March 2006

To: Tom
From: Clark
Date: March 1,  2006

Between the "two of us riding no where, Sunday driving" I never knew what the oats were, but that is one of my favorite Beatles songs. I would like to see that movie (Let it Be) again but I can't find it anywhere.

The be-be target thing sounds cool and all of those 3D sighting calculations sound like fun for the Math Geeks . . . bet your glad that use computers now instead of the slide rules we had to learn on.

Keep the positive attitude/energy going, combined with all of that technology it will prove to be an amazing arsenal, Love Clark

To: Tom
From: Steve
Date: March 8, 2007

In response to a question Tom asked about radiation.

Great question.

Alpha, beta and gamma radiations are exclusively emitted from radioactive material (like uranium 238, cobalt 60, cesium 137, etc.). The radiations are emitted from the nucleus of the unstable atoms (which are the same as radioactive material). Radioactive materials decay at a certain rate until they reach stability. The term half-life is associated with the rate of decay of these unstable atoms.

X-rays are predominantly emitted from radiation machines (like an x-ray machine or a linear accelerator). X-rays are generated when an electron (from an electrical machine noted above) is slowed down as it passes through a material known as a target. This slowing down process generates heat (heating of a copper wire for example) in addition some of the energy is transferred to the generation of x-rays. The process of generating x-rays is very inefficient meaning most of the energy from the electrons generates heat. Hence extensive cooling systems are needed for x-ray machines. There are some radioactive materials that emit x-rays but that has to due with interactions in the electron shell around the nucleus.

Alpha particles and beta particles have mass and charge.

X-rays and gamma rays are massless packets of energy known as photons collectively (quantum mechanics stuff) and they do not have any charge.

I will not ramble on any further unless you are interested.

Steve

To: Tom
From: Steve
Date: March 8, 2006

Yes, the only difference between x-ray and gamma rays is how they are made. If an x-ray and a gamma were sitting at a bar together you could not tell them apart until you looked at their birth certificates.

Well the Hulk thing is contrary to all I’ve heard about radiation treatments. So I would not use this technique to bulk up. But if you begin to turn green let me know.

Steve

Date: Thu, 9 Mar 2006
Subject:  my first tattoo

I got my first tattoo on Monday. Well, three of them actually. Nothing fancy, they all look like moles. Not the little animals that burrow in your yard, the skin variety.

OK, that was a joke, kinda. I really did get three little dots tattooed on me. They tattooed my aiming marks so that they would not accidentally get washed off, which means I can enjoy my spa again since I don't have to worry about losing the marks and having to start the aiming process all over again. This is good because the spa makes winter (even if it is just California winter) much more bearable.

I began radiation treatments on Tuesday. I'm receiving x-rays but I entertain myself by calling them gamma rays because that's the type of radiation which creates most of the comic book superheroes. Whereas you normally receive millirads worth of radiation spread out over a fairly large area when getting an x-ray, I am receiving rads worth (1000 times as much) in a very focused beam to an area about the size of the palm of your hand.

There is not much else to report about the 5 minute process as it has no apparent effect on me. . . . yet. The effects of exposure to radiation are cumulative and sometimes don't manifest until years later. This is somewhat true of these treatments also, although the effect on the tumor will begin immediately, any damage to normal tissue (due to inaccurate aiming) will probably not show up for 1 - 3 years. In my case, the most likely 'collateral damage' would be to the right lung (tumor is in the left) or to the heart. The only things I can do to ensure that only the target area gets hit is to establish a friendly relationship with the technicians so that they care about me and want to be very careful and to hold very still and ignore the itches that invariably start as soon as they get me lined up.

One thing I'm sure of though, if those little dots stung that much, I don't want any more tattoos. Guess I'll never be a 'real' biker. *grin*

Hangin' in there,

Tom

To: Tom
From: Art
Date: March 10, 2006

Hey Tom,
Glad to hear your attitude (through your words) is so good.
That's gotta be 90% of the battle.
The other 10% being the physical stuff the docs and techs can do.
That 90% can be shored up lots of ways.
Personally, I use a lot of prayer, even prayers for others are great for
your attitude.
You mentioned tats and being a real biker, ,,
One of the guys in my bible study group (an older biker) is suffering from
hepatitus that he and his brother got from the same tatoo artist.
Yes, he may even die, and he has a daughter of around 13 that is trying to
care for him...
The whole situation is very tough,,,
One saving grace is that we know Frank's salvation is sure...
I ain't going to push Jesus on you Tom, I respect you too much for that.
But remaining silent about something so good isn't like me either.
To withhold the good news would be selfish.
Anyway, I'll quit there.
You now where I am if you want me to continue.

Blessings and as speedy a recovery as He wills is for you too.

Art

To: Tom
From: Chris
Date: March 10, 2006

Hi Tom,
I'm glad to hear treatments have started, and that you are coping well.
I've always believed that humor in the face of adversity is either a mark
of insanity or true courage. I admire your courage in all this. And by
the way, I never got a tattoo in my whole Navy career, or even during my
Viet Nam tours. Guess I was less scared of bullets than needles.

Chris

To: Tom
From: Clark
Date: March 10, 2996

Did you know that those radiology dudes have something they call a gamma knife? I think it may be as scary as it sounds. Did you get the e-mail I sent about using the thermal discharge instead of radiation?

Clark

To: Tom
From: Clark
Date: March 19, 2006

Oh No I DIDN'T EXPECT YOU TO CHANGE treatments, I almost said in that message that I wasn't even suggesting that you ask your doctor about it because this probably isn't even the time to be quoting magazine articles to him (I have friends that are doc's and they just love it when the patient quotes TV commercials).

This irradiating your brain sounds kind of "interesting"!!!! Maybe I should have that done so I can use it as an excuse for my erratic behavior, people are starting to question my usual story about being struck in the head by lightening as a kid.

Peace and Love, Clark

To: Tom
From: Sally
Date: March 12, 2006

Dear Tom,

I was thinking of you and wandering how you are. I know treatments have
adverse side effects on those receiving them. At church today we had
prayer for you in my Sunday School Class. Take care and
know you are constantly being thought of with love, Aunt Sally

To: Tom
From: Joe
Date: March 13, 2006

Hi Tom

Thanks for the update. I am glad to hear that you aren't feeling any
adverse side affects from your treatments. I'm sure the tattoos are
awesome. Maybe you can create a story around them -- struck by lightening
and those were the grounding points ... or something like that. Kind of
goes along with the super hero radiation.

Everything is going well here. Not getting everything done -- but then I
don't guess we ever do and if we did we'd be out of work ...

Keep hangin in there

Joe

Date: Thu, 30 Mar 2006
Subject: Enjoy every sandwich

One of my favorite song writers, Warren Zevon, died of lung cancer a couple of years ago. Prior to his death, David Letterman dedicated an entire show to him. At one point he asked Warren if, in light of his imminent demise, there was anything that he knew that the rest of us do not know. Warren smiled, shook his head and said, "No, unless it's how much you're supposed to enjoy every sandwich". I miss Warren.

*******************************************************

I met with my radiologic oncologist (the cancer doctor in charge of my radiation treatments) last week to discuss Prophylactic Cranial Irradiation, an additional treatment process that involves dosing my brain with radiation to prevent cancer from metastasizing there. This procedure is fresh from clinical trials and is claimed to add another 5% chance of survival at 5 years to an otherwise dismal statistical average. It is suggested for patients who are responding well to the standard treatments, but it has a possible long-term side effect of unspecified "brain damage". It's a decision I don't have to make until the standard treatments are complete at the end of May.

In the way of some background, small cell lung cancer grows quickly and metastasizes (spreads) readily. Approximately 70% of patients who respond completely to standard treatments will see the cancer start again within another year, and when it does, it seems to like to start in the brain or in the bones. Oddly enough, this is not considered brain cancer or bone cancer but metastasized lung cancer. For those patients, the whole process of chemotherapy and radiation is started again (when possible) and the cycle is repeated as many times as it is both necessary and possible. The statistical average of survivability at 2 years, derived from a large number of studies, is about 25%; at 5 years, it is approximately 10%. The addition of cranial radiation treatments boosts that to about 15%. There are no available statistics that go beyond 5 years.

While these are not encouraging numbers, I recognize two essential facts:

1. I am on the favorable side of seven out of the eight essential prognostic factors listed (the remaining factor being that females tend to have better response than males). Therefore, I am in the group that the 15% comes from.

2. No one (at least no human) knows what will happen to any given individual, how long that individual will live or if there are any miracles in store for that individual.

However the statistics are not just conjured from nothing, they come from case studies of real live human beings, all with the same hopes and will to live as me.

These facts have caused some sobering realizations and presented me with the decision of my life.

First, it's time for me to take care of some things that I should have already handled. For instance, I am going to turn 53 in about a week, I ride a motorcycle and yet I have no Last Will and Testament. Even worse, my friends Dave and Sandy have agreed to take charge of things in the event of my death or serious injury, yet I have no written instructions, have not granted them legal rights to make medical decisions for me if I am incapable nor provided a fund to handle my final expenses. These are details that any responsible adult my age should have already handled and it's time for me to step up to the plate so that I don't leave my friends in such a difficult situation.

As for the decision, I need to decide on a course of action for my remaining lifetime which takes many unknown factors into account. As you probably know, I have a long-standing dream to live in Hawaii. If I am only going to live another 2 years then I don't want to work any more, I want to get to Hawaii and enjoy my remaining time there, but that will be difficult with my financial situation. It will require a lot of preparation be completed quickly and some good luck; and I will need to qualify for Social Security Disability to survive. However, if I am going to live more than 5 years I am going to have to return to work (damn it!) and plan on retiring, but it would allow me to better prepare and save money for an easier move to Hawaii. Realize my dream now, in a limited fashion? Or bet that I am going to be in that 15%, with time at my disposal to live my dream someday in the future? The only things that I know that you may not know are the statistics.

Tom

To: Tom
From: Art
Date: March 30, 2006

Tom,
I want to read this again, think more and write a fuller response.
For now I want to say this,
God has a reason for everything.
Most of the time, we can not fathom it.
It is wreckless to presume to know His mind.
And, perhaps you are serving as a herald right now.
Your words are making important impressions on me (and surely others).

Blessings from your friend, Art

To: Tom
From: Brother
Date: March 30, 2006

The statistics aren't great but there are people who have pulled through -
you might as well be one of them. You can't put blinders on and ignore the
possibilities but you HAVE to keep looking for the light at the end of the
tunnel.

Bro

To: Tom
From: Jan
Date: March 30, 2006

Tom,

Thanks for the update. I guess I would want to know a lot more about what “brain damage” means in your setting before making the decision.

I just had the big 53, which is very old here where the life expectancy is 62. Thanks to American lotions and some good genes, I look about 10 years younger than other women my age here. It is amazing how quickly poverty and hard manual labor age a person. Most Filipinos will live and die without ever seeing a doctor. For the second time in thirty years I was glad to have a birthday. (The first was the year my malignant melanoma was found early and quickly treated.)

I continue to pray for your miracle and that you recognize where it comes fromJ Hawaii (Oahu) is the most beautiful place I have ever been.

Jan

To: Tom
From: Joe
Date: March 30, 2006

Hi Tom,

Thank you for the thoughts and the update. I did not realize the
statistics were so bad.

I heard you were in the office earlier this week -- I am sorry I missed
you.

Can I buy you lunch sometime next week?

I'll be saying some prayers,

Joe

To: Tom
From: Pamela
Date: March 30, 2006

Hi Tom,

You know I think you should go to Hawaii, as much as I would miss you, you have to go. I have a statutory will and advanced medical directive for you. I can bring them up this weekend if you want. The medical directive has to be notarized and as luck would have it, I am a notary. :)

I love you.

Pamela

To: Tom
From: Stacy
Date: March 30, 2006

Morning Tom,
Thank you for the update.
I admire your courage and wonder if I posses such an inspiring hidden
quality!
You bear sobering news...but God's miracle factor on human existence can be
quite awesome! Keep praying I know I am!

P.S. I too am a Warren Zevon fan and I'm sure he would agree.... If women
have a better chance of surviving this... then by all means ask your Doctor
for a sex change!

Stacy

To: Tom
From: Steve
Date: March 30, 2006

Tom,

It has been a while, it is good to hear from you again. Thanks for the statistics. With regard to changes, even though I work relatively diligently I too enjoy not working more. As a result I would opt for Hawaii as soon as possible. If things work out positively, then you would at least be in a more comfortable place even if you are “financially” poor. You may even find some opportunities to earn a modicum of income working in the IT field, selling beads, singing on the street corner or heaven forbid turning a wrench again. You could also charge friends when they come to visit you, no you wouldn’t do that. Also, I’m sure there are many “things” you currently possess that you could sell.

My friend you have an opportunity, if you want to call it that, to make the dramatic move you’ve always wanted to, so I say aloha, but I will visit.

Take a big bite of that sandwich.

Take care,

Steve