Snowballs in July

Today, I learned the results of last Sunday's CAT scan, which confirmed what was expected, given improvements in my blood work, skin color, and energy level and a weight gain of about nine pounds. My tumors have been reduced in size by chemotherapy since my first and only previous CAT scan in early March. Although the tumors have not responded as dramatically ("they are not melting like snowballs in July") as is sometimes the case at this point in chemotherapy, the progress is consistent with continuing the current regimen. 

Also, I learned that the dermatologist's initial reaction, when he heard last Friday by telephone that there was a patient who had a skin rash after being injected with Neupogen, was that they would have to discontinue giving me the drug. He changed his mind after actually examining me.

Optimism

Although most of my family seem to accept the reality of my diagnosis, a number of my friends have obviously been disappointed with me for "giving up," i.e., for not believing that somehow I can "beat" the cancer that afflicts me or at least survive for a long time. I am deeply touched by their concern.

In part, some of my friends' difficulties in accepting the fatal ending of my condition may be owing simply to incomplete information about my diagnosis and/or incomplete understanding of the resultant prognosis, given the current state of the art of oncology. Difficulty in acceptance by others may stem from a belief that if I "give up," my outcome will be negatively affected. For some, the difficulty may go to the heart of their belief systems, such as beliefs in miracles, miracle cures, divine intervention, and the curative power of prayer and positive thoughts. (I am profoundly grateful for friends' thoughts and prayers.) For some, if I do not believe that I can survive my condition for an extended period of time, it is harder for them to deal with my plight. Each of these difficulties is well taken and would be more than worthy of a separate discussion. 

In spite of my acceptance of my fate, I do not find myself lacking in optimism or positive thoughts. As the recipient since my diagnosis of extraordinary kindness from loved ones, friends, and care-giving professionals, I have never felt closer to my fellow man or more optimistic about the human condition. I see no contradiction between being a realist and being an optimist. 

Perhaps I could describe my current state of mind as that of a realistic optimist. Susan and I recently made a monetary contribution to cancer research, not out of any hope that it will benefit me, but rather out of faith that eventually cancer research will result in significantly lower death rates and significantly longer survival times for those afflicted by cancer. I enjoyed myself today with friends at lunch and dinner, and I have plans to do the same, and more, tomorrow!

Annual Meeting

Today, for the first time, I attended an annual meeting of Harris & Harris Group, Inc., as an outside shareholder. Because, like most entrepreneurs, I had always tried to control my environment, I had been a little curious about how I would feel sitting in the audience in a passive role. I felt completely comfortable. Undoubtedly my comfort was in large part a reflection of my confidence in the management team (which gave an interesting presentation). But my comfort may also be an indication that I really could have retired as I had intended, that I did not need to occupy my time with commercial pursuits.

Two Cups of Coffee

As I have written previously, when I learned that I have cancer, from the nature and extensiveness of it, I realized immediately that under no circumstances would I now live to a ripe old age. Because of my parents' extreme longevity, and because I had long taken great pains with respect to diet, exercise, and medical check-ups, I had always been concerned about disabilities of old age. In particular, I was concerned about going blind one day. My father suffers from wet macular degeneration, and my mother is legally blind from glaucoma. About 10 years ago, I was diagnosed with a complicated case of glaucoma as well, for which I meticulously administer four different prescription eye drops in various combinations each day to lower my interocular pressure from normal to sub-normal. About seven years ago, I serendipitously discovered that caffeine raises my intraocular pressure. Since then, I have abstained from caffeine, which had always been my drug of choice.

The morning after I learned that I have cancer, I decided that, now that I don't have to worry about outliving my eyesight, I may as well go back to enjoying coffee. So I had a cup with my breakfast, and it was every bit as enjoyable as I had remembered. And I did the same thing the next morning. But the third morning, I decided that even though resuming coffee consumption would now be perfectly rational behavior, it seemed like a self-destructive, negative thing for me to do. To date, I have not had another cup of coffee.

Sunday Silence

I spent the morning at MSK getting an injection of Neupogen and a CAT scan. My exercise for the day consisted of walking back and forth from the hospital in light rain, amidst bicyclists who had the run of the city in a sanctioned event. After having lunch and watching reruns of Hot Money's race, which we had recorded on Tivo, I devoted the rest of today to reading by the fireplace in our living room. Since starting chemotherapy, I am a much slower and more contemplative reader, but reading is still essential to me.

Hot Damn Hot Money

Shortly after returning from the winner's circle, I looked at my Blackberry and saw, to my surprise, that I already had a number of e-mails congratulating us on Hot Money's win today, one of which was entitled, "Hot Damn Hot Money." I hope that the e-mailers had a bet on as well: Hot Money went off at 8.6 to 1 odds. As the track announcer called, "Hot Money got the money!"

Hot Money actually has a nice story line. Our trainer, Christophe Clement, trained Hot Money's dam, Smoldering, for a European owner. Smoldering showed some potential, but slipped and fell on the way to the track one morning and injured herself badly. Saving her would require an expensive operation followed by a long convalescence, and she would be unlikely to race again. Her owner declined to undergo that expense and ordered that she be put down. Christophe then received permission to pay for her surgery himself and took title to her. When I learned about it, I offered to take on the expense, and when my partner, the late Peter Karches, learned about it, he offered to share the expense with me, and Peter and I became the owners of Smoldering. There are more twists and turns to the story, but Susan and I wound up as the owners of Smoldering and bred her to Not for Love, a stallion in which I owned part interest. We named the resultant foal "Hot Money."

Hot Money got sick as a foal and was on antibiotics for months. He grew to be a small, but well-made, balanced horse, with one pronounced flaw: he walked wide behind for some reason we could not determine.  For want of a better solution, I had him gelded this winter. He tracks better now, and certainly ran well today in his second lifetime start, the first since he was gelded. He is quick on his feet and can be a bit naughty, unseating his exercise riders in the morning if they are not alert. We hope to have a lot more fun with him!

Kicking On

Since I developed a rash on April 20 after receiving a shot of Neulasta for the second time, I have been quite apprehensive about what would happen the next time I received Neulasta. Given how suppressed my white blood cell count became when I received chemotherapy without Neupogen or its longer acting version, Neulasta, it is obvious that if I could not tolerate Neupogen or Neulasta, my chemotherapy would have to be curtailed significantly.

Neupogen and Neulasta commonly cause bone pain, which I experienced with Neupogen, but not with Neulasta. Neither is supposed to cause a rash, and I had received Neupogen twice and Neulasta once with no skin rash. Dr. Saltz, my medical oncologist, decided to give me Neupogen this time, so that if I got a skin reaction, it would not be exacerbated over an extended period by the longer acting Neulasta.

I received the injection of Neupogen at 8:50 a.m. today, and when I got home and checked in a mirror about an half hour later, I saw that I was developing a rash. After several telephone calls with Dr. Saltz's nurse; a visit to the urgent care center at MSK's main campus, where I was seen by a doctor who conferred with Dr. Saltz by telephone; and a subsequent visit to MSK's other facility to be examined by a dermatologist, who conferred with Dr. Saltz by telephone at about 3:30 p.m.; Dr.Saltz decided that if my reaction to Neupogen does not worsen significantly, I can receive as planned another injection of it each of the next four mornings.

Susan and I got home in plenty of time to watch with our son the televised Kentucky Oaks, which was won as easily as I have ever seen a horse race won by the great three-year-old filly, Rachel Alexandra. Had she been entered in tomorrow's Kentucky Derby against the colts, I think she would have been favored to win. In one of Susan's and my greatest experiences in racing, we were guests of Bert and Diana Firestone when their filly, Genuine Risk, won the Derby twenty-nine years ago, the second time a filly ever won the Derby. As the field for this year's Derby stands, I think the lightly raced colt, Dunkirk, is the most talented entrant. 

We are planning to run Hot Money, one of our three-year-olds, in a six-furlong grass race, the 10th race tomorrow at Belmont Park. It is raining here now, and it is supposed to rain tomorrow, so we have our fingers crossed that the race stays on the turf. He has never run on turf, but his dam was a turf horse, and he moves well on that surface. As it would be over a month before another suitable turf race would come up for him, we plan to run him even if the race comes off the turf. His trainer, Christophe Clement, says Hot Money is  training well, looks well, and should be ready to run tomorrow.