HOUSTON AGAIN !

Once again it is time for a trip to Houston. It has been a year now since they sliced me open for a second time to repair, or I guess replace, my stomach lining with a pig skin. I have always been a big fan of football, so I guess a pig skin in my belly is appropriate. It has been about two and a half years now since I had the cancer surgery. I have been told twice recently that only 20 out of one hundred people diagnosed with pancreatic cancer qualify to have the surgery I had. Out of that group who qualify for the surgery, only 20% - or 4 people out of 100 survive for two years. I know that I have been so abundantly blessed and I am so very grateful for this.

As I think back there are so many people who are responsible for me being alive today. First the doctor in the emergency room who found the tumor. I finally tracked down the name of this doctor. Dr. Mark Sagarin, at Presbyterians Ana Kaseman Hospital spent almost seven hours giving me tests, and every doctor I have talked to has said they don't know how he even found the tumor. It was so well hidden and he wasn't even looking for this. They thought I was having a heart attack when I first went in. But he was so thorough and deliberate that he did find it. However, even after he found the tumor, the people at Presbyterian Main who did the CAT scan couldn't positively identify the tumor. Then the surgeon I was sent to pretty much blew the whole thing off and asked why I would want to do anything about it. He stated I could probably live several years without doing anything about it. I was blessed again by another Presbyterian doctor, Dr. Thomas Riley an endocrinologist. He found the tumor and with a camera device he inserted down through my throat was able to provide proof of the tumor. One of the greatest blessings of all was my own son, Scott. Scott is an engineer and very thorough and very smart. He accompanied me on all of my visits and started doing research on everything related to my condition. By the time I saw Dr. Riley, Scott had a stack of research material he had created and took to the meeting with Dr. Riley. Scott had discovered MD Anderson in Houston and both Scott and Dr. Riley wanted me to go to one of the major cancer institutes for surgery. MD Anderson appeared to be the best and it was also the one nearest to us. Actually, Scott and Dr. Riley had a high level conference with me being a spectator, but they decided I should go to MD Anderson. Dr. Riley was the only one person at Presbyterian who favored me going out of the system for this surgery and he gave me a referral to MD Anderson.

Even after the referral by Dr. Riley, Presbyterian denied my request to go to MD Anderson and said I would need to have the surgery done at Presbyterian in Albuquerque. Another blessing was that Presbyterian was required to notify me of an appeals process I was entitled to, and once again, Scott went into action. Scott created a letter to the appeals board in New York and both Presbyterian and I were obligated to accept their decision. Based on Scott's appeal, the Board ordered Presbyterian to allow me to go to MD Anderson and to pay for the costs.

At this point there was no guarantee that we would be accepted by MD Anderson. They are very straight forward in their approach. If they don't feel they can do anything positive for you they will not accept you as a patient. They said they didn't want to waste my time or my money if they were not convinced they could help me. I went through all the examinations at MD Anderson and they reported that I definitely did have pancreatic cancer and they felt they could help me and accepted me as a patient.

We went back down to Houston in June and rented an apartment and started a program of chemo and radiation. I was doing oral chemo and going in for radiation treatments every day. There was no pain involved in this course of treatment, however the radiation was what destroyed the lining in my stomach. While there was no pain involved, I started feeling the affects of the treatment and was soon feeling weak, tired, somewhat nauseated - and probably for the first time in my life - a little grumpy and hard to get along with. (The last part might be disputed by my good wife Mary and others who have had a close association with me for some time.) As always, my son Scott was with me on every visit and every examination as was my good wife Mary. After being in Houston for a couple of weeks, my son John Leslie came in from Dallas to spell Scott so he could come back home and go to work and then my son Andrew came in from Florida. Among the other many blessings I have had, the most important is the great support team I have from my own family. And of course, this support team has been increased by the many friends and relatives I have who have kept me in their prayers and have encouraged me and supported me through all of this.

My blessings have continued in the form of a fantastic staff of doctors in Houston. My primary doctor and surgeon who performed the ten hour surgery, Dr. Jason Fleming, is also a professor at The University of Texas School of Medicine. Dr. Javelie was my Oncologist and created the protocol for my chemo and radiation treatment and then Dr. Baumann, the plastic surgeon who put the "sausage" lining in my stomach. In addition to all of these people there are numerous staff and support people who were just fantastic. The one thing that is perhaps different at MD Anderson is that on each visit the support staff is different. I guess you have to be high quality just to get into the University of Texas, let alone the School of Medicine. Many of the practicing physicians and students are from foreign countries. For the most part these are people who are in medical school who rotate through the various departments as part of their training in medical school, but they are all high quality people. In fact following my first surgery, we had a girl come in and I noticed her tourquoise necklace and found out she is from Albuquerque.

With all the many blessings, this journey has not been without some bumps in the road, starting with the conflict with Presbyterian about going to Houston. While I was in Houston going through the chemo and the radiation, as I said, it was not painful but it did have a significant affect on how I felt. During this period I started getting calls from some wretched woman in Albuquerue telling me that the charges for treatment I was racking up would not be paid as I had not been approved for these treatments. This was very distressful and I felt almost helpless as I was in the middle of treatments and I couldn't stop, I was in Houston which made it difficult for me to communicate with these people in Albuquerque and I was already stressed out about my condition, finances and too many other things. I did finally get this resolved once I returned to Albuquerque and I think this woman was fired once I got a chance to review this whole problem. In any event, I did tell them I did not ever want to talk to this person again during my lifetime, and that was accomplished.

I came back to Albuquerque and had a few unpleasant experiences with chemo treatment I had here in preparation for surgery. One time my blood backed up into the chemo cannister and another time the needle came out and it was pumping the chemo directly into my hand. I looked down and my hand was almost the size of a football. When the chemo was completed in Albuquerque and I was ready to go back to Houston for the surgery, I once again started having problems with Presbyterian granting an approval for this trip. Out of the clear blue sky, a lady whom I have never met, at New Mexico Oncology - where I was getting my local chemo treatments - called me and said she heard I was having some problems and volunteered to be an advocate for me. Within a short period of time, this lady, Mabel Coker, called me and told me everything was approved and I was on my way to Houston again.

After about a year I started to develope some major disfigurement in my abdominal area and was having a sifnificant amount of pain. When I went to Houston for my next examination they discovered I had a several hernias in the stomach area, which I was told was normal. They scheduled me to come back for another surgery for this. However in preparation for this surgery we discovered I had developed blood clots in both legs and had an aneurysm in one leg.
I was put on blood thinner and kept going back for tests and they kept postponing my surgery until about one year ago I went down for another four hour surgery where they inserted the pig skin as a new lining for my stomach.

After the second surgery I was off work for about a month and started back on a limited schedule. This is another great blessing I have had. My employer and all the associates I work with have been absolutely wonderful and fully supportive during this little ordeal. We have an eoffice where all phone calls and emails come in from potential customers. We are assigned different shifts in this office and during my recuperation period other associates graciously gave up their shifts so I could sit in the eoffice full time. This was about all I could do as I couldn't actively move around, go on test drives, open up hoods and trunks and all the other activities involved with selling a car. Everyone has been great. My employer basically told me to come when I wanted and to leave when I wanted. No wonder it has been listed by Forbes Magazines as one of the top one hundred companies to work for every year for the past six years.

When I finally got out of the eoffice and started doing some limited work outside, it wasn't long until I developed a severe pain which turned out to be yet another hernia in the groin. This was like tinker toys compared to what I had already gone through but I did have to go in for another surgery to get that hernia repaired. I was off work for another week or so and have been back at work since sometimes putting in up to twelve hours a day. There have been times when I am just completely wiped out and I guess it shows as other associates or managers have told me to go home, but I am getting stronger and am pretty much able to hold my own now. I do have to wear the elastic wrap around my body all day long and I can feel it almost every time I breathe and for sure when I stand up, sit down or move around. But that is a small element of pain compared to everything else.

In the meantime, while everyone has been so good to me and taken such good care of me, Mary had to have a hip replacement and Scott has had to have surgery on a knee. Also during this time John Leslie was also diganosed with cancer. His treatment was a little different than mine. His treatment was chemo with a pump inserted into his chest. I never had that and am happy I didn't. However, he did not have to have surgery. Even without surgery, his treatment was tough on him and he lost a lot of energy and was pretty well worn down for quite awhile. He lost all his hair as a result of the chemo. My hair stopped growing for awhile but I never lost much if any. The latest tests indicate his cancer is gone, another fantastic blessing. I would much rather have any disease or ailment than to have any of my family have it. I guess I fancy myself as being tough, but I am not tough when I see people I love in pain or hurting.

Mary just finished a nasty bout with pneumonia. I got up on Saturday morning about seven to go to work and she was sitting in a chair fully dressed and was going to drive herself to urgent care as she was having severe pain in her chest and back. I got dressed and took her to urgent care and they examined her and took some xrays and said they couldn't find anything wrong and gave her a couple of prescriptions. She came home and went to bed and they called later in the day to tell me they couldn't find anything in the xrays. Three days later they called and said the radiologist had looked at the xrays and decided she had pneumonia. She then went to her own doctor who confirmed this and she came on back home and just kind of had to wait this whole thing out. She is a very active person and to see her just lying around and sleeping during the day was really out of character for her. But now she is back going to jazzercise every day, working in the yard, cleaning house, moving things around and cooking, so I guess she is cured.

This upcoming trip to Houston has added yet another frustration. About a month ago I went to my primary care doctor and asked for a referral for this trip. After a couple of weeks, when I heard nothing, I started calling and first I was told I needed to request an authorization not a referral. So I started calling almost every day and I got the run around every day. Each time I was told that someone would call me the next day but no one called. I didn't know whether to cancel the trip or just go down and hope that Presbyterian would accept the charges. I didn't feel comfortable with gambling somewhere between $10,000 and $20,000 if they should come back, which would be typical, and say they would pay because it was not pre-authorized. MD Anderson does have a slight association with Presbyterian here with an MD Anderson radiation facility at the Presbyterian Hospital here. I have met with the Oncologist here but have never had any treatment from them. As a last resort I called them and within a couple of days another "Angel" called me and she took over and within a few days I finally got authorization to go down as originally scheduled.

With all the "Crap" coming out of Washington I was truly concerned and still am. At one point there were comments to the affect that we should not waste money on the older people as they are going to die anyway. Instead we should give "free" coverage to all of the illegal immagrants and others who have elected not to purchase health insurance coverage. I have paid my premiums for years - a hefty premium at that. I paid for years when I didn't have any health issues. That is what insurance is all about. I have no problem with providing health care to those who truly can't afford it otherwise, but it isn't always about not being able to afford it. I have spent the best part of my life in association with the insurance business. I know so many times people make a choice - they spend their money on cigarettes and beer, on boats, on pickup trucks and campers, vacation trips etc., and then say they don't have any money to buy insurance protection. They are making a choice - if it is a bad choice, that should not be someone elses problem. When it gets to pre-existing conditions, I am personally aware of so many people who don't want to "waste" their money on insurance until they need the protection. The guy who thinks he is a stud and has a wife and four kids but can't see the need for insurance and then goes to the doctor and is told he has a heart condition and wants to buy insurance. That is like asking the insurance company to insure the barn after one corner of it is on fire. To me this is not a small problem - it is an additonal burden that someone who does have the worry of a medical condition doesn't need. I have made plenty of bad decisions in my life and they have cost me, but I have paid the price for these decisions - I have not asked for a "bailout" or for anyone else to take responsibility. Anyway, there is some good to everything. I figure they are going to keep me around for awhile - which means I am going to live - just because they need my tax dollars. GOD BLESS AMERICA!

Thanks to all of your for your support and blessings over the past few years - I will continue to survive, maybe not forever but for a long time to come!

AL