The Economics of Cancer

Because today is “tax day” it seems only appropriate to have money on the mind; and today I did.  After emailing Bo the very last piece of information he needed to finalize my tax package, I decided to do a little research on the economics of cancer.  Here is what I discovered. 

·      Cancer is a very common life threatening disease.  One in three people will develop some form of cancer, while 1 in 4 will die from the disease.  In fact, cancer is expected to become the nation’s #1 cause of death within the decade, surpassing heart disease. 

·      Cancer treatments and diagnostics are increasingly costly.  In fact, the average cost to produce a new cancer drug ready for FDA review is approximately $1 BILLION.  Unfortunately, only 8% of these new drugs are given final FDA approval. 

·      While the United States spends $2 TRILLION on healthcare per year (2007), we spent $89 BILLION for direct medical costs to treat cancer.  If we factor in the indirect costs, the total costs for treating cancer in America are at $219 BILLION. 

·      Cancer drugs account for 10% of health care spending. 

That’s lots of money for only one disease.  But here’s the disappointing news.  The U.S. government has doled out more than $75 BILLION for oncology research since President Richard Nixon declared his War on Cancer in 1971.  Investment and outlays by the pharmaceutical industry have been far greater.  Yet the death rate from cancer has dropped by only 7% in the past three decades, with most of that progress in the last few years. 

Then there is the debacle found within the Food & Drug Administration – far too much to write about today.  More on that later . . .

Cancer Costs for Cancer Patients

While the overall cost for treating a typical breast cancer will top $50,000 or even $100,000, the total bill for breast cancer treatment widely varies by the cancer diagnosis and treatment required.  In my case, my total costs for hospital care and cancer treatment are coming close to exceeding the “typical costs.”  And remember, I’m only two months into my diagnosis, have completed only 3 out of 8 chemo treatments, have still not had surgery.  Some might say, “that’s too much.”  And I say, “THIS IS MY LIFE, I have insurance, and it’s none of your business.” 

But here’s more startling news:  1 in 5 cancer patients WITH INSURANCE will use up all or most of their savings during the course of treatment. 

Individual patients are increasingly feeling the cost of cancer through insurance premiums, co-pays, co-insurance, tiered formularies, and Part D donut holes.  Due to the mounting costs, patients are making cancer treatment decisions based on out-of-pocket expenses.  How unfortunate.  In fact, a survey conducted by USA Today and the Harvard School of Public Health found that 33 percent of cancer patients have trouble paying medical bills and 43 percent report skipping treatments or not filling prescriptions because of the cost.  For millions of people with cancer, there is little hope when the costs of treatment are more than they can afford

As I continued my research on this topic, I realized that entire books have been written about the costs of cancer – to society and to the individual patients.  And today I’m not up for writing a book, especially one on anything to do with economics.  So I will close this post with this:

First – always participate in any kind of cancer screening that is available in your community.  Without a doubt, detecting cancer early is the surest way to control costs and prolong life. 

Second, in addition to hospitals like UAMS who will work with patients to negotiate bills and payments, there are some very good and charitable organization in the US that can help with the costs associated with diagnosis and treatment. 

·      At the American Cancer Society Web site, you can enter your zip code or call 1-800-ACS-2345 to find out where to get a free mammogram.

·      The National Cancer Institute can be reached at 1-800-4-CANCER, and the representatives can tell you where to find a center for a free mammogram.

·      The National Breast and Cervical Cancer Early Detection Program is designed to provide access to mammography and related services, including breast biopsy and treatment, through local providers. The program works differently in each state, so check the specifics for your area.

·      Breastcancer.org has advice on how to pay medical bills.

·      The Susan G. Komen Foundation provides a listing of organizations to which they have granted funding, so call to see what services might be available in your area.

·      YWCA Encore Plus Programs provide services on a sliding scale. Screening mammography is available to women 35 years and older who are medically underserved. Call 1-800-95-EPLUS (1-800-953-7587).

·      At the American Breast Cancer Foundation you can apply for mammogram assistance.

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Today has been a good day for me.  I spent some time working on insurance paperwork and did some research and writing for a new client project.  Tonight a few of my CJRW colleagues, led by the legendary Buckband, came by after work and really lifted my spirits high.  It was much fun.  Tomorrow I will have lunch with my longtime partner in crime Jim, and this weekend I look forward to spending time with some of my best friends in life during Hendrix Alumni Weekend.  Jim is already here from DC, Dennie is making the trip from Florida, and Jay flies in Saturday from Dallas – and there will be more.  It is my many dear friends who keep me going each and every day.  I feel the love and, in the end, I'm going to win!  

Another Cancer Escapade: FALL RISK!

When I had my unfortunate three-day hospital stay following my first chemotherapy treatment, an unusual thing occurred, not something I’ve really mentioned until tonight. At the time I was transitioned from an emergency room visitor to a full-fledge hospital patient, the very nice nurse placed on my right arm a bright yellow armband that said FALL RISK - in big, bold, black letters.

Fall risk? Are you kidding me? Isn’t this the bracelet nursing home patients wear? Old people? Wait a minute – I’m still in my 40s, even if just barely. I mentioned to the nurse that maybe she had me confused with another patient nearby. She nicely told me that this was not the case.

The next morning, I commented to my doctor that surely somebody had made a mistake by placing this bright yellow FALL RISK arm band on me?” That’s when he explained to me the Fall Risk Index (FRI).. He went on to explain that people with cancer can have an increased risk of falling due to certain medications, dizziness, low blood counts and/or numbness of the feet from chemotherapy. And then there’s more good news . . . Those who fall are at risk of serious injury due to bone weakness and/or low platelets.

Tim and I laughed, and we’ve been laughing about it every since. Until today . . .

Without going in to all the details, here is what I remember:

• I am going to lunch with my mother and Aunt Alice. They are in Mom’s SUV, parked on the street. I am leaving my home, walking down my front walk to get into the car. 
• I am now falling off the curb and into my street. It feels like a slow motion instant replay and I can’t seem to do anything about it. 
• I stumble. I tumble. BOOM! I hit the street. 
• My mother screams. She creams again. She then jumps out of her car and is standing over me. I’m still on the ground, on my back. 
• My Aunt jumps out of the car. I’m not seeing her but she keeps screaming “Call 911.” “Call 911.” I’m not sure WHO she’s directing to call 911, but surely it’s not me. 
• I’m still on my back, lying on Stonewall. Mother is still screaming. My ankle and right food and knees are hurting. My head hurts too. 
• I’m wondering what I’ve done to myself. But I’m also curious – is anybody else watching this escapade? Surely we look like Keystone Cops, the Three Stooges, Lucy & Ethel with a third side kick. 

The end result: My ankle is sprained. I’ve pulled some muscles in my foot. Both knees are bunged up. My back is strained. I’m sore, including my head. Unfortunately I hit it too, and without any kind of protective padding, like hair!! But probably more than anything – I have a new thing to fear. Will this happen again? When? Where? Who will be there to watch this? My ego is a bit bruised.

At the end of the afternoon, I received a package by mail from the Birdman of Little Rock (i.e. Dean Rutherford). Inside was a personally signed note from the Dean directing me to a personally signed note from the U.S. Surgeon General, Dr. Regina Benjamin, M.D. It’s a lovely note wishing me good luck in my fight. WOW! Dean Rutherford says in his own note: “I figure if America’s Doctor is on your side, this is a good thing.”

Surely he’s right about that. This can’t be anything but a good omen. Never mind that I’m now “upright challenged.” I’ve got Dr. Regina Benjamin on my team! Maybe tomorrow I’ll give her a phone call – ask her if I should be carrying around a cane or a walker, or sporting my body in a wheel chair. Or maybe I should move to a very flat one-level residence with no stairs coming in our out. Maybe she can explain just how it is that a normally healthy woman in her late 40s can now become a true live FALL RISK. Maybe she can give me advice on how to prevent these kinds of embarrassing falls in the future.

Along with getting kicked out of the wig store, this will go down as another cancer escapade, for sure.

Lesson learned: There are definitely fewer side effects if you can manage to walk down the street in an upright position. But even if somebody was watching from their window, even if a neighbor’s surveillance camera captured the entire incident on video, I know one thing for sure: Although the big fall was a bit painful, I l definitely looked very pretty sprawled out on my street because I was wearing one of my magic hats.

As Tim keeps reminding me, "you have to deal with whatever the day dishes out." All in all, it was another good day, other than the fall.

A New Strategy for the Fight-Complementary Therapy

Dr. Bernie Siegel, a cancer surgeon wrote, "Show me a patient who is able to laugh and play, who enjoys living and I'll show you someone who is going to live longer.

In my initial meeting with my oncologist Dr. Makhoul, he clearly laid out each of our areas of responsibility.  He explained that it was his job to know everything about my cancer and provide me with the most aggressive and best researched conventional medical treatment, to ultimately shrink my Stage III cancer to a size that will allow for successful surgery, hopefully in July.  It would be my responsibility to take charge of my mind and attitude and emotions, to create and maintain my own world of support that will help me deal with the emotional and psychological stresses that result from cancer treatment.  This is often referred to as “complementary therapy.” 

There are several methods of complementary therapy:  acupuncture, aromatherapy, art and music therapy, biofeedback, hypnosis, imagery and visualization, massage, prayer and spiritual practices, relaxation and yoga. 

None of these therapies have been proven to shrink cancer.  However, it has been proven that the recurrence-free cancer survival rate at five and ten-year follow-ups is much higher for patients who respond with a fighting spirit attitude.  Because the five-year survival rate for Inflammatory Breast Cancer is between 25 and 50 percent with a higher likeliness of recurrence, I think I’m headed down the right path. 

The world is not a peaceful place and within each of us there is some form of tension and stress. Life situations can bring disappointments, sadness, anger, frustrations, and other negative emotions, which not only can adversely affect our minds but our bodies, as well. 

In 2004, after surviving three contentious and time-consuming years of education reform in Arkansas, I made two major life-style changes.  First, I learned to eliminate alcohol as stress reliever.  Second, I took a Mindfulness Meditation class at UAMS.

In general, meditation is an effective way to help the mind create positive and peaceful thoughts, to change thoughts from negative to positive.  Mindfulness Meditation is a specific technique that combats life’s problems and situations.  It allows one to be aware of their surroundings, to develop a high sensitivity in perceiving every moment, and enabling them to accept stressful situations, instead of avoiding them.

Mindfulness Meditation can train our minds to achieve a state of tranquility, without being disturbed by outside forces. Not only is it an emotional and spiritual experience, it is also a peaceful lesson in self-discipline and strength of mind.  The practice of Mindfulness Meditation focuses our attention on our thoughts, actions, and present moments non-judgmentally. It does not encourage evaluating or thinking on our past actions and neither does it take our thoughts to the uncertain future. Mindfulness Meditation helps and trains our mind from getting distracted by outside disturbances and enables us to focus our thoughts and relax the mind.

To fight some of these cumulative chemo effects, I’ve made a decision to move myself into some additional complementary treatments.  Maybe acupuncture is not on my list, but I feel fortunate to have been trained in Mindfulness Meditation, to already have been given the tools of discipline that have made this an easy therapy to get back into.  Maybe even a little music therapy will be good for my soul.  I love music, all kinds except raw country.  And my dear friend Ruth gave me a very cool green iPod, so maybe some jazz or classical or even light opera would do my soul good. 

This weekend Tim said something that is so very true – I’m going to have to deal with whatever the day dishes out.  And he’s correct.  Some days it’s been a little nausea, most days it has been extreme fatigue, a few days it has been a strong sense of loss.  I think I’m entering a new phase in this cancer fight that will require more from me, a more proactive plan of self-support, and I’m ready. 

A Beautiful Day For Feeling Good

After two long days and lights of experiencing an overwhelming feeling of lethargy, this morning I woke up feeling rested and without weakness.  That meant cooking a breakfast of pancakes and bacon for Anna-Lee and her friend Mary Elizabeth.  There’s not much that feels so good as feel like a mom in service aain – a real mother who cares for her daughter and friends, especially from my kitchen.  I then cleaned out the refrigerator, and then took a little nap.  Okay, I know it’s not the same level of energy I’m used to, but it sure beats the heck out of being in bed most of the day and night like the past forty-eight hours.  If enjoying the Arkansas Derby is not a part of my agenda right now, at least I can find a few things to enjoy on this very beautiful day.  

FINALLY, AT 12:30 PM, WE CATCH THE BIRDMAN OF LITTLE ROCK IN ACTION!!  For the past two months, Dean Rutherford has kept all my birds (and squirrels too) in feeder heaven with seeds, nuts and suet.  I’m just not sure how he manages to do all that he does, making me quite jealous of his stamina and energy.  But these days his never-ending energy works on my side.  My birds and squirrels are quite happy with his regular refills of the feeders. 

After some time engaged in our favorite topics of politics and media, Skip departs and Tim and I take off with a finite list of errands, not to exceed a couple of hours – big box errands like Office Depot, Tuesday Morning and a berry-buying run at Sam’s.  I’m eating berries like one of Skip’s birds – blueberries, blackberries, raspberries and strawberries.  And if my body says to eat berries, that’s what I’m going to eat.   

After two hours of running errands, it was time to get back home and rest.  And that’s where we’ve been since 3 pm today.  A visit from Tim’s office colleague Jennifer and her husband John was much fun, including a riot of a time trying on hair band wigs she purchased today at another wig store in town.

Okay, maybe a little too blond, but the black band attached to the wig sure made for a comfortable fit.  I might explore these hair band wigs further.  It’s the best to date in terms of comfort.    As Jennifer and John left, longtime friend Frances came over with the most delicious sorbet I’ve ever put into my mouth.  Can you say “Blackberry Cabernet?”  Oh my goodness – it’s over the top in terms of flavor, like drinking a lovely red wine with a mouthful of blackberries.  I highly recommend this delectable treat, which can be found at Fresh Market.  Frances says there are tons of great flavors, but this one hit my taste buds and appetite on so many levels. 

Although most foods do not sound good to me right now, I admitted to Tim that I really do miss cooking.  Cooking has always been my source of relaxation and end-of-the-day therapy.  While I’m certain that entertaining friends is also not a part of my agenda right now, I CAN STILL COOK, even if I don’t eat it.  So, tonight we’re cooking my super secret Italian Ragu sauce.  We have all the ingredients and I’m looking forward to a very normal night in the kitchen with my favorite cooking partner of all time.  It will be a perfect way to end a beautiful day of feeling quite good.  A tavola!  

Cumulative Chemo: An Endurance Test

For as long as I can remember, I have lived a very high-energy lifestyle.  This includes requiring less sleep than most people, no need for naps, and maintaining a very scheduled calendar.  To add insult to injury, part of my insomnia results in the challenge to shut down my thought processes each night.  I’m will lay in bed with a flood of ideas for how to solve the next challenge I’m involved with.  I then get up, write down the ideas, do a little reading or Internet research, and begin building my new plan. 

Living at that pace, do I get tired from time to time?  Heck yeah!  But everyone experiences the feeling of being tired, usually knowing that a good night’s sleep or a weekend of rest can usually solve the problem. 

Not to be confused with tiredness, fatigue cannot be corrected with sleep.  Otherwise, I should have been “Peppy the Wonder Squirrel” after my 16-hour sleep-athon Wednesday night.  But that’s not been the case.  Here are two new developments and things I learned today from my UAMS medical team:

First, Chemo Fatigue, as it is often called, is a daily lack of energy, an unusual or excessive whole-body tiredness, not relieved by sleep.  Today I described it to my doctor as entire weakness over every inch of my body – my legs, arms, neck, even my face and eyes.  To move across the room requires an inordinate amount of strength that is quite difficult to muster.  My mind is alert, as I’ve written a few documents today.  However, I’ve had difficulty getting my hands and fingers to work well on my keyboard. 

Second, I may also be suffering from what is called “cumulative chemo.”  We’re all familiar with the possible side effects that can accompany the various cancer treatments.  But what I didn’t know until today is that some side effects can develop with cumulative doses of chemotherapy.  In other words, these side effects can intensify with each chemo does administered, are they more likely to occur to a greater degree with each subsequent treatment cycle. 

The good news is this:

• If I have to experience a cumulative chemo side effect, I would much prefer fatigue than an extremely low white blood cell count, nausea, bone pain, numbness, or those horrible mouth sores. 
• Fatigue does not necessary take away your spirits.  And it has not taken away mine.  I am hopeful that after a few days, this terrible weakness and fatigue might go away, at least until my next treatment on April 20.

Cancer and chemotherapy are definitely tough journeys.  But God and my family and friends have given me some pretty strong shoes for the climb.  If this is a test of my endurance, I plan to pass this exam with flying colors too. 

Many thanks to Anna-Lee and Mary Elizabeth! You girls are the bomb!!  

Day #2 after Chemo #3: The Sandman Cometh

Yesterday afternoon I went to bed, didn’t wake up for sixteen hours except for a little bit to enjoy some of my mother’s delicious Italian rice. 

SIXTEEN HOURS!!  As my friend Leslie said, there have been some weeks in my life when I only slept sixteen hours. 

Today I have been taking care of the economics of cancer – another topic for another day.  I’m still very tired, feeling not so good this evening, including a little nausea.  I’m going to call it another early evening and hope that tomorrow I feel much better. 

Night Night.  Sleep Tight . . . 

The Many Faces of Cancer

It was another day spent with the very caring medical team at the UAMS Rockefeller Cancer Institute. I’ve already grown accustomed to the routine.  And today it felt good to have many of my various caretakers begin to remember the special circumstances of our battle together, to call me by name.  These are new relationships in my life, and they are ones I now covet. 

The routine each treatment day is this: 

1. Lab work to check my white blood cell count, and a few other things like liver function and vital signs
2. My appointment with Dr. Makhoul, which is always a real treat since in addition to being a medical doctor, he’s also good medicine for the soul.
3. And finally, the big chemo treatment, which takes about 90 minutes.  Today was round three with the current chemo cocktail – Cytoxan and Adriamycin, both administered intravenously though my chemo chest port, followed by a Neulasta shot in my stomach

       Today was another good report; my white blood cell count was exactly where it needed to be, and Dr. Makhoul says I’m responding very well to the chemotherapy.  I’m hopeful that the good news continues throughout my treatments and I’m looking forward to an upcoming breast MRI sometime around the first of May.  We’ll know more then as to the true clinical effects of the treatments. 

Because I’ve grown accustomed to and have no fear of the chemo routine, today Tim and and settled quite comfortably in our chemo cubby.  But instead of reading my book and listening to my iPod, I found myself focused on the other cancer patients around me.  Their stories and journeys with cancer have their own set of circumstances. 

A woman in the infusion area directly next to me was there for her first treatment, her husband accompanying her.  She was very anxious, and her husband said she was unable to eat due to extreme stress.  When the my nurse asked me how I had handled my own treatment the past two weeks, I told her that the nightmares of chemotherapy – other than the extreme fatigue – had been way over-exaggerated, that I was feeling good healing throughout my body.  I noticed that this first time patient and her husband were listening.  I went on about the healing elixir of chemo and that I had come to think of it as my dear friend in the battle to regain my health.  I’m hopeful she felt a little sense of comfort as I described how round #2 had been a positive transition in my treatment. 

An elderly woman, obviously on the same Tuesday schedule as me, was there for her return visit. Two weeks ago she was in the infusion cubby across from me, and on that day she left in tears.  Her white blood count was too low to administer her regularly scheduled treatment, and she was sent home with great disappointment.  Today, she and her daughter were back and she was proudly taking in every drop of her chemo, left the Infusion Center with a smile on her face. 

There were two older gentlemen in the Infusion Center, one receiving chemo, the other receiving a blood transfusion.  As they visited with one another, they soon discovered they both grew up in the Danville/Havana area.  And while they did not know one another, they had much fun sharing stories about mutual friends and acquaintances, neighbors, schoolteachers, community leaders and life experiences in those two little communities.

And finally, a young girl, who looked to be about Anna-Lee’s age, about 17 or 18 years old.    She was there with her mother, definitely on a repeat visit as she too had lost all of her hair.  She seemed quite accustomed to the routine, discussed with the nurse some complications she had experienced, and seemed thankful that a new chemo strategy was to begin today.  Throughout the conversations between the mother and daughter and nurse, the young girl kept a beautiful smile on her face, her eyes with a sparkle of hope.  When she walked, this young woman seemed almost empowered in her stature, confident in her own fight against this nasty disease. 

Today I had the good fortune to listen, observe and encounter several other Cancer Warriors, all of them writing their own life chapters about cancer, experiencing their own good days and bad days.

This year an estimated 1.48 million Americans will be diagnosed with some form of cancer.  While an estimated 66% will survive over a 5-year period of time, another 1,500 Americans will die each day from this deadly disease. 

How selfish of me!  There are 200 different kinds of cancer and so many good people in their own relay for life, hoping to join the final ranks of “survivor.”  But up until today, my prayer has been about me – a prayer asking God to help me heal or teach me to cope with grace and in unity with Him. 

Today that prayer will change. 

Dear God in Heaven, I ask you to work out your ultimate will for those with cancer, for those undertaking surgery, chemotherapy and radiation.  Take away the natural feelings of hopelessness, fear and despair; replace our hearts with abundant strength, a ray of hope and faith in your ability to guide us through this challenging journey.  And give those fighting cancer the blessings of love of family and friends, and the joy of everyday moments in life.  In your name we pray . . . Amen. 

I hope dear friends that when you say a prayer for me, you will change your prayer to ask for blessings for all of the men and women and unfortunate children experiencing a similar, or even tougher, struggle each day. 

Many thanks to all of my Prayer Warriors, and supportive friends.  I don’t need group therapy to lift my spirits.  YOU are my group therapy and your many words and acts of encouragement are making a difference in my life each day. 

Tomorrow I plan to sleep away the day, other than some time planned by my dear friend Frances Jane.  Along with having several head scarves made for my little bald head, this former Miss Arkansas has arranged for a scarf expert to teach me and my friend Patty how to make sense of this new mandatory headdress.  It should be fun time with a few friends sharing love and support for one another.  

Chemo #3-Bring It On, Every Drop!

Today will be my #3 chemotherapy treatment.  Somebody asked me last night if I have anxiety before each treatment.  The answer:  Absolutely NOT.  In fact, last treatment I explained to the nurse that I wanted every drop of chemo in that bag.  “Don’t leave one drop in there.  I want ALL OF IT inside my body.” 

I’m sure I’ll be on the same regime – chemo today, followed by three days of mostly sleep.  After doing some research last night, it appears that the more treatments you receive, the more tired your body becomes.  If I struggle with anything throughout this cancer journey, it’s the constant exhaustion.  It doesn’t work well with my normal routine.  But it’s temporary and I will be patient. 

Here’s to three down, five more to go before surgery.  I think we’re making huge progress.  I can feel it in my bones and in my heart and in my soul.  Thank you friends for sharing your encouraging spirit with me.  

Morgan Freeman and The Bucket List

Last night Tim and I attended the Oxford American’s Best of the South Awards Gala at the invitation of our friends Mike & Bet.  It was a fabulous evening for many reasons, not the least of which were the two southern men who received the inaugural awards:  literary legend Charles Portis and the very talented actor Morgan Freeman.  Charles is the brother of my longtime business partner Jonathan, and the author of several novels including True Grit, Norwood and Dog of the South.  I’ve always been a huge Morgan Freeman fan for his onscreen talent and for his contributions to the Mississippi Delta.  We’ve been to Clarksdale, MS, and had dinner at his award winning restaurant Madidi and have stayed in the apartments on top of his well-known Ground Zero Blues Club.  If you’ve never been to Clarksdale, I highly recommend it. 

There are so many Freeman films that I love that I cannot even begin to list them all.  But one that stays on my mind quite frequently right now is The Bucket List, a film directed by Ron Reiner, which stars Morgan Freeman and Jack Nicholson. This film tells the story of two terminally ill men – Freeman as a car mechanic and Nicholson as a billionaire hospital magnate - who escape from a cancer treatment facility and take an around-the-world vacation with their “bucket list,” or things to do before they die.  Together, they go skydiving, get tattoos, climb the Pyramids, ride motorcycles on the Great Wall of China, and dine at Chevre d’Or in France. 

But the most touching moments of the film are about the truly meaningful wishes that involve those they love and life's everyday special moments often taken for granted – items like laugh till you cry, kiss the most beautiful girls in the world, help a complete stranger for the good and witness something truly majestic. 

When you’re looking into the face of Stage III cancer, I think you can’t help but contemplate about all the things you’ve always wanted to do but just haven’t taken the time or managed the resources to make them happen.  But the truth is, why would any of us wait until mortality is staring us in the face to assemble our life’s wish list?  For many, the end of life provides no warning, no time for planning.  For that reason alone, every one of us should begin to make our “bucket list” today. 

And the bucket list can take on many different varieties too.  I have some young friends who recently married, and have decided to postpone having children until they complete their pre-baby bucket list.  They are much in love and want to experience several things together that will be more difficult after the birth of a child.  They have some great things on their list including a trip to Greece, cooking classes, running a half marathon together, and one-week road trip staying only in old strip motels. 

One strange bucket list interpretation happened just last week in a small town in Florida.  A woman suffering from leukemia and bipolar disorder robbed a Bank of America branch, managing to elude law enforcement for three days.  At the time she was captured, the press asked her why she did it.  Her answer: robbing a bank was on her bucket list.  Interesting item for sure, making me wonder what else is on her list.  As you would suspect, she now sits in jail pending a hearing before a judge.

Making a bucket list has gained such exposure and popularity that one group has set up an interactive web site for people to prepare their personal list and keep track of their progress.

For those who have given little thought to creating a bucket list, this site also provides you with sample lists as food for thought. 

The ultimate question for all of us – what really matters to me?  What are the things I want to enjoy during my lifetime before I fall off the perch, bite the dust, kick the bucket, or meet my maker? 

As Jane Seymour said, "You have to count on living every single day in a way you believe will make you feel good about your life, so that if it were over tomorrow, you'd be content."  Great words to live by. 

So, what are we waiting for?  Let’s all make our bucket list today and then put it in a place that we can read it and review it often.  I don’t plan to let this nasty cancer beat me, but I do plan to get re-focused on the things that matter most to me.  Bucket list, here I come!  But meeting Morgan Freeman - well it's already done and I won't have to put it on my list.  Last night was a wonderful experience that I will never forget.  

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Easter Sunday was great.  The girls and I attended the Community Easter Sunrise Service, the 18th and final service under the direction of our pastor Rev. Vic Nixon.  We then enjoyed a pot luck brunch with family and friends.  I slept most of the afternoon, probably because I've overextended my limited energy.  Tomorrow Anna-Lee returns to school, Allyson returns to Missouri; but tonight we will eat matzo ball soup (Thanks Liz!!!)  and enjoy watching movies together.  It's been a beautiful and restful Easter Sunday.  

The Good Doctor Is In, and She's Right Here in Little Rock

If you’re battling cancer, there can’t be anything much more assuring than to open up the morning newspaper and see a front page color photograph of the head of your breast cancer team. 

That’s my brilliant surgeon on the right, Dr. Suzanne Klimberg.  Yesterday Dr. Klimberg was awarded a $4.5 million research grant from the national Susan G. Komen Foundation.  WOW, that’s got to make all us UAMS breast cancer patients feel quite fortunate, as they don’t pass out big grants like that to the average Joe Blow doctor, now do they? 

Considered by her peers to be a world-renowned expert in the field, Dr. Klimberg is the Muriel Balsam Kohn Chair of Breast Surgical Oncology in the Department of Surgery at the University of Arkansas for Medical Sciences. She also directs the Breast Cancer Program and the Disease of the Breast Fellowship Program at the Winthrop P. Rockefeller Cancer Institute.  In her spare time, Dr. Klimberg has proven herself to be a leader in preventive research including the discovery of breast cancer protein patterns in tears. 

And there’s much more!!  Click here. 

I tell you all of this because so many dear friends continue to ask me about getting second opinions at Mayo or M.D. Anderson or Sloan-Kettering.  The truth is - I’m not interested and it’s not definitely NOT necessary! 

People who live in Arkansas are very fortunate to have UAMS right here at home, especially the Cancer Institute.  While the name may not be widely known by the average person, physicians around the world have recognized the UAMS Cancer Institute as a leader in delivering results for cancer patients.  You must know that foreign dignitaries and well-known celebrities travel to UAMS for cancer treatment and consultation – not just breast cancer but for other cancers, as well.  I have no doubt that I'm receiving the best medical care by this brilliant and world-renowned medical team.

Today I will give thanks for this beautiful day, and for the outstanding cancer team at UAMS, right here in Little Rock, Arkansas!!    

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Anna-Lee and I will attend Good Friday service at noon where she will be a reader.  Allyson will fly home tomorrow after a Spring Break cruise with a gaggle of Mizzou Chi Omega seniors – their last “hoorah” before graduation.  This Momma is so excited to have both of her girls home for the Easter weekend!