Status Report:
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| Dr. Hugh Tildesley |
The most recent blood work showed a complete reversal of
the low White count, which is now back to baseline. This means we can go ahead
with the poisons next week. Additional good news is that my weight has remained
stable, as has my energy level.
I walked 18 holes on Monday, at Shaughnessy,score was unfortunate but
my host, Dr. Ted Wilkins,was as always gracious.While on the 10th hole one of the
pros, Vaughn Marshall,made a point of coming out to great me. He knows my story
and wanted to say hello, I was needless to say touched. When I first took up
golf Vaughn worked at UBC, we had a regular game at dawn every Sunday, Bill
Vlahos, my late colleague, was a regular as was Dave Riddle and Jean
Cormier,very fond memories.
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| 16 th at Point Grey |
On Wednesday I walked Point Grey, 2 games in 3 days.
Score of 88 respectable.
Travel: The trip to Arizona is taking
shape, a few days in Scottsdale, then a sojourn to Sedona, followed by an
overnight at the Grand Canyon. We then travel back to Phoenix, for a few nights,
then on to Tucson to watch nephew Liam in a baseball tournament.
We had always wanted to go to the Canyon and some extra
time on this trip gave us the flexibility. A serendipitous check of the bucket
list!
Some questions about travel?
Insurance:
What do you do about insurance? Initially I thought I
had to self-insure, but in fact BCAA has a plan which I thought was quite fair.
For pre existing conditions I am insured for up to $200.K, for non-
pre-existing up to $ 10 Million. The coverage is up to 15 days, for 1 year,
irrespective of how many trips we take. My premium was about $950.00, Deborah’s
about $300.
I manage my travel based on my proximity to recent chemotherapy,
optimally I should be at least 2 weeks removed so my immunity is less
compromised.
Minimizing the
exchange hit:
Quite a learning process. The best way is to get a
charge card in US funds, and have a bank account in US $, so that money is only
“exchanged” once.
Some advice. Avoid AMX their program is basically a fee
scam.
The Canadian banks are more transparent and fair,
although in spite of my being a 50-year RBC client with a perfect credit
history I was treated as if I was a new applicant! They wanted tax returns back
2 years, stock account info, and corporate information. Totally over the top,
as if my credit history was irrelevant.My subsequent conversation with the manager was reassuring and his response to my complaint was reassuring. Strong letters to RBC VP and Rbc Visa will follow.
My recommendation is to get a US card
that allows points to be collected and transferred and open a US bank account
to avoid repeated gouging regarding exchange rates.
1)
On
a scale from 1to 10 how do you feel.
There are good days and bad. The best days I am 9.5, the
worst 8.0. I can usually tell within the first hour of waking. When compared to
May, June and July, which I would of scored 6.0, this is really quite good!
2)
What
% of your former workload are you able to maintain?
Really unknown, of course, even without my challenges I
planned to go to 60% in 2016 anyway.( I am currently at 20%) I still enjoy seeing patients, many of
whom have been under my care for 25 years. After my ½ day in the office I
generally have a nap, which seems non-negotiable.
3)
How
much has your handicap changed this year?
An embarrassing answer, it is up by 7 strokes. I have
lost considerable distance but I am working on some new techniques to recapture
those yards.
4)
What
about the bucket list?
I am quite disciplined with the list. I never really
plan outside of 8 weeks in advance. I can tell you it is lengthy but out of
necessity we are on fast forward. I am quite proud of the last 11 months, here
was what was on the list:
BUCKET
LIST 2015-16
Live 12 months April 2016
Donovan’s Birthday check
Hamish’s Birthday check
Baseball in Seattle check
Liam in Portland check
Tesla road trip to Portland check
Burnham and Berrow Oct 20-25 check
London Theater Oct 20-30 check
Catts Birthday check
Palm Springs late November,
early Dec neg
Hawaii Dec neg
X mas party check
Jan LA Jan 10-17 check
Feb Palm Springs Feb 7-12 check
Feb – Tofino Feb 21-28 medical issues neg
March Phoenix/G Canyon/Liam in Tucson booked
Bandon Tournament April 15-18 booked booked
I ‘ve
been lucky to get all this in. About an 80%
successful execution rate.
5) What is your investment
philosophy.
Get
your own broker …..parasite!
There
were a number of practical decisions that had to be made. I am now penniless,
houseless and carless. Deborah either owns or co-owns everything. This was all
done with expert legal advice to minimize any hardship for the family.
6) Can
you give a layperson-understandable explanation of the glucose-tumor
interaction mechanics?
Simply put many tumours, notably lung,
pancreatic, bowel and brain take up glucose preferentially, that is outside the
usual controls mediated by insulin and glucagon. These tumours force feed
themselves, using unrestrained energy from glucose metabolism to speed their
division and spread. This phenomenon was recognized close to a century ago by
Nobel Prize Laureate, Otto Warburg, and is known as the Warburg effect.
Research has shown both in the test tube and in animal experiments poisoning
the glucose metabolic pathway ( glycolysis) stops the process and kills the
cancer cells. There are now strategies that can be used in humans to apply this
science: Vitamin C infusions, intra- arterial infusions of D-pyruvate (
invasive, to date no controlled trials) and ingestion of DCA (
dichloroacetate), again no controlled trials.
7) If
you were to redesign the cancer care system in BC what would the key strengths
and elements be? How should it be run? How would patients give input into the
design? Is there a role for a mixed public-private hybrid system of care? How
do we increase a personalized medicine approach?
Redesign:
I am a lowly endocrinologist and patient so will comment on what is obvious.
The cancer agency is a silo, It has it’s own budget and really has outgrown the
usual administrative checks and balances.
Let’s
dwell on the positive, the staff is uniformly pleasant and helpful. Outcomes
are competitive with world results.
Legitimate
progress is being attempted regarding targeted therapy using genomics.
The
unfortunate negatives: Communication with referring MD’s is hopeless, this
needs to be addressed urgently. The release of imaging and lab results borders
on malpractice.
Paper
files still rule, they need to get up to speed with the digital age.
Appointments
are done by phone ( that’s ok), but also by mail, ( is that really necessary?)
Patient
privacy has been lost, interviews are done in public places, totally
unacceptable.
I am a
Lee Iacocca fan. Just walking around can give great insights as to how an industry or plant is functioning.You may remember that Chrysler was "dead" in the 80's, Lee turned it around.He went into every management office, and every plant and if he could not understand that person's job by their explanation ( 1 min or less), they were deemed redundant and gone. As I pretend to be Lee in my travels, overstaffing is obvious, this reflects
poorly on day to day management decisions.
Public
private models for cancer management is not something I support, mainly due to
the patient costs that would be potentially incurred.
Within
5 years the first test that one will have after the diagnosis of CA will be genomic
which will help target therapy. The age of protocol driven therapy is over.
8) How does Donald Trump do his hair ? Short
answer he doesn’t.
In physics his "doo" would be described as
Brownian movement.
Defn: Brownian movement, any
of various physical phenomena in which some quantity is constantly undergoing
small, random fluctuations.
And
so endeth Question Period!
Over the next few days there will be a short blog on Oscar predictions. Stay tuned.
Until
next time…
