" side of the building. I think the thing I'm looking forward to the most in my new job is once again focusing on the programming side of the building...and (very rare these days) focusing on just one station.

And with that, my corporate duties for Q2 are finished. If you haven't done so already, please schedule your one-on-one with the Bobs ASAP. The sign-up sheet is beside the copier...right next to the TPS reports.

Friday, June 26, 2009

Found A Job

So think about this little scene; apply it to your life. If your work isn't what you love, then something isn't right. - Talking Heads: "Found A Job"


Okay, okay...so I didn't jump; I was pushed. I was fired on March 30th and I have spent much of the past few months finding a job. My goal was to be employed by the time my severance ran out and by the time my radiation treatment was over. Both of those dates pretty much coincide with July 1st. Despite the omnipresent fear of being without work as the unemployment rate inches up to 10%, I resisted the urge to apply for every opening I saw. I came to grips that I may have to leave Montana to find a suitable job...and I realized that this may finally be the time to run screaming from radio - my career of the past 25 years.



(By the way, my former company has since fired two more of their Montana Managers...All three of us were either lazy idiots who were bringing the company down - or - Our 55 years combined Montana radio experience was viewed to be less important than our combined salaries. You decide.)

(new update...as of 6/29...they just fired their 4th Montana manager...70 years of Montana radio experience is now out)


So while I was still receiving severance checks and radiation I figured I could be picky and only apply for jobs that I really felt were a great match for my skills AND would also be personally rewarding. I applied for a few non-profit positions (mostly environmental) in Bozeman. I also found 4 radio jobs that I thought were "right". Three of those four radio jobs were at non-commercial stations. And now I have accepted the position of Program Director at 88Nine, RadioMilwaukee. http://www.radiomilwaukee.org/






Wow...I know what that appears to be on first glance. I've gone from the General Manager of a corporate seven station cluster to the Program Director of a single non-commercial, class B1 station. But if you don't get it, then you probably don't get me. To start with, 88Nine already has nearly the listenership of the combined total listenership of the 7 stations I used to work for.




I have already (at great length) explained the precarious position that commercial radio is currently in (go back 2 or 3 blog postings) so I won't repeat any of that negative stuff here. I'd rather focus on what makes 88Nine such a great station and an attractive job.



88Nine is already a very solid radio station. It sounds great...no small feat considering that the station is primarily a mix of two very different music formats. AAA (Adult Album Alternative and Urban/Hip Hop). But the music is presented with care by people who are knowledgeable and passionate about what they're doing. Home-grown Milwaukee music is featured...and not just at 3am. A Milwaukee artist is pretty much played at least every hour. 88Nine is not your stereotypical "left end of the dial" non-comm. In fact the presentation and formatics are much closer to commercial radio than you may think. It's, uhm, professional. (Dave, you say it like it's a bad thing! It's not.) I'll be a (mostly) off-air Program Director with a staff of four full-time (mostly) live announcers and 3-4 part-timers. My radio friends will immediately realize that a staff like this is unheard of in commercial radio these days. Your typical PD is now overseeing 2-3 stations and is lucky to have one or two announcers (seldom live outside of mornings) on his or her staff. We also have a Producer who is responsible for the public service segments that are a major part of our programming. Serving the Milwaukee community is a key cornerstone for 88Nine. Public service campaigns are identified well in advance and executed to great depth and detail. They're well-done, entertaining and achieve results.



The staff is (mostly) young. They're smart, talented and generally haven't had their spirits crushed by soulless corporate suits who only view them as a line on a spreadsheet. Unlike much non-commercial music radio, the station sounds consistent throughout the day regardless of who's on the air. That's not to say that the personalities don't come through...they certainly do - and each jock has one or two speciality shows or segments where they can break format and spotlight something they have a personal interest in. The station is tied to the live music scene. There are several awesome live music venues in Milwaukee. Coming attractions include Buckwheat Zydeco, Stevie Wonder, John Legend, Tracy Chapman, The Psychedelic Furs, Brett Dennen, Malford Milligan, Mat Kearney, G Love, Earth Wind & Fire, Rusted Root, Buddy Guy, The Fray, Elvis Costello, Kill Hannah, Tab Beniot, Black Francis, Peter Murphy, Sonic Youth, Lyle Lovett, The Bottle Rockets, Shooter Jennings, Social Distortion, Tori Amos, Pete Yorn, Justin Townes Earle and, yep, the Jonas Brothers....all coming in the next two months. As I type this I'm listening online and 88Nine just segued "Jeepster" from T. Rex into Paul Weller's "Sunflower".




The General Manager and Chief Engineer are radio veterans that actually have Montana ties. The new Executive Director has extensive experience fundraising with many successful Milwaukee non-profits. Some people that were associated with the station start-up a couple years ago include Mike Henry and his team at Paragon Research and J. Mikel Ellcessor (formerly of New York City NPR and now GM of Detroit's NPR)... Finally the station is partially funded by Peter Buffett's Novo Foundation (go ahead, Google it)... The outgoing PD (leaving on his own accord as his wife just accepted her dream job) came to 88Nine from "This American Life" in Chicago.



And, by the way, the station is only about 2 miles from Miller Park...the impressive home of the Milwaukee Brewers. That's got to count for something. To make a Montana reference, Milwaukee reminds me a bit of Butte. It's lost some population over the years as it has battled to redefine itself after the loss of traditional industry. Both towns are noted for tough, blue-collar neighborhoods. Each town has an historic ethnic component. Each is the occasional butt of jokes. Milwaukee, like Butte, is a town full of character. Each is filled with proud natives that wouldn't be anywhere else. The main tag line for the station is: Diverse music for a diverse city - 88Nine, Radio Milwaukee.







So I truly think I just got one of the best jobs in all of radio. I'm gonna try not to screw it up. 88Nine is a treasure...a treasure to be cherished and nurtured. Most of the staff thinks that they've just really hit their stride and great things are in the future. I agree.

Friday, June 19, 2009

The Tinkerer





You probably know one. This guy cannot stop tinkering with stuff. Even when there's nothing wrong, he's gotta dive in, tear it apart and build it back up again. The tinkerer is exhausting in his all consuming pursuit of perfection - there's no detail so small that it escapes his attention. Fueled by an over-abundance of hubris, the tinkerer works 24/7....analyzing, measuring, evaluating and (yes) tinkering.


Back when he was just a kid (a loner...promoted ahead a grade and without friends) the tinkerer realized the need to form an alliance with someone that would compliment, but not threaten, his skills. The tinkerer found the stress-tester perfect for this idea.


The stress-tester was always seeing how much he could pile on before something gave in. The tinkerer observed him stress-testing ants under a magnifying glass, kittens reaction to a lighter and smaller children and their reluctance to part with their lunch money (until the stress-tester found the necessary amount of pressure to apply). The stress-tester had friends...but these were just boys who were weaker and whose friendship earned them protection. This would be the start of a productive relationship.


Even the stress-tester knew that he needed an accomplice. Deep down, he knew that he wasn't too smart. He was receptive to the tinkerer's overtures.


They're into adulthood now and making their mark. The tinkerer shows the stress-tester just where to apply the pressure. Sometimes the flaw is obvious and the faulty part is quickly exposed. More often though, the tinkerer has to tinker a bit...and the stress-tester has to apply firmer and more constant pressure. This sometimes takes months, but the tinkerer is never wrong, and the weakness is always eventually identified. The good news is that the tinkerer has found that these weak parts can always be replaced by cheaper parts. These parts seem readily available these days.


After all, life in the business world is all about getting the right people on the bus. First, of course, you have to get the wrong people off the bus. Through the proper application of stress and careful, constant tinkering, this can be accomplished. But head's up...it's easy to drive the bus off the road while you're having so much fun tinkering around. Have a nice ride.

Monday, June 15, 2009

The Proton Experience

Now that I'm in the middle of my treatment I get questions from friends about it. Specifically the daily ritual. I often say, "it's nothing" or, "piece of cake". I wonder if they think I just don't want to discuss it, but the truth is that it is so mundane and non-invasive that there is really very little to discuss. I'll give it a shot.


First I guess I should explain why I chose Proton radiation. Prostate cancer, unlike many other diseases has several treatment options. You can make strong arguments about the effectiveness and side effects of each. The fact that a disease has a half-dozen treatment options probably means that none of them are great. Most people choose surgery. Within the surgery category, you have two choices: conventional "open" surgery or (in theory) less-invasive robotic surgery. And right there you could have a heated discussion about the pros and cons of each surgery type. No surprise, but the best surgical outcomes seem to be directly tied to the (significant) experience of the surgeon. It is a extremely challenging procedure. The urethra is clipped - as it runs right through the prostate - and then sewed back to the bladder. The nerves that allow for erections run along both sides of the prostate. If either of these nerve bundles cannot be saved or is damaged in surgery the patient will almost certainly experience ED issues. Some people are not even candidates for surgery. If it is determined through tests that the cancer has escaped the prostate capsule surgery is not usually recommended (what's the point?) Most of those guys are treated with a combination of hormone therapy and radiation.



Many men chose radiation. Conventional radiation. Guided radiation techniques are improving, but I did not seriously consider this option because a lot of the radiation is spent entering the body and in exiting the tumor area. Some men have radioactive seeds implanted in the prostrate (usually about 100 seeds, each the size of a grain of rice) This is Brachytherapy. A very few choose "freezing" or Cyrosurgery. The latest "new" technique is HIFU. High Intensity Focused Ultrasound. It is not approved yet in the USA, but is available in Europe, Japan, Canada and Mexico. I really think there is a lot of promise for HIFU as a high-success, low side effect treatment. I wouldn't be surprised if it became the preferred standard in 10-15 years. But for now there are two competing machines being evaluated and doctors are still perfecting their skills with HIFU. I read of a couple guys who had the procedure in Canada with less than wonderful outcomes.



I chose Proton therapy because it seems to offer cure rates on par with surgery and it seems to have fewer side effects. I liked the physics behind it. With protons, the technicians can deliver the majority of the energy directly to the prostate. (I won't even try to explain it here... Google: "proton Bragg Peak" for more). I was pretty sure that my small and modestly-aggressive tumor would be killed by the radiation. Surgery just seemed so medieval. Not all insurance pays for Proton radiation, but mine will. And being temporarily unemployed I had the time to travel to one of the 5 proton centers for treatment. I also chose a clinical trial where I receive a larger daily dose of radiation and have fewer total sessions. This will make my stay in California one month shorter and (in theory) get me back on someone's payroll a month sooner.



Loma Linda has three proton treatment gantrys (the 30' rotating "cone") You are assigned a gantry and always are treated in the same one. This leads to affectionate referrals to being a "gantry 3" graduate just as someone might refer to the "class of 1995" or "Pi Kappa Alpha". Prior to beginning treatment your "pod" (what I'm laying in above) is crafted especially for you. Liquid mold is poured into the pod shell while you lie still. This way your body is always in the same position for each treatment. Also prior to the first treatment a CT scan is taken and the doctors use that to design unique apertures for each patient. These apertures guide the proton beam even more directly to the precise area. Patients receive radiation each weekday. You're supposed to drink 2-4 glasses of water 30 minutes before each treatment. This helps to lift the bladder up and out of the way of the radiation beam. I'm not sure some guys always drink the water but I was lectured that it was especially important for the clinical study, so I am very faithful with my water intake. I cannot tell you how many times my bladder has been ready to burst toward the end of a session, but it is a minor inconvenience. Patients are called into a changing room and we don our hospital gowns...no reason to tie them closed...we all just flap open in the back. When the guy in front of you is done, he comes back to the dressing room and sends you in. You climb into your pod and the first thing you do is turn on to your left side for your "balloon". It's the necessary evil of Proton treatment. A technician inserts a condom-like balloon into your rectum and inflates it with 2 ounces of water. The balloon remains inserted for the next 10-20 minutes of treatment. The purpose of the balloon is to protect the rectum from the radiation. The pod is then positioned exactly using laser beams. The patient-specific aperture is loaded, the technicians leave the gantry for the safety of the control room and the radiation is delivered. And now through the magic of copy and paste, here is how it happens:

Each proton begins its journey at an injector located within an electric field. In the field, hydrogen atoms are separated into negatively charged electrons and positively charged protons. The protons are then sent through a vacuum tube within a pre-accelerator. This process boosts their energy to two million electron volts. The protons continue in the vacuum tube and begin their high-speed journey in the synchrotron. They travel around the synchrotron about 10 million times per second. Each time they circulate, a radiofrequency cavity within the ring delivers a boost of energy. This increases the protons' energy to between 70 and 250 million electron volts. The voltage achieved is enough to place them at any depth within the patient's body. After leaving the synchrotron, the protons move through a beam transport system, continuing in the vacuum tube through a series of steering and focusing magnets that guide them to the four treatment rooms. (A fifth room, used for beam calibration and basic research, contains three additional beam lines.) One treatment room has a stationary beam with two branches. One branch is for irradiating eye tumors and the other branch is for central nervous system tumors and tumors of the head and neck. The other three treatment rooms have gantries. Gantries are wheels 35 feet in diameter and weighing approximately 90 tons, which revolve around the patient to direct the beam precisely to where it is needed. From the patient's perspective, however, all that is visible is a revolving, cone-shaped aiming device. Each treatment room has a guidance system to direct the beam that treats the patient. The guidance system monitors the beam until it enters the patient and positions the Bragg peak to conform to the size and shape of the tumor and the immediate volume at risk for tumor spread, according to a plan designed by the physician. Field sizes to accommodate regional spread of tumors can be as large as 40 by 40 centimeters. The beam delivery system, or nozzle, is the last device the protons travel through before entering the patient's body. The nozzle shapes and spreads out the proton beam in three dimensions. When calculating the number of protons to be delivered to the designated volume and the velocity and shape of the proton beam, radiation oncologists take into account the location and shape of the target and the tissue density and depth through which the protons must travel to reach their target. After leaving the nozzle, the protons enter the patient's body. The entire proton facility is controlled by computers that are equipped with safety measures to ensure that patients receive proton radiation treatments as prescribed. Three host computers control the accelerator and beam transport system. A second set of computers, located in each treatment room, controls the beam guidance system and all other treatment room systems. These computers verify patient identification, set operational parameters for each patient's treatment plan, and direct the host computers to deliver a specified beam.

The actual delivery of the proton radiation takes about a minute. As a patient you feel nothing. There is a flywheel that you hear once the beam is into your gantry...this is followed by a smoke-alarm (though not as harsh) type beeping...it's just the radiation detector in the gantry. Usually there is a CD in the boombox...something soft like Jack Johnson, John Mayer, Sheryl Crow or James Taylor. Since I'm in the clinical trial I get radiation on both sides each day. So the gantry rotates 180 degrees and the process is repeated for me. It adds 5-10 minutes to each session for me...but I'll be done five weeks sooner than patients in the standard protocol. I roll back over, my balloon is removed and I'm on a beeline for the dressing room bathroom.

That's it...kind of boring, but not much to it. Certainly nothing like the chemotherapy my wife suffered through three years ago. Possible side effects during treatment include fatigue, urinary frequency/urgency and some urinary difficulties. I'm not experiencing any fatigue, but I'm noticing some of the plumbing issues. The long-term side effects of Proton radiation could possibly include rectal bleeding and a degree of erectile dysfunction. Long-term proton side effects usually do not appear for 6-12 months post treatment - if at all. Of course I hope to be in the "if at all" category.

Sunday, June 7, 2009

Turn and face the strange

Ch-ch-changes...look out you rock n rollers - pretty soon you're gonna get older.


Terrestrial radio - the venue where I have made my living for nearly 25 years - is in a world of hurt. Some of its problems, to be sure, have been self-inflicted...other challenges to radio have simply come along with technology and innovation. Greed, iPods, the economy, the internet, and satellite radio have all contributed to the fall of terrestrial radio. Some people will tell you that deregulation/consolidation was what really precipitated the fall. Others will argue that consolidation has saved radio. For sure, it ain't what it used to be - nothing is. The last thing I want to do is to come across like Andy Rooney. I really don't like people who live in the past and struggle to embrace change. They end up looking like weak and helpless victims of that change.



Radio will never be the same. As a general statement, its quality and relevance will never approach what it once was. There can however be isolated bright spots. These bright spots may be one personality on a single station, one station in a market or one ownership group among many. The remaining listeners that have not left terrestrial radio will learn to pick and choose their shows and stations...and the employees that are still left with a job in the industry after this "adjustment" is over will hopefully still have the spirit and the opportunity to make a difference.



I've now been unemployed for more than two months. In that time I have only applied for three radio jobs. Not only did I think that all three were a great match for my skills, I also believe that all three are unique and special jobs where passion and quality are expected, and where potential personal rewards could be great. Sit back, pour yourself a drink, and I'll tell you what went wrong with radio and where the bright spots still exist. This could be painfully boring if you are not a radio geek....fortunately a good percentage of my friends already qualify.





We'll start with consolidation. Rules on radio ownership were first eased in the 1980's and then really relaxed in the mid-1990's. Generally, prior to consolidation, a company was allowed to own two stations maximum in a given market. After consolidation that number increased to as many as eight stations in a market (depending on market size). In a medium market you may have had a dozen stations and six different ownership groups. Under consolidation those dozen stations could now be owned by two groups. The argument here was that Mom & Pop were having trouble making a profit...so where it used to take 6 offices and 6 receptionists and 6 engineers and 6 traffic directors and 6 business managers...you could now run those dozen radio stations with only 2 offices and 2 total of each the above employees. This would (in theory) allow Mom & Pop to survive and thrive with a smaller payroll needed per station. In reality, consolidation pretty much pushed Mom & Pop right out of the radio business (don't shed too big a tear, many made out like bandits in selling off to larger companies) because the larger companies with the greater resources gobbled them up. Not all larger companies are inherently evil...but the loss of Mom & Pop spelled the beginning of the end of local ownership ties to the communities served by these stations. Mom and Pop were usually playing with their own money...they realized that there would be good years and down years and tried not to overreact to either. Larger companies are usually not playing with their own money - annual expectations from lenders must be met...and in lean years they would be met by expense reductions (translation: people's jobs). Consolidation did not kill radio. In fact radio THRIVED in the early years of consolidation (just about any endeavor thrived in the late 1990's). But consolidation did sort of kill the spirit of radio in many cases. Consolidation apologists say that it added more choices and formats to the airwaves. For example they would argue that the previous six owners in a 12-station market would all be trying for the most popular formats, so you would have 4-6 rock or country stations in that market....after consolidation, the remaining 2 owners would be free to explore other formats. Maybe, maybe not. I believe that consolidation took a lot of local control away from radio...and also took away much of the risk-taking. We eventually ended up with more format choices, but it was due more to greed than to consolidation.

Greed. The second thing that brought radio to its knees. It happened in a couple different ways. First was owner/operator greed. From the mid to late 1990's, radio was on a roll. The competition from internet, iPods and satellite was still a couple years off. The new, larger companies created from the deregulation/consolidation legislation were growing their profits nicely. And what is expected after a year of 15% profit growth? Certainly nothing less in the following year. For a bit there in the late 1990's broadcast groups were able to grow the profits 15% every year in part due to a strong economy, in part due to the expense reductions enabled by consolidation, but truthfully due in large part to the simple addition of more commercials. Fueled by greed and by corporate demands to grow by 15% every year, managers and companies simply loaded up on commercials. Why not? Radio had no real competition at the time. In the 1990's commercial loads went through the roof and challenged the patience of most any radio listener. Clear Channel and others figured it out. Eventually. But many loyal listeners were driven away to those "new" options (iPods, internet, satellite, non-commercial radio)

Greed part two was a joint effort between the FCC and many radio broadcasters. In the old days, getting a commercial radio license was a lengthy legal process....a process not unlike that cliched radio contest where you have to be the last one placing your hand on the new car to win the vehicle. Only instead of taking hours, this licensing process often took years. You would have to submit paperwork to the FCC stating why you would be the best license holder for the new frequency in your community. Usually you were up against several other applicants. The FCC would then (eventually) decide who "won" the license. Often times behind the scenes, competitors would pay each other off to drop out of the process. Finally the FCC realized that people who wanted a radio license were paying their competition to withdraw. Smart FCC. They revamped the entire process and now auction off new radio licenses without any pretense on who'll best serve the community. Highest bidder wins. Some sharp broadcasters also figured out how to stretch the intent of the FCC rules to allow a station licensed to a given community to be engineered to actually serve a much larger market. All of the sudden these tiny communities, often mere wide spots in the road, became potential hot properties for a new FCC radio license. And the commission was more than happy to now auction them off to the highest bidder. In the past 15-20 years, the number of FM radio stations has probably grown to a figure beyond what the economy can support. Metropolitan areas with barely 100,000 people now may have 20 commercial radio stations. Greed was building an industry that was not even strong enough to support itself. (Disclosure: I personally have benefited from this as I have worked for two of the best-known and pioneering move-in specialists).



All of this was just the set-up for the perfect radio storm, and it is crashing down right now courtesy of the recession of 2008/2009. Let me explain how radio works now that Mom & Pop have long since exited.



In general (and in a "normal" economy) a radio station is worth about ten times its profits. No one buys single stations any longer, so the rule is that a radio cluster of 5 or 6 stations is worth about ten times cash flow. Now, this is an example of what's been happening all over radio for the past ten years. You find a group of radio clusters in several markets that may be for sale (you either build them up one at a time, or you might pry them away from a larger company)...Say you end up with stations in ten communities and say that those stations have revenue of $25 million and profits of $5 million (a modest 20% margin). You take those numbers to the corner capital management firm. You ask for $50 million (ten times cash flow) to buy those stations. You tell the capital firm that with your management and synergies you can grow the revenues to $35 million and the margin to 30% in 2-3 years. That would make the group of stations worth $105 million. Not a bad return on that $50 million investment. They happily put up the money. Examples similar to this have played out in radio in the past, but they ain't happening now. The recession has driven radio revenues down 25% and has caused trading multiples to fall to 6-7 times cash flow. Uh, oh! That example above just went from a $50 million profit to a $25 million loss (assuming you could find someone to even take it off your hands). So radio panics and cuts, and reels and cuts even more because someone who was promised a nice return is actually losing their ass. There's no more risk taking, no more money for interesting formats...the final irony is that many terrestrial, commercial stations are just cousins of the iPods that helped kill them. A few years ago I was forced to change an interesting format with strong community ties to a generic jukebox programmed 2,000 miles away and then received via satellite. During the community outcry our corporate president remarked that our company wanted to be "the McDonald's of radio." He really thought that was a great thing (it probably was music to the investors' ears) but it didn't sit too well in my unique community.


Finally I offer one last item that will certainly drain more value from radio. It's the new way that radio ratings will be figured with Arbitron's "Personal People Meter"


In the past people would receive a diary from Arbitron and write down their listening habits. Now, as the people meter is rolled out, people wear the device and it will detect which station is being heard. So what's the difference? The people meter seems to give different results than the diary. I'm not saying it's wrong, but this new data is already causing the radio Lemmings to race each other off of the nearest cliff. It seems that the people meter favors stations with high cume (highest number of listeners) while the diary seemed to give better results for formats and stations that may have smaller, but more loyal listenership (they listened longer). Radio ratings should factor in both the number of listeners and how long they listen on average. This means that under the diary method, station A could have half the listeners as station B, but the same ratings share assuming A's audience listened (on average) twice as long. Again, the people meter seems to favor the high cume, independent of TSL (time spent listening). So what? Well, in markets where the meter is in use radio companies have already jettisoned heritage formats in favor of formats playing more popular music. New Age/Jazz is nearly extinct after losing its radio home in Chicago and San Francisco. You're telling me that this format cannot survive as one of 50 commercial stations in the Bay Area? Now KKSF is just one of several flavors of classic rock available. The people meter will bring us more stations playing the same popular hits. It will reduce the exposure for new songs and new artists - as the familiar is again emphasized over the unfamiliar. And God forbid a jock talks longer than 10 seconds...in fact, let's just get rid of more announcers as the people meter seems to show they are a detriment. Once again radio is programming TO THE RATINGS SERVICE and not to the listener. Once again there will be a painful lesson learned from all this...give it 3 or 4 years.

Okay...I DID promise a ray of hope. Here's what I believe: I think that now is a great opportunity for some smaller operators to get back into radio. maybe some Mom & Pops here and there...or maybe some people who sold stations for big money in the 1990's (and did not lose it all in the past 12 months) will put together small radio groups. Now for the first time ever I believe that it is possible to go into a market with just 2 or 3 FM stations and wreck havoc on a heritage operator saddled with 6 or 7 stations (probably including 1 or 2 worthless AM's) and saddled with the failed math of trying to appease the bank or the capital firm (described above) and kick their butts. Someone with their own money in this game will be able to attract the best (remaining) people and will be able to ride out the occasional bad month or bad ratings book without overreacting (or being forced to overreact to appease the lender)... In the Hare and Tortoise race, I've always been the turtle. It's a great time to be a Tortoise (with your own cash)!!

I also believe that there are a handful of non-commercial stations doing a fantastic job of radio. I don't just mean NPR stations, although many of those do a fine job. Most larger communities now have a station at the left end of the dial that is still committed to their community, still plays new artists and local artists and is still creating fans. (BTW, when was the last time you saw a commercial radio station bumper sticker displayed?) I know, I know...there are challenges in that world as well. The Board of Directors can be a blessing or a curse....and non-profit gifting is way down in this economy. But I think I'd rather take my chances in the non-comm arena. Besides, there are no guarantees, and should it end badly I'll just bet the journey would have been more interesting and personally rewarding. So, I have a job interview at one of these stations soon. Wish me luck!

Sunday, May 31, 2009

Twlight at the Oasis




Okay, it's been a few weeks since a blog update. I made three trips to Loma Linda in May, but now I'm here for the duration of my treatment (unless I am fortunate enough to be able to sneak away for a job interview). My Proton Beam radiation starts this week and is scheduled to end the first week in July.



I find Loma Linda to be an amazing oasis. Having lived in Montana for 18 years and having only made a couple very brief trips to Southern California, Loma Linda is practically an exotic foreign country to me. (I realize this works in both directions - right now someone from Rancho Cucamonga just returned from a vacation to Galcier Park and is blogging about how Montana is a beautiful oasis...practically another country.)


It's not just the climate, terrain and flora and fauna differences that make Loma Linda unique - lots of So Cal looks like this. It's also the enormous presence of the Medical Center and the Seventh Day Adventist influence that make Loma Linda unlike anywhere else - that make it the perfect place for a "radiation vacation."


I love walking around the town. It's not very big...maybe 20,000 people and 8-12 square miles. Loma Linda is about an hour east of Los Angeles...buffered from San Bernadino by I-10 and the railroad tracks and protected to the south by a ridgeline. With my blood still "Montana thick" I prefer to take my long walks in the morning or at dusk. It's a total feast for the senses. Sure, there's the ubiquitous Palm trees and the well-represented orange trees - and roses seem to grow like weeds without any thought or planning. But there's soooo much more. Most of the trees and flowers are new to me so I can't list them here. I did make a point of asking a lady I met one evening to tell me the name of the large trees with the purple blossoms. They're Jacaranda trees (picture above) and they are pretty much in bloom here in May. They're beautiful and can be seen for miles from a good vantage point. I cannot tell you just how good it smells walking around the neighborhoods. Just watch out for the skunks in the evening. I've crossed paths with more skunks here in May than I've directly met in my previous 45 years.



I'm renting half of a little cottage on the west end of town. I can walk to just about everything I need. The Medical Center is a 12-minute walk from my cottage and the amazing Drayson Center athletic complex is a 15 minute walk away. My cottage is sweet...really tiny, but everything I need. It's furnished and has DirecTV, high-speed internet, a full kitchen and it is air conditioned. It's quiet for the most part...the dog next door gets fired up every now and then...and the helicopters come and go at all hours as LLMC is the Level 1 trauma center for all San Bernadino County. I actually find the helicopters comforting as I imagine a good outcome when they arrive at their destination.


No one ever comes to Loma Linda for a steak and a beer. This town probably has the highest per capita percentage of vegetarians in the country. There's two grocery stores and a small market. The largest grocery store (a chain) does have red meat, wine and beer but the other two do not. The cafeterias at the hospital are 100% vegetarian. This is due to the Seventh Day Adventist presence in town. It's an awful stereotype to say that Seventh Day Adventist are similar to Mormons (probably about as fair as saying Koreans are "like" Chinese) but I don't have the space to get into deep detail. Adventist are conservative, follow a healthy diet (even more so than LDS), and like Mormons even have a 19th-century prophet (Ellen White is to Adventists as Joseph Smith is to Mormons). The motto of the Adventist is "to make man whole", and that is really seen in the Loma Linda Medical Center. I cannot think of a better place to be treated and to stay during treatment. If you want a more detailed description of the Seventh Day Adventist religion, you can always Google it. Radiation patients also get a free pass to the Drayson center (below)...it's an amazing fitness facility, and I'll go there most every day, even if it's only just to swim.



My treatment starts in a couple days. I'm not nervous, anxious maybe, but not nervous. I'm hoping that I'll sail through with no side effects, though some fatigue is almost certain. I feel great...I spent some time this weekend with people who had not seen me in several months. A couple thought that my cancer was working on me...I laughed and told them that I just finally got serious about eating healthy and quickly dropped a lot of weight. Truthfully I feel better than I have in years...now if I can just find a job. I'll update that quest soon, but tomorrow I think I'm going to the Joshua Tree...and the next day to the Getty Museum in LA. The job can wait, the radiation vacation will continue. For now.

Friday, May 8, 2009

Beta Omicron Beta (or Dave joins a fraternity 28 years late)




I never joined a fraternity in college. I sort of found them to be silly and a time-waster. In reality, the best fraternities probably would not have taken me. Plus, I had the same girlfriend all through college, (I do not recommend this) thereby eliminating one of the biggest selling points of joining a frat. Finally I was concerned that during the pledge process objects could possibly be placed in my rectum. So I skipped the entire Greek experience. (Pun intended)






So it is with a touch of irony that I join my first fraternal group at age 45. A group of 4,000 men that has one thing in common. In fact the name of the group is even based on the fact that we all have had the same object inserted in our rectums. Yes, isn't it ironic? Welcome to the "Brotherhood of the Balloon" - my first fraternity. We 4,000 actually have several things in common...once again starting at the rear and working my way forward - we all have had urologist's fingers and biopsy needles up there as well. But of the hundreds of thousands of men with Prostate Cancer what really makes us 4,000 unique is the balloon and the fact that it means we all have chosen Proton Beam Radiation as our treatment.






So, what of this balloon you speak? This comes from the website (members have access to the super-secret parts) ...



The only criteria for membership in the BOB is having been diagnosed with prostate cancer and choosing Proton treatment. One need not have completed proton therapy to join. During treatment, the Proton Beam is focused on the prostate gland plus a 12 millimeter (half-inch) margin around the gland. Treating this extra margin helps to kill any cancer that may have escaped the gland . This margin of safety may include part of the rectum, which is adjacent to the prostate. In order to protect the posterior (outside) wall of the rectum from radiation, a small, lubricated balloon is inserted into the rectum and inflated with water prior to each treatment. A secondary function of the balloon is to help immobilize the prostate, by pushing it up against the pelvic bone..So, our fraternity has the infamous “balloon” as the common denominator for all members.





Maybe I should be a bit more respectful about the group I just joined. But humor really helps deal with the frustrations and stresses of Prostate cancer, so I default there often. Probably the best thing that helps deal with the frustration and stress of a PCa diagnosis are the many websites out there. They are true communities where one can find information, support, guidance and friendship. You are joining these communities along with newly diagnosed people (just like you)...and when you arrive you can usually find many others who have "been there and done that" and are willing to share their stories and offer advice. Oh sure, like anything else on the internet there's some misinformation out there....there's know-it-alls and bullies and the occasional troll or person with an agenda. However the percentage of these is much, much smaller than your typical websites where one might join to discuss sports, politics or current events. I believe that members go out of their way to be respectful of the plights and views of all at most of these prostate cancer sites.



I assume that most doctors must hate these sites. They create instant medical "know-it-alls" who challenge the advice of doctors who went to school for years and have practiced in the real world for many more years. And some of us are better at using the internet for research than others. The internet is a dangerous weapon in the hands of some people.




But let's turn this around...I'll bet there are more than a few well-grounded doctors (who do not have agenda's of their own) who appreciate not having to start from the very basics with their informed patients. (What was the Vince Lombardi quote??? "Gentlemen, THIS is a football.") When you consider just how limited the actual doctor-patient face time can be I think much more gets accomplished when an informed patient is asking the doctor a series of questions about his diagnosis/treatment rather than that precious time being spent just getting the patient up to speed on the basics. In my case I did exhaustive research online and then I actually spoke to 4 people that had prostate surgery and to 5 people that had completed Proton Beam Radiation. I only knew one of these gentlemen prior to our conversations.




These website communities are invaluable and I lurked and learned and eventually participated at most of them as I journeyed from high PSA toward biopsy to diagnosis to treatment....and I'm sure I'll continue to participate and advise those who follow.



Some recommendations:






The first site is probably the best. It has great background information for anyone concerned about prostate cancer and while it does not have a true message board it has an amazing database of personal experiences that goes back years and can be searched by age, PSA, Gleason score or treatment choice.


The second site has an active and helpful message board. It tends to be surgery-heavy, but that's the route most men take....and, it's the treatment with the most variables so you'll see many discussions of the potential consequences of surgery.


The last site is focused on Proton Beam Radiation and is therefore biased towards that treatment...but hey, they're my fraternity brothers.






Thursday, May 7, 2009

Defending Your Life



And now....the title track from our new album... I mean, blog.

Today I had my consultation for Proton Beam Radiation at Loma Linda Medical Center. I had pretty much already made up my mind that this is the path I was going to take for treatment. I also needed to decide if I would participate in a clinical trial currently going on at LLMC. The premise is that equivalent results (without any negative change in side effects) can be achieved by delivering a higher daily radiation dose over fewer days. Trial participants will receive 3 Gy of radiation daily for a total of 60 Gy. The current protocol at Loma Linda is 1.8 Gy daily for 45 days. (One gray is equal to an absorbed dose of 1 Joule/kilogram (one gray equals 100 rads)

First I should back up and explain a bit more about Proton Beam Radiation. Compared with conventional X-ray radiation, the Proton radiation focuses much more of its energy on the tumor and much less on surrounding tissue that may be just in front of or behind the prostate. Proton Beam Radiation offers results equivalent to surgery and conventional radiation with fewer side effects. (That previous sentence is a simplification of a mountain of data and real life experiences that is still hotly debated...but I believe it to be true...especially for early-stage modestly aggressive cancers such as mine.) So why don't more people choose this treatment? Several reasons: It's expensive - it's currently only offered at 6 places in the country - and, as stated earlier, the treatment (including preliminary work) requires about 10 weeks. Had I not lost my job I probably would not been able to get the time off necessary for my treatment choice...so, there's one silver lining there for me. (Maybe two silver linings as my insurance that I'm "Cobra-ing" is awesome) Finally many people diagnosed with prostate cancer simply follow the recommendation of their urologist. That recommendation is almost always surgery for all but the most aggressive cancers. Urologists are surgeons.

Back to the clinical trial....why would I agree to be a Guinea Pig? My doctor here at Loma Linda is certainly one of the most respected doctors in his field. He was able to answer my questions on side effects and on the effectiveness of the overall lower dose. You see, the alpha-beta ratio of Prostate cancer is lower than other cancers...making prostate cancer especially sensitive to fractionated changes in radiation doses. (Isn't it funny when somebody repeats something they learned just 11 hours ago as if they have known it for decades?) So, I'm assured that 60 Gy delivered over 20 sessions is equivalent to 81 Gy. I also have personal reasons for favoring the trial. The 4-5 weeks I'll be saving in treatment will save me money renting temporary housing here in California. It will also allow me to ramp up my job search sooner. It's bad enough that right now I'm telling prospective employers I'm not available for two more months. The trial will hopefully allow me to select my preferred treatment and allow me to start earning a paycheck sooner.

So that's the plan to defend my life...a bit hyperbolic of a title - my life's not in danger. Maybe "Taking Care of Business" is more appropriate. At any rate, I have a plan. If it works, two months from now I'll be strong, healthy, cancer-free, tanned, rested, ready and employed.

Wednesday, April 29, 2009

Persistence of Memory


I find myself thinking more about family these days. Probably driven by my recent medical issues and the family medical issues discussed below. Also facebook is behind these thoughts as old neighborhood friends have sparked my memory and had me running for the stored-away photo albums by their postings of new scans of tattered old photos.

The picture above is just one of dozens of old photos I have of our small immediate family. Thankfully, it never meant any more or any less to me than any of the many other photos that have survived my dozen or so moves the past 25 years. I say thankfully, because if it had meant more to me than the others, then my life would probably be much different than it is now. I don't remember that day in 1970 - I don't remember that shirt, that watch, that haircut. Nor do I remember the sounds and smells associated with that photo. Thankfully. I did not know this until many years later, but the photo above was staged and was taken with a very clear purpose.

Mom and Dad were each 41 in that picture...I had recently turned 7. It was late September but I don't remember if I got out of school for this...I don't remember much of it. The building in the background is Sibley Hospital in Washington, D.C. - The following day Dad was having surgery. I was told that a bee had stung him in the eye...that he had a detached retina and may lose his sight in his right eye. The truth was much more serious...he had cancer. I guess that the surgeon really had no idea what he would find when he began operating. He knew that the eye could not be saved. I'm told that the night before surgery NASA actually did some experiments on Dad's eye to see what extremes of heat and light the human eye could stand. The surgeon told Mom that losing the eye was the best outcome, but he feared that when he got "inside" that the cancer could be well into the brain. If that was the case, he would have to decide just what to do, if anything...Mom was told that Russ could die during the operation...or soon after, if the cancer was already into his brain.

The surgeon was great, the operation was a success. My Dad's eye was removed, and they (thought) all the cancer was gone. Dad's first prosthetic eye didn't fit too well...it even fell out once during a presentation at work. The second one worked much better, and (to me) Dad was pretty much the same old guy as before (although with lack of depth perception and peripheral vision, he was responsible for the destruction of many end-of-aisle displays over the years.)

Dad would live 14 more years. That same melanoma would get him at age 55. The years between 7 and 21 are pretty important for a boy, and I'm sure glad he was with me that additional time. You see, that photo above was meant to be a last family portrait - just in case. Years later when I found out the true story of what happened to Dad when I was seven, I was upset. Upset that I had not been told the truth. But I really was too young to grasp what was happening. I can hardly imagine how my life would have changed if he had died. I was an only child. I cannot imagine the fear I would have grown up with. As it is, I cannot imagine the fear that my mother went through...her own father died when she was just 11. I'm glad that I don't remember that shirt, or haircut, or that watch. I'm glad that I cannot remember the sights, sounds and smells of that day at the hospital. I'm glad that turned out to be just another photo.

Wednesday, April 22, 2009

Ironically, prostate cancer just might save my life



For years I have given lip service to living a more healthy lifestyle. Eating better, getting more exercise and avoiding stress have all been discussed, but I have been pretty much all talk and no action. Somehow I always manage to find an excuse to avoid tackling these issues.


As I look for a new job, I really hope that I can find a fit with a company where I will be able to limit my stress. Really, the stress thing has got to be up to me. Stress is everywhere...the effects of stress are what's important, so clearly, I'm going to have to learn to cope with stressful situations better than I have in the past. Frankly it's sort of silly to imagine me in a job interview (with unemployment approaching 10%) asking of a potential employer: "You're not going to yell at me are you? I hate that." Or: "I find that I work best under less pressure." I'm sure I'd get the job.


How stupid is it that it took a diagnosis of cancer to get me to finally eat better? In the 3 weeks since my diagnosis I have already lost 10 lbs.. And it really has been pretty easy. Almost every workday I used to eat breakfast in my car during my 40-minute commute. I would grab a Mountain Dew from the refrigerator on my way out the door. Then, usually it was a Sausage McMuffin....sometimes I was a bit better and ate a Jimmy Dean biscuit (hey, it was Turkey Sausage). Now breakfast is a half banana sliced on granola with Soy milk. Prior to diagnosis I ate lunch at my desk most days. Taco John's or Arby's or perhaps Subway. Occasionally I would go out for lunch. You cannot find lunch entrees for under $8...add to that a $1.99 pop and a tip and lunch out is pretty much a minimum $12 investment. If I'm spending $12, I'm eating well....and I'm cleaning my plate. Now lunch is very light, if I have it at all. Or just maybe a snack of some nuts, grapes or (yes) Cauliflower. I'm planning dinners much better now...more fish, more veggies...less starch, and usually smaller portions. While I was nowhere near an alcoholic, I probably drank more than I should have...now I drink less alcohol than I'd like, but it's not drastic. We used to probably split a bottle of wine at dinner 3 times a week...now it's once. I used to have to have a couple cookies before bed...no more. I thought I'd miss all of those things...but I don't. Not one single bit. I hope to lose another 10-15 lbs. before I begin treatment next month. A lean, mean, cancer-fighting machine.


Maybe I'll even get serious about exercise...my treatment choice is going to help me there, I think...more later...


The Prostate cancer I have is early-stage...I probably could ignore it for a couple years, but I have a perfect opportunity to deal with it now. How sad would it be if I treated my cancer only to drop dead of a heart attack in my 40's or 50's? My cholesterol was borderline high last I checked...my mother has already had two heart attacks. I believe that the fright of a prostate cancer diagnosis will eventually have long-term benefits for me because of the positive change in diet, exercise and stress management that it prompted me to implement.

Wednesday, April 15, 2009

Jennifer





This is hard...I should have done this last week. I don't want this blog to be exclusively about sad things...and it pretty much has been from the beginning...things will get better...we're due.


There were 23 of us cousins on my dad's side. We've always been all over the map as our families grew up in Montana, Washington, California, Texas and Virginia. The ranch in Montana was our focal point, and us cousins would occasionally meet up should our summer vacation plans overlap. I was not especially close to Jennifer...we lived 1500 miles away from each other our entire lives...but I was pretty close to her folks and to a couple of her siblings. A couple weeks ago, Jennifer became the first of the 23 to pass away. At 41 she was also one of the youngest of us cousins. She leaves a husband and three girls. What's fair about any of that?


Ironically Jennifer died of cancer on the day I was diagnosed with cancer. That's where any similarity ends...because compared to Jennifer, I have a paper cut. All who visited her these past months said that she handled things with a tremendous amount of grace, strength and dignity. I should have gone to visit her...but I was so concerned about my job that I never went. I was so concerned about my all-important job that I could not manage to visit my sick cousin...or to attend the surprise 50th birthday party for an old friend...or our last family reunion held in Colorado. I managed one vacation in the last two years of my job...a 4-day-weekend ski trip.


Jennifer is dead at 41. My wife and I have both been diagnosed with cancer in our mid-40's. My dad lost an eye to cancer at 41...and his life to it at 55. Why for the past four years have I probably worked 50 hours a week for 51 weeks a year and still feared I was not doing enough? How much value have I created for the people and companies I have toiled for these past 20+ years? So what will it take for me to realize what is really important in life? If the events of the past two weeks aren't enough, there's no hope for me.