LCSC Blog

It may not have been the miracle I was hoping for: shrinkage or tumor disappearance, from my most recent diagnostic scans but no growth and/or new metastases is nothing to be taken for granted. However, I did experience a miracle of sorts when the envelope I received at home from the "State of Maryland, Maryland SafeZones Automated Speed Enforcement" authority specifying and picturing yours truly exceeding the speed limit by 12 mph was for information purposes only. It was not an invoice. It was a warning. And the $40 fine associated with this kind of infraction was left on the cutting room floor. Perhaps this is the extent of the miracle that Solange was able to perform when she prayed for me and my burned feet - and thyroid cancer, on July 20 in the Houston airport. Though this outcome was not exactly the delusional outcome I was hoping for, when we consented to her extremely kind offer to pray for me. Nevertheless, a win is a win. And though a shrinking/disappearing cancer tumor would have been an amazing - albeit unlikely outcome, the tumors remained "stable" and I saved a $40 outlay. On balance, not a bad day's work. For which I am extremely grateful. Soon after I entered the cancer-patient world, I learned that any not-automatically-bad news - whether internally or externally to that world, should be acknowledged and appreciated. Any port in a storm you might say. Moreover, I always sought to find the positive in this sea of negativity. Whatever I could see - through any rose-colored glasses I could find, served its purpose to emotionally support me for the many long and lonely nights that followed. Certainly, there's family and friends to help share the burden brought on by a "terminal" diagnosis, but at the end of the day, literally, it's sort of you and your thoughts. Finding a way to navigate this minefield of unpredictable results and anxiety is paramount. On the one hand, you can't take what the doctors and radiologists say as seriously as a cancer diagnosis obviously is, but neither can you pretend that you're not in the fight of your life. That being said, one must be open to new ideas and unexpected offers. Filtering and interpreting whether any of the suggestions made by your doctors and/or your well-meaning friends and family becomes your lot in life. And it's an awful lot at that. Still, a cancer diagnosis is not nearly the death sentence as it used to be for the previous generation. Though it would be naïve to characterize a cancer diagnosis as an opportunity, nevertheless unceasing research in a variety of hospital/cancer centers, medical schools, clinical trials, pharmaceutical companies and the like have led to an evolution in the treatment in cancer, particularly non small cell lung cancer which is the type of cancer I was originally diagnosed with in late Feb., 2009. (Though I am now being treated for papillary thyroid cancer as you regular readers know. As to whether I ever had lung cancer, the jury is still out, not literally.) And since I have an incurable form of thyroid cancer, as written about numerous times in this space, I am forever open to new experiences that might create a path forward for me. The underlying problem in my situation is the odd circumstances that ultimately led to my more recent diagnosis. Since I had years of heavy-duty chemotherapy while treating my presumptive lung cancer, I have suffered kidney damage which only manifests itself in lab work and in what medications/treatment I can be given. As such when I went to the hospital after my thyroidectomy for post-surgical eradication of the remaining thyroid cancer that the surgeon was unable to remove, the dose of nuclear isotopes I was given was only one-third the dose it should have been had I not been so previously chemotherapy-damaged. As a result, I'm sort of stuck. I have a usually curable type of thyroid cancer which is now considered incurable. The solution? I need to find a clinical trial for patients who have been treated for lung cancer for nine years, perhaps mistakenly, suffered irreparable kidney damage from those years of toxicity, who now has been diagnosed with thyroid cancer and who is now unable to process the medicine likely to cure him and thus is: incurable. You bet I need a miracle, and sooner rather than later. Maybe I should fly back to Houston.

Life goes on. My warranty has been extended for another 90 days as all three scans from Sept. 23rd indicated stable and/or no new metastases. News with which I am extremely fond of saying, I can live. Though the radiologist's report that I received lists both non-small cell lung cancer and papillary thyroid cancer as "the indication," my endocrinologist feels what I have is thyroid cancer and likely have always had thyroid cancer. I wish I could say that will be for the lawyers to argue, but peculiarities of law and the three-year statute of limitations in Maryland makes a final resolution unlikely. Therefore, I will continue to live with my amazing good fortune and possible misdiagnosis as part and parcel of how I roll. And how I roll, as you regular readers know is chemotherapy, targeted therapy, immunotherapy and targeted therapy once again - in that order, and diagnostic scans every three weeks in the beginning and eventually and presently, every three months. As such, over these nearly 13 years of being a cancer patient, I figure I've probably had at least 50 CT scans and another 20-plus MRIs, plus an occasional PET scan. The point being that over the years, I've done an awful lot of waiting for scan results with my life/immediate future hanging in the balance. And 'balance' is exactly what one needs to endure these incredibly anxious situations. Though I'm fairly experienced at this juncture, the actual moment of truth when I receive the email containing my results is oft-putting to say the least and downright heart-stopping to say the most. However, my personality is perfectly suited for these ongoing challenges. I never presume the worst. I never woe is me. I never bemoan systemic delays in communicating the results to me. As my close friend, John, would most definitely say: "It is what it is, and it will be what it will be." I never put the proverbial cart before the horse. I can take it. No problem. My wife, Dina, on the other hand, cannot. For her, the results cannot arrive soon enough. Granted, immediate feedback would be much preferred. But, that's never been the process. I can accept it. Dina, not so much. That being said, I will admit that after all these years/scans/waiting for results, I have become less able to take it all in stride. It's as if a layer of patience and understanding of the process has been worn away with time. Even though I've mostly received good news (unexpectedly given my original "13 month to two year" prognosis - in Feb., 2009), I have had my share of disappointing news. But on the whole, I've been one of the luckier cancer patients. Still, each scan I wait for results is hardly an adventure in wonderland. I am constantly wondering and worrying when the other shoe will drop (the bad news). In fact, opening up the email that contains my scan results literally takes my breath away. Not to be negative, which I'm not, but during the Team Lourie meeting in late Feb., 2009 when I first met my oncologist and were given all the medical reports/assessments of my recent X-Rays, CT scan, PET scan and surgical biopsy from the pulmonologist, thoracic surgeon, pathologist and internist, it was clear and convincing from all these doctors that I had lung cancer. And my prognosis? Grim, and it was no fairy tale. It was surreal to hear and nearly impossible to process. I have what? When I was told the survival statistics by my oncologist of stage IV non-small cell lung cancer patients (me): 2 percent survive beyond two years, my brother asked if there are exceptions. To which my oncologist replied to me: "Could you be the one? Sure." Little did I know that the doctor was being literal. One was the answer. Ever since I heard that, I felt my days were numbered. All these several years later, I'm not exactly counting days, but neither am I counting chickens. I live quarter to quarter and am grateful to do so.

Speaking of side effects (at least I was in last week’s column, “Enough Already”) being a regular part of chemotherapy, targeted therapy and immunotherapy; the big three non-surgical options for cancer patients, I am currently experiencing a new side effect which as it happens is a dream come true: weight loss. Which has enabled me to eat to my heart’s content without your typical consequences. Meaning, for now, I can be comfortable in whatever food I eat. As Curly Howard of The Three Stooges might say: “What an experience!” For my entire life, I have not been thin. Growing up, all my clothes were purchased in the “Husky Department." In spite of that accommodation, my clothes always had to be let in or let out and nothing ever fit. I’ve stood over so many piles of clothes in store dressing rooms which didn’t fit, and made so many “walks of shame” out of the dressing room and onto the floor (where my mother would look me up and down to determine if the shirt, sweater, pants or short I was wearing had any redeeming qualities) that it has left a permanent mark. Most of the time, it was hopeless and I was forced to retreat back to the dressing room with even more clothes to suffer yet another indignity. To this day, some 60-odd years later, I am still traumatized by the years of suffering and humiliation I endured as an overweight child/adolescent forced to buy clothes for the fall/winter and the spring/summer. Oh, how I dreaded those shopping trips into Boston to visit Jordan Marsh, Filene’s and Kennedy’s. If it wasn’t for the two Joe & Nemo’s hot dogs I was promised, the day would have been a total loss - for me. However, after years of being fat, tubby, obese (per the health and fitness charts), slow-footed and unable to do even one chin-up during those annual phys-ed exams in secondary school; and moreover, never being able to lose any weight or change my diet to facilitate losing a few pounds, I have stumbled onto a surprising and quite unexpected remedy (of sorts): lenvima, my thyroid cancer medicine. A 10 mg pill I take once a day, rain or shine, seems to induce weight loss. Now that’s a side effect with which I can live. In fact, for an eater like me (challenging), living a scan-to-scan existence when the quarterly results determine my immediate future and/or whether my life hangs in the balance, it doesn’t get any better than that. After nearly nine months on this treatment, in speaking to my endocrinologist last week, she happened to mention in response to a question I asked concerning my shortness-of-breath side effect, about another side effect: weight loss. Ding, ding, ding. We have a winner (without the chicken dinner). The patient (yours truly) who was apparently originally misdiagnosed with a terminal form of lung cancer (stage IV) instead of what would have been a very treatable and curable form of papillary thyroid cancer, known as “the friendly cancer,” finally got some good news. Unfortunately, the re-diagnosis came too late and I’m still on a limited schedule, if you know what I mean? (F.Y.I: the nickname given to papillary thyroid cancer as being friendly is because it’s very curable.) Not that I don’t already eat my share of “comfort” food, but by consuming it so regularly, I usually pack on a few pounds and rarely, if ever, lose weight. My entire life, until this recent lenvima revelation, food had never been just for thought. As a result, lenvima has become my second favorite word after “stable,” (scan results). Now it seems, so long as scan results continue to be stabilizing, I’ll be able to eat what I want and let the chips fall where they may, literally and figuratively.

As I approach my four-week anniversary of "the burning," I do so with cautious optimism that one day soon, I'll be walking upright once again and doing so without the assistance of my walker. No more leaning over at the waist to grab the walker's waist-high grab bars. No more pulling/pushing myself up as I try to gain leverage in order to balance my weight so as not to fall backwards or to the side. And finally, once standing, no more hopping on my right foot as I favor the left; the location where the podiatrist pointed to and said at our last appointment: "You can see where that is ground zero;" meaning, the worst of the burn. And four weeks later, 'ground zero' is still ultra sensitive and not bearing too much weight. The emergency room doctor had said the healing will "likely take weeks, not months." And four-plus weeks into my recovery, I would say her assessment/prediction was spot on. But I'm not there yet. I'm somewhat better than I have been, but I'm still not ready to solo. Although I did drive for the first time yesterday. It was no problem (my driving foot is my right foot so pressing on the pedals was not the least bit painful. However, if there had been a clutch involved, I wouldn't have been up to driving). Still, success, and a feeling of independence once again. Fortunately, the clown shoes that the local emergency room provided finally are proving to be useful. The strappy, cushiony, black, open-toe sandals with the thick white soles I'm now wearing all day were designed to give the foot breathing room along with some support. However, in the early weeks following "the burning," when I placed my foot in the sandal, the insole felt rough as if it were tearing up the bottoms of my feet, exactly where the second degree burns had occurred. Since it seemed like it was hindering my recovery, I rarely wore them and instead put on thick socks (over the bandages lined with medication) and walked around on the heels of my feet while attempting to keep the balls of my feet (where the burns were) elevated and off the floor. It enabled me to mostly get around, but now, being able to wear the sandals, I'm much more ambulatory. And so it finally feels as if the worm has turned, as they say. The sole on my right foot is exhibiting all the proper signs of new skin having formed and is a few days away, according to my nurse-wife, Dina (who has been bandaging my feet up to three times daily since "the burning") of returning to its pre-burned status. As such, I am nearly able to put all my weight on my right foot as necessary as I continue to favor the "ground- zero" left foot. However, if I ever inadvertently place my full weight on my left foot, I am transported emotionally back to July 17 when I first stepped on that hot pavement. I don't exactly see stars, but I certainly feel pain until I lift up that left foot and start to hop on my right. Oh, what a relief that is, as I attempt to retrieve my bearings and find some place to sit, immediately. That being said, I am most definitely on the mend. Getting on my feet, still with the aid of my walker, doesn't conjure the same fear and loathing and pain as it once did. Urges to visit the bathroom are no longer delayed as much as possible. Nor are they fraught with anxiety and exasperation concerning the effort required to make the short walk to water the closet, especially in the middle of the night when the house is dark. But today, I can just about see the future (and a return to normal/independence) which may include a visit to close friends who live in Ocean City, Maryland, a k a the beach. And when I do, I'll certainly be upright and walking normally, but I won't ever be barefoot, inside or out. I can't take any chances. As slow as my recovery has been, I don't suppose its pace has anything to do with my underlying medical condition: thyroid cancer. Nevertheless, I don't see any benefit to stressing my immune system anymore than is absolutely necessary. It already has more than enough to do attempting to keep the cancer in check.

It all started innocently enough: on Crystal Beach in Galveston, Texas while enjoying a family vacation. Due to 11 years of chemotherapy, I have neuropathy in both feet. As a result, I never walk barefoot, especially on a beach, unless of course, I go into the water. Which on the Saturday before last, I did. When I returned to my beach chair, with my feet all sandy and wet, I elected not to put my sneakers and socks on for the 50-yard walk back to our accommodations. Oh (literally), how I wish I had. Not 10 feet from the end of the beach was a narrow strip of road (tar, concrete, I can't remember) which we had to cross to reach the grassy margins which would then take us to our house. No sooner had I stepped left, right, left, then I felt like a buffalo which had been shot on the Great Plains, as I immediately collapsed onto a neighbor's yard swearing in pain as I landed, as the heat of the pavement seared through the bottom of both feet. As I sat on the grass with my heels clenched and my toes pointing skyward, I thought,"I'm not going to be able to walk the 25 yards to our house." Somehow, within a few minutes, I summoned up the strength to stand and somehow I managed to hobble my way home. (I'll spare you the details of the excruciating pain I endured walking up the 20+ wooden steps to get inside our house.) The following day, I remained inside with my feet off the floor and my socks on angling for some kind of relief. The only times I had to move (to visit the bathroom) were sheer torture. Later that day, I relented and let my wife, Dina, look at my feet. She removed my bloody socks and recoiled in horror. To say it wasn't a pretty sight isn't really stating the obvious. It's stating that I was oblivious. I suffered through the rest of the night, taking only Extra Strength Tylenol for pain. It didn't really work. The next day we drove to Urgent Care. I was seen within 15 minutes of my arrival. The physician's assistant on call removed my socks and assessed the damage. He said I had second degree burns on the soles of both feet. He prescribed an antibiotic pill, a pain pill, and some medicinal cream. The cream was to be smeared on a non-adhesive bandage, which then was to be placed on the affected areas and wrapped with a self-sticking, ace-type bandage which was to be changed twice a day. I was given my prescriptions and a set of crutches. Soon I was out the door - via a wheelchair, and then Dina drove us across the street to a pharmacy where we picked up our goodies. Finally, we had a treatment plan and relief was in sight. Oh, (literally) how I wish it were so. The next day was our last day of vacation. Of course I was no use to anybody as the house was cleaned and everyone packed their stuff as the cars were loaded with luggage (and back down those same 25 wooded steps). It was nearly three hours later (after a two-hour car ride) with Dina driving (don't tell the car rental place) as I squirmed in pain, until we arrived at our airport gate with yours truly getting wheelchair assistance. Circumventing lines to drop off baggage and pass through security, with haste and super efficiency, we eventually were deposited at Gate A17 in plenty of time to make our departure. Unfortunately, the pain had not really subsided. In my mind, I knew I was going to Urgent Care later that night after we arrived home in Maryland. These painkillers couldn't kill a fly let alone the pain from a second degree burn. (We were seen that night at a local Urgent Care around 11 pm. They confirmed the diagnosis, but they prescribed a more serious painkiller: percocet. Which so far hasn't stopped the pain. Dulled it, maybe?) Back at the gate, while we waited to board, a woman came over to sit next to where I had stretched out across two seats to minimize the pain. Dina explained to her the reason why I had my legs outstretched was because I was injured. She smiled and said: "Would you mind if I ... ?" Stay tuned to this space for "Still Bedridden in Burtonsville" publishing Wednesday, August 4th.

(Again, not a cancer column. Given the title, it would be a pretty gruesome reference to my life in the cancer world if it were.) No. Not even close to a cancer column. But I am writing about a similar mind-numbing experience. However, this experience has nothing to do with disease/dying. Instead, it has to do with the effort, patience and excruciating lack of success in attempting to contact, meaning speaking to an actual person, at the Internal Revenue Service and/or at the Social Security Administration. The phone numbers you're "googled" to call are the opposite of hot lines. They are frigid. Almost too cold to tolerate, but since your financial life expectancy may be at risk, somehow you have to hold on for dear life. Or else pay, or rather be unable to pay, the consequences. So I'm on hold for 14 minutes and counting, sort of. More like listening to some unrecognizable instrumental between looped messages that say (A) You're still on hold and (B) They haven't forgotten you and your call will be answered in the order in which it was received. (Actually, you're hoping they remember you.) Unfortunately, you have no choice but to hold on. The answers you seek are only found at these places/numbers and unless you go to the source, you'll be barking up the wrong tree and/or not squeaking the right wheel. I'm fairly certain that if you don't call them, they're unlikely to call - back, or forward, especially if the reason for my two calls is to secure money coming to me instead of negotiating how I'm planning to pay them. So sit tight and be brave - and be near a bathroom to make sure nature's call doesn't interrupt your interminable wait on hold and/or be sure there are enough bars on your phone so a draining battery doesn't end your pursuit. However, presuming the time it will take to speak to someone to be hours, not minutes, it can be an opportunity to while away your wait by multi-tasking and have the music offered up for your listening pleasure to serve as a kind of white noise as you go about some other personal business. In short, you can get things done rather than become increasingly frustrated that you're stuck by the phone accomplishing nothing. But you have to prepare and anticipate. This wait is not going to be a pleasurable experience. It's a means to an end, hopefully a rewarding one, but hardly one that's guaranteed. If you can only talk yourself into realizing how good you'll feel once this phone task is completed. Rolaids has nothing on the relief you'll feel when you're finished with this day's work (almost literally). Moreover, knowing you don't have to call them back tomorrow is nearly motivation enough. Crossing this task off your to-do list free's up not only time but mental space, as well. It's almost as if you've given your life back, at least for a few hours, anyway. As I sit and continue to write this column, it is 38 minutes since I began this exercise in time utilization. And it's just now happened, a representative from the Social Security Administration has just interrupted the music loop and offered their assistance. Let me get my bearings and organize my thoughts so I'm clear in what I'm saying. I don't want to have to make this call again. I already have once before. I have called previously and after telling my tale, was put on hold while the operator researched my claim only to be disconnected when the operator returned to address my question. But this time, there was no disconnect. I received my answer in a reasonably timely manner and off I now go into the rest of my day. Next up: the IRS. Do I dare test my limits and call them on the same day as I called Social Security or do I reward myself and take a well-deserved break? Either way, it's one down and one to go. I think I'll call tomorrow. I don't feel like testing my patience yet again, and besides, I'm finished with this real-time column.

(Not a cancer column.) For the past six months or so, I have been the email-recipient of $50 gift cards to numerous to count/tally. They have run the gamut from Ace Hardware to Zappos.com and everything in between like CVS, Kohls, Walmart; you name it. I have rarely clicked on any of these "giveaways" because the one time I did, the answers required on the site - to claim my winnings, seemed a bit intrusive, as in what they were asking was none of their business. If they truly want to incentivize me to spend money at their store/site, they need to leave my personal business out of their equation. You don't need to know my mother's maiden name or the name of the city where I was born, to give me money, and you definitely are not getting my credit card number into which you'll make "the transfer." I've been down that rabbit hole before, and it's not good. For a time, I was naively open and curious about these presumptive money/data grabs. I figured that in a pandemic world where millions of potential buyers are quarantining at home, and brick and mortar businesses are left fending for themselves, finding an alternate route to my wallet/credit cards while many of us were less inclined to go out and mix with the masses, a gift card teaser seemed prudent and reasonable. Moreover, given the very extenuating circumstances we've all endured these last 18 months, it was safe even; given our collective evolution in terms of purchasing goods and services online over the last decade to buy remotely. Throw in the same day service available with some vendors and there really is very little need to leave your house. But after being nearly hooked and gutted by a phishing expedition once before, I've become extremely cautious about taking any bait/ tipping my toe in the figurative computer water, especially when the offers seem to be pulling at my heart's strings: free/easy money. Certainly I am mindful of the advisory: "If it sounds too good to be true...", yelled from the highest mountain tops in the past decade. However, the fraudulent pursuit of our almighty dollars are not being sent by idiots/innocent target marketers. Hardly. These callers, with whom you eventually have to make verbal or online contact are quite proficient at answering your questions and/or allaying any fears that the about-to-be-extremely-unlucky mark is exhibiting. And once the caller/responder to your query has control of your computer - which you provided (it seemed like the logical thing to do to close/finalize the deal), the gift card party is officially over. The "free" money you had anticipated receiving is now going to cost you real money, as opposed to the offer you initially received which, as it happens, wasn't real/free at all. Still, even with my previous near-death financial wipeout, I did click on a CVS offer. The site had all the CVS bells and whistles and colors which I've come to recognize and the offer seemed genuine: three choices to click on a box to win a $50 gift card. And of course, it was the third and final red box on which I clicked that offered up my $50. That was easy. Too easy. As it soon became apparent, claiming the money was the problem. Once I answered a bunch of questions about my name, rank and serial number of where I live and so forth, I realized I was leading the caller down the garden path to my identity and all sorts of harrowing misadventures which I'd prefer not to experience first hand. Before it got too late/too personal on the sight, I politely backed out before any damage was done. As a result of this near calamity, I am no longer clicking on anything that seems the least bit enticing with unsolicited offers of direct payments/gift cards to me. If however, there are solicitations to me for gift cards to be mailed to my home without any preconditions or questions answered, I'd be happy to receive them. Otherwise, I won't bother. I've been shamed once, I can't afford, literally, to be shamed twice, then it is my fault (a fool and his money ...) .

... stable, with a side of shrinkage, however modest. No jeopardy here, final or otherwise. Simply more of the same here, but hardly ho hum. A status quo with which I am fond of writing: I can live. Promises and guarantees left the building on that fateful day in late February, 2009 when an oncologist who I had previously never met summarized my condition and identified it as stage IV, non small cell lung cancer. A "terminal" disease if there ever was one, and of course there are many. And along with that bombshell came the excruciatingly unpopular prognosis: "13 months to two years." I was 54 and a half with no history of cancer in my immediate family. Much has happened and many medications prescribed since I infused my initial chemotherapy back in early March, 2009. Most of which you regular readers know. If you recall anything from my 12 years of weekly cancer columns, it is that regular diagnostic scans: CT scans, bone scans, P.E.T. scans and MRIs have been recurring nightmares. Every three months, I am scheduled for some type of scan, sometimes more than one ("BOGO," I call it), which based on its findings will determine my subsequent course of treatment. If the results are encouraging, a change in my treatment is unlikely. If, however, tumors are growing, newly appearing or spreading then it's "Katy bar the door," as we say in New England. Which means, hang onto your hat, among other things, as a new health situation presents, and one without an automatic solution. After years of conversations with my oncologist, I've learned: The best one can hope for is a definite maybe. It's this unpredictability which fills my day - and night. Nevertheless, my life has gone on way longer than my oncologist anticipated. It may be because I was misdiagnosed (as a Georgetown Cancer Center oncologist suggested) and had a slow moving form of papillary thyroid cancer rather than an aggressive form of lung cancer, which kills more often than it cures. Or, I may simply be my oncologist's "third miracle," as he's fond of saying. Presumably, my positive attitude and good humor about my circumstances in conjunction with the many supplements I ingest with alkaline water exclusively have contributed to my unexpected survival. Regardless, as Frankenstein might have said: "I'm alive." As scary as Frankenstein, Dracula or Lon Chaney ever was, a cancer diagnosis tops them all. Being told by a doctor you have never met that you have two years to live, at best, is as you might imagine, nearly impossible to process. It's not exactly what you had planned on or expected hearing when you sat in the doctor's office. Yet, as Ralph Edwards used to say, "This is your life." And as many others have said: "You're stuck with it." And as grim as you feel about your future, this is no fairy tale. As always, reality beats make-believe any day, and in this instance, not in a good way. But I am in a good way. I am still typing, among other activities. And after having just received a "looks good" comment from my oncologist concerning this week's CT and bone scan, my warranty has been extended for another 90 days, when the results of my next quarterly scan will be emailed. Until then, I am in high cotton. To say I'm not worried is of course naïve, but in the interim, between scans, I am in "the rocking chair, good buddy," to invoke a familiar CB-ism. This is how many cancer patients live: from one scan to the next. It's not ideal, but it is a living, and one for which I'm extremely grateful and fortunate to still have. It may not have been the life I expected, but I'm glad to live it nonetheless.

... and I suppose life is back on, especially for those of us who have been vaccinated. No more hiding your emotions and expressions behind your face-covering as you once again start interacting with the general public. They can see you and, of course, you can see them - and you can hear/understand them, too. Conversations will flow more evenly now that they won't be interrupted by an "Excuse me, I can't understand you," or a "Could you please repeat that?" Conversations that were previously affected by fits and starts will revert back to questions and answers and what abouts. For me, the mask was an impediment to normal conversion. Necessary and prudent during a once-in-a-lifetime, public health emergency, but apparently, the time has comer. Previous directives: masks, social distancing, contact tracing, quarantining and vaccinations were all most of us ever talked about. Now with vaccinations getting into more arms, our lives are expanding. From our living room to just plain living. Though there are still mask-on requirements - in schools, on public conveyances, and in airports, train stations and the like, and while obtaining healthcare services - we are now, especially those of us vaccinated, free to return to our previous life, mostly. Soon, capacity restrictions will be lifted as our lives, so far as the activities which involve large crowds, both inside and out, can open back up in their entirety. Moreover, social distancing will likewise become a thing of the past. Now, all those round stickers marking six feet of distance as well as the plexiglas dividers will disappear as well. However, individual businesses retain the right to require visitors to mask up. As Bobby Brown used to sing: "That is my prerogative," and so too will businesses have their own prerogative to require patrons - or not, to abide by their mask-wearing requirements. All of that being said and understood, even though I'm fully vaccinated, I still feel like I should mask-up. From the national vaccination statistics, there are plenty of people who have not yet been vaccinated and/or are unwilling/unconvinced they need to comply. I can't quite understand the "vaccine hesitancy" or the disinterest in following these most recent public health advisories. It seems like such a small, relatively risk-free/preventing risk step to take. I mean, whatever temporary side effects/discomfort one might experience a day or two after the injection pales in comparison to the effect on your body and/or life expectancy contacting the virus might have. I'll take a definite over a maybe anytime. Besides, I don't want to be responsible for my own demise, or any others for that matter. In this situation, I'm happy/proud to conform to the public health directives. The virus is bigger - and badder, than any one of us; so to be bigger and badder than the virus, literally and figuratively, the more of us who receive the vaccine, the more of us will be able to survive this pandemic and safely embrace our former lives while not fearing the consequences of our inactions. The other day at my local Giant, I happened to walk by the customer service desk where I heard a customer bragging to an employee about not planning on getting a vaccination, like he was proud of it. What a disconnect! I'm proud to have gotten my vaccination, and I'm equally proud to have participated in a national effort to try and combat the greatest health crisis this country has suffered since the Spanish Flu first infected Americans over 100 years ago. I just wish more people would put the country ahead of themselves. For all that we're given here, it really doesn't seem too much to ask. In this circumstance, paybacks are not hell, they're heaven.

As previously referred to in a recent column, even though I am hardly cancer-free; nonetheless, I am cancer interruptus for the next four weeks. That means I have no cancer-related activities: no lab work, no scans, no infusions, no injections, no appointments, no video visits, no interaction whatsoever. Other than taking my daily thyroid cancer pill (the side effects of which are marginal at worst), with which I ingest another 50-plus pills (supplements and so forth), I am, too quote my late father, "unencumbered" by my less-than-ideal circumstances. I wouldn't say I'm actually on vacation, but I'm certainly willing to say, there's a definite break in the action. It's not exactly a "staycation," nevertheless, it is a positive occasion, and one with which I can live. Not that being diagnosed with "terminal" (originally) cancer and/or still undergoing active treatment is ever fun; tolerable is as grandiose a description as I'll accept. However, four weeks without any involvement with my oncologist and endoicrinologist or with any health care-related staff, puts a real bounce in my step; my neuropathy notwithstanding. Though I have difficulty walking and especially running, I am, for the next four weeks anyway, on easy street, figuratively speaking. The psychological wear and tear us cancer patients (especially the ones characterized as "terminal") endure is ever present and any excuse/opportunity to let one's mind wander to a place other than your presumptive demise, is a mental trip very much worth taking. Oddly enough, a month of not having anything to do with my cancer team/healthcare facility is hardly the norm. Usually, there's more than enough cancer-related activities to keep me preoccupied. In its own unique way, the nothingness is kind of challenging. I keep looking over my shoulder, almost literally, as the great Satchel Page once said ("to see if anybody's gaining on me") , and flipping the pages on my appointment book to see if I've whiffed somehow on some of my usual and customary obligations. I mean: it is so rare to be so disconnected when you've been diagnosed with a "terminal" disease. As you might imagine, cancer treatment is very hands-on. Not much is left to chance. Moreover, cancer is very unpredictable and insidious. Often it is in control, despite the oncologist's best effort. To be thrown into this cancer-centric world after mostly standing still, healthwise, for 54 and a half years, is a fate not worse than death, but one, depending on the type of cancer you have, which could very well lead to a premature death. After decades of neglect, the last 15 or so years has seen a huge increase in funding for lung cancer research which in turn has led to more than a dozen new drugs - and an entire new class of drugs: immunotherapy, for the treatment of lung cancer. The result has been increased survivability and quality of life for those of us so diagnosed. And very directly, I have been the beneficiary of some of these drugs: avastin, alimta and tarceva having been my life extenders. Where despair once dominated the initial prognosis, now there is hope. It's not so much a cure as it is a way to make cancer a chronic disease, one which requires a lifetime of monitoring, like diabetes, as an example; but it's potentially for a lifetime, not for a life with very little time. At this immediate juncture, I am being treated, but still living my life - outside, and rarely ever in a medical facility. Not having to endure the ongoing exposure and reminder that I have cancer and a shortened life expectancy to boot, enables me not only to breathe easier, but also allows me to take an occasional deep breath as well. A deep breath which doesn't lead to a coughing fit, a fit which, for us lung cancer patients is never a good sign.

I'm sort of invoking Southwest Airlines here, but not exactly. What I am invoking are the incredible number of television and radio commercials for legal gambling sites and for car insurance. Both offer rewards while requiring payment upfront. In anecdotal fact, if it wasn't for these two entities advertising on television especially, and on radio to a lesser degree, the airwaves would be a lot less redundant. I'm so used to seeing Flo from Progrssive, LiMu Emu and Doug from Liberty Mutual and all sorts of familiar characters from Geico that I am actually contemplating making an insurance inquiry. Together, these insurance companies in particular have combined to nearly beat me into insurance-quote submission. The last time I changed car insurance companies was after seeing a plane at the beach flying a banner for all of us who could see encouraging us to make a call. It was - for me, the last straw. I called the company the following week and was indeed rewarded for that call: hundreds in premium savings. Likewise, DraftKings, Fanduel and BetMGM have combined to nearly entice me into entering their world of online, sportsbook betting. Unfortunately, I have a much better grasp of the jargon and issues addressed by car insurance advertisers (having been a Certified Financial Planner in my previous profession). With respect to the sportsbooks, even though I'm a long time "sports guy," and as such understand the nature and risks of anticipating a desired outcome, I've rarely ventured outside the lines. Those lines being an NFL most-winners pool held weekly in season at my wife Dina's former employer, a season-ending Super Bowl point-totals-at-end-of-each-quarter thing, and a yearly participation in the annual NCAA's "bracketology,"(which I've actually won once). But the modern sportsbook and even the individuals hired by the radio and television networks to discuss/albeit recommend the various "plays;" the over-under, the parlays and all the extra-special, apparent can't-miss, opportunities for new/first-time bettors/gamblers hyped as if there really is nothing to lose by playing and only money to win, is all too much for me to process and understand. After listening to all the noise, I really feel a need to take a class to protect myself from simply losing/throwing money away because I think I understand, but likely understand very little of the actual risk/reward dynamic. Certainly, I can appreciate the excitement of winning money at the expense of others, but as most would attest, at the very least; expecting outcomes will satisfy your financial needs is a slippery slope at best and a rabbit hole at worst (why else the "If you become afflicted to gambling" advisories on all the advertisements). The car insurance companies are certain we all want to save money on such necessary got-to-haves like car insurance. And the sportsbooks are betting (pun intended) that we all want to find free money and are not opposed to taking a chance to get it. A chance which if successful, might actually provide the extra money needed to pay their car insurance premiums. I fear however, that once dipping my wallet into the gambling waters, and win a little, but likely lose more, it might be difficult to extract myself from their figurative clutches. The car insurance companies are sort of the same. They entice us by advertising lower prices then hope to retain customers by offering various other incentives such as "accident forgiveness," "vanishing deductibles" and the like. In effect, they're both trying to bait us and hope we don't switch. Their motivation is quite similar: they want our money and they want us beholden to them. it's not ideal, but it sure is prevalent. In each instance, you're "betting" money on an outcome which is totally out of your control: predicting scores and predicting whether you'll have a car accident or not. Whose to know? Not me. In addition, I've grown weary - and skeptical of the never-ending pursuit of my dollars. Besides, I got out of the predicting business as soon as I received my "terminal" cancer diagnosis in late Feb., 2009.

What are all these "Toe Nail Clipper" emails I receive nearly every day? And how do these senders know that I'm actually the perfect recipient. Toe nail clippers and cuticle trimmers have been the bane of my existence going back as far as I can remember. And as recently as I care to mention, these two accessories have been front and center on my bedside table, in a drawer in my living room coffee table, in my car's console/glove box and in any suitcase/overnight bag I take with me out of town. The fact of what has been the matter with me is that I bit my nails and trimmed my cuticles constantly, not out of appearance but due apparently, to some undiagnosed mental condition, according to family and friends who were subjected to my relentless pursuit of whatever ailed me. The constant gnawing and "cuticlizing" of my nails drove my parents nearly around the bend. Whatever they tried, which was not professional help, couldn't stop the train, so to speak. Unfortunately, they weren't alive to see me stop. What joy they would have felt for this change. Exultation. Unfortunately, the change occurred quite by accident and with no intent of mine. What happened was that I was diagnosed with cancer, rather than make me a nervous wreck about my original "terminal" diagnosis, and bite my nails for a good reason, I just stopped, and it's been over twelve years now. I still haven't been to a manicurist, but I no longer scoff at the suggestion. And though neither of my parents lived to see me stop biting my nails, they also both died before learning about my lung cancer diagnosis, for which I was extremely grateful. Aside from the obvious reason why my mother would have been upset about her "baby" being diagnosed with lung cancer was the fact that throughout my childhood, my mother smoked four packs of Chesterfield Kings every day. Then suddenly, she stopped, cold turkey, the coldest you can imagine. It happened in the early 60s when the anti-smoking campaign about the association between smoking cigarettes and lung cancer began in earnest in this country. From that point forward, my mother never wavered in her commitment. There were no more cigarettes and she lived to age 87, almost, when she died from natural causes, not cancer. Oddly enough, it was her non-smoking son, yours truly, who was diagnosed with lung cancer, part of an ever increasing percentage (upwards of 25% most recently) of non-smokers so diagnosed. Whether secondhand smoke or environmental exposure to certain chemicals, the numbers of lung cancer patients who were non-smokers has been steadily increasing. And in a fortuitous twist of fate, it was this increase specifically in the number of non-smokers being diagnosed with cancer which led to a huge increase in research funding. Funding which has spawned an increase in the numbers of drugs approved by the FDA which have directly affected my treatment and subsequent survival. Now what percentage of nail-biters are diagnosed with cancer, I can't say. But this hyper-targeted email campaign - which features almost daily emails from people who are on a first-name basis with me and I them, according to their sender's name, is remarkable in its having reached a prime candidate, and one with a history of having used imperfect and/or failed implements for this very purpose. If anybody would appreciate the possibilities of this product, the relief it might provide, it would be me. If my mother were alive today, I'm sure she'd agree, nobody ever bit their nails more than I did. That's how I learned the meaning of the word "quick: "the soft-tender flesh below the growing part of a fingernail or toenail." With all the self-consciousness I endured while nail-biting (and the visual condition of my fingers as a result), I wish I could take credit for having figured out the underlying cause, or had found a topical solution and/or a hypnotic suggestion that would help me stop. But I didn't. Apparently, the cancer made me stop, and not even consciously. To quote the late B.B.King: "The thrill is gone."

Literally and figuratively. After a year or so living the pandemic life - staying at home/quarantining, wearing a mask, social distancing, washing my hands and watching the death toll from covid-19 top 500,000 in the United States alone - I recently became of the lucky ones to have been injected with a vaccine. I have to wait another two weeks to get my second shot. No worries. I have some protection now, but according to Dr. Fauci, the second/follow-up shot increases one's protection "tenfold." It wouldn't exactly be foolish to throw caution to the wind - and reintegrate back into society (depending upon where you live), but it seems premature and irresponsible to risk being stupid when in another two weeks, I could be smart. My wife, Dina, also recently shot, has been very smart all along, especially as it concerns my actual standing in the world. (Moreover, she has no plans to step out until she receives her second shot.) Belonging in the special co-morbidity group (presumably, a 66-year old with cancer/weakened immune system), I presented a very appealing target for the virus. I mean, my immune system is already compromised and with occasional breathing problems side effected by my thyroid cancer medication, I was potentially easy pickins. As such, Dina refused to give me passage out of our house. Victor Laszlow had a better chance of leaving Casablanca than I did of leaving Burtonsville. But soon it appears I will have my own "letters of transit." However, Dina has already informed me that I won't be returning to my former errand-running ways. She intends to continue ordering food online from the grocery store - and then drive to pick it up contact-less in their parking lot. Actually, I might be allowed to go that far since I'd be remaining in the car and still wearing a mask while popping the trunk and keeping my distance as the groceries are loaded into the boot. We'll see; we're still negotiating. But definitely not until I receive my second shot. In the interim, I imagine our lives will change very little. Thanks to the vaccine, though, there is hope that once again, I'll be able to interact with people, places and things. But return I shall and relieved I will be. However, having lung cancer, and/or thyroid cancer which has metastasized to the lungs, in the midst of a pandemic with a virus that often locates in the lungs and creates breathing/pulmonary problems - even with the two shots, is still as scary and risky as it gets, especially if you're of a certain age as I am. In two weeks, I'll have received my booster shot, and I'll have a lot less to worry about, thankfully. And for a cancer patient still undergoing treatment with a less than a "normal" life expectancy anticipated, being fully vaccinated is as good as it gets. And I suppose I can live with that, live being the operative word. Having cancer, irrespective of the type, your diagnosis/prognosis, is pretty damn difficult. It impacts every facet of your life. The thought (your reality) is never far from your conscious mind. And once you become a member of this less than exclusive club (more every day, unfortunately), a club that nobody wants to join, there are more risks to your life than you ever imagined, and many more for which you have absolutely no awareness. Having an external complication, like a virus, with variants that seem to spread rapidly, which have now infected infected over 30,000,000 Americans, and an infection for which there's no specific cure, and seems to have its greatest negative impact on people exactly like me (age and disease) is about as foreboding as it could possibly be. And with no place to hide, other than in your own home - with no visitors allowed, a precaution most recommended (to invoke the syntax of Hercule Poirot, "the greatest detective in the world") has made many of us impatient and perhaps a bit tense. I can, as many healthcare professionals have said, almost see the light. Hopefully, it will be July 4th of this year as the President has suggested and not July 4th of next year.

I realize I'm cancer-centric, especially in these columns, but for some reason that centricity didn't acknowledge my February 27th cancer anniversary. That date, in 2009, is when I was originally diagnosed with stage IV, non-small cell lung cancer, the "terminal" kind. I remember it well. It was a Thursday. It was the initial Team Lourie meeting with my soon-to-be new best friend: my oncologist. A week or so prior, I had received the first indication - from my primary care physician, that my life was about to change: the results from the previous surgical biopsy confirmed a malignancy. It's rather an awkward dynamic to meet someone - for the first time, who immediately becomes the person who will control, manage and, in effect, be responsible for whether you live or die, and for how long. From then on, he becomes the most important person in your life; a person who is now entrusted with your most precious asset: your health. It was not an unfamiliar experience for me meeting someone cold and attempting to build a rapport. As a long-time salesman, that was my modus operandi. Whether in person or over the telephone, I have regularly been engaged in this kind of pursuit: trying to create an environment of trust and honesty in order to reach a shared goal. Previously, it was about making a sale; now, it was about understanding my options and agreeing on a course of treatment. However, the one major difference between these two pursuits was control, or rather the lack thereof. Cancer was now in control as compared to my life as a salesman where I chose it because it allowed me to be in control: who I called, when I called, scheduling appointments, et cetera. Soon it became apparent, I was no longer in Kansas anymore. I was in the hands - figuratively speaking, of my oncologist - in Maryland: my new boss. If I wanted to live beyond the "13 month to two year" prognosis I was given, I would have to be as attentive and compliant as possible. In spite of our shotgun-type of relationship, we have persevered together, which has enabled yours truly to acknowledge, albeit a week or so later, an amazing achievement: 12 years and still living. Not that my circumstances have become de rigueur, hardly; especially since the thyroid cancer diagnosis of late has put into question my original non-small cell lung cancer stage IV diagnosis. Apparently, after making a few inquiries, it appears unlikely that we can litigate the past any more than we can guarantee the future. It seems that cancer, whichever type, will be a part of my life and likely a part of my death as well. I'm surprised how it's (my life) all turned out and grateful to whomever for what I'm not entirely sure. Nevertheless, somehow it's worked and here I am: alive and reasonably well. Not cancer-free and never to be cured of my stage IV papillary thyroid cancer; still, it's a living and it sure beats a dying. Treatment and scans and all will continue, but so what? Originally it appeared my die was cast, but as it has happened, not nearly so fast. All of which is nothing new, really. A cancer diagnosis is all about change, ceding control, and hanging on for dear life as you will be up and down and all-round, emotionally, physically and spiritually. Expecting a normal kind of pattern to your future life ended the moment a biopsy confirms a malignancy. Either you adjust to the vagaries of your cancer life or you will die having failed. I think I have succeeded beyond my wildest expectations. So much so that I didn't even acknowledge my "cancerversary" last week. I guess I needed the week off from worrying about it and didn't even realize it. I have to admit though, it felt good not focusing on it for a change. Almost like I was a "normal" person.

Well, those last two weeks were kind of fun (comparatively speaking) to the dozen or so previous weeks. 'Fun', when you're a cancer patient experiencing side effects from treatment, is a moderation, absence even of said effects. My recent two-week break from taking my thyroid cancer medication was due to those side effects. Mentioned in a previous column, I was having balance and dizziness issues. In short, I couldn't walk or drive - for that matter, in a straight line. After consulting with my oncologist who deferred to the oncology pharmacist who's been monitoring/adjusting my medication dosage, it was agreed that I should cease and desist until my symptoms subsided. As of this past Thursday, my symptoms had mostly disappeared so I have resumed my treatment, albeit at a lower dose. (This will be the second reduction in my dose since we've been trying to find the sweet spot where the tumors are stable and the side effects are manageable.) Actually, these last two weeks of being side-effect free was more than just a break in the action. It was a revelation of sorts. The infirmity/muscle weakness I was having was not due to the older age I have become. It was the medication. During this past fortnight, I began to feel like myself again. I could get in and out of chairs without pacing myself. I could roll over in bed and pull up the covers without a fuss. And of course, I could walk and drive a straight line. It was wonderful. When one is in the midst of a cancer diagnosis/existence, any indication that your bodily functions are performing "within normal parameters," to quote Lt. Comm. Data from "Star Trek: Next Generation" is somewhere between reassuring and life affirming. Generally speaking, we all know that cancer doesn't make its diagnoses big and strong. Realistically speaking, you're happy with normal. Conversely, when 'normal' isn't how you feel, it's hard to portend that death/disability is not fast-approaching. Moreover, it's an especially slippery slope when one has been given a "terminal" diagnosis originally and more recently had that diagnosis modified to include a second type of cancer: papillary thyroid cancer stage IV, to go along with my pre-existing non small lung cancer, also stage IV. One has to fight emotionally to keep from getting lost/going down that rabbit hole. Any good news/an unexpected positive reaction with your disease, like your mind and body returning to pre-cancer normalcy is about as good as it gets. So even though I'm back on the medicine, I feel empowered, upbeat, hopeful even. To that end/continuation of life, I am not going to worry yet that the reduced dose will allow my tumors to grow. I'm just not going to go there. What would be the point? I'll find out soon enough, a few days after my next CT scan in mid-March. Until then, I am going to bask in my semi return to glory. Speaking of 'glory,' as a cancer patient, one has to grasp and hold on to anything of emotional, physical, psychological or spiritual value. In addition, what information you receive which is not particularly positive, in that it's premature/unproven/not corroborated by science, has to be compartmentalized. As with Jerry Seinfeld, you have to put it in the vault and almost throw away the key. Allowing negative possibilities or unpalatable scenarios to take root in your brain really does a disservice to your potential survival. Ever since I was diagnosed with a "terminal" form of cancer, I've tried not to put the cart in front of the horse, if you know what I mean? The diagnosis was bad enough on its own. I didn't/don't need to make it worse by pilling on. If and when my life becomes more challenging/more cancer centric than it is now, I'll deal with it. I don't need to bring it on any sooner than is absolutely necessary. I've had 12 years I wasn't expecting since receiving an initial "13 month to two" year prognosis. Twelve years later, I don't see any reason to change my approach.