Lake Wobegon Days

"It's been a quiet week here ..." - or multiple quiet weeks, rather. We keep waiting for the rain that's been promised and seems imminent, but so far have garnered only a little over an inch from all those hurricanes and fronts moving through. Given that my brother and sister both have had multiple rains with multiple inches involved during the same time period, I can't help but feel a little left out. We did escape the effects of Hurricane Ike's winds that devastated other parts of central Ohio and I'm grateful for that.

I'm beginning to see the familiar and detested signs of hand/foot rising again for the first time in months: little tingles in my feet; shiny, blasted-looking patches of skin on my thumb and great toe; itchy spots on my hands. A week's vacation from Nexavar will be beneficial; I'm just not sure when to start. It's a fine balance to strike - not to let it go too long, as the resulting sores on my great toe take a relatively long time to heal up, yet not stopping the dose too soon or too long, should anything else arise. I'm not good at second-guessing myself so will check with Dr. G.

Our favorite contractor Jerry has been working on the barn. We now have a storage area, and have installed vents, windows and translucent roof panels to lighten up the interior. The last tasks are addition of guttering and a tank for water collection; I've plans to get some solar-powered lights for the interior, and then we should just have to add horses and stir. Sounds good to me.

Numbers Game

Last week at our renal cell support group, we heard from Dr. David Sharp, an oncologic surgeon specializing in renal cell carcinoma, and specifically robotic surgery for tumor removal. He looks like he is 12 but has been in the business at least that long ... At any rate he quoted the most recent statistical estimates for renal cell: 2008, expected case discoveries, 54,000. 2008, expected deaths, 13,000. Mind you, when I started on this journey in 2000 the annual expected case rate was 38,000 and the expected death rate was 12,000. So in a few short years the reported incidence has increased by roughly 30%, and reported deaths have increased by about 8.3%. What's interesting about RCC is that it's generally an "incidental finding", that is, one goes to one's physician for something else and RCC is identified through nonspecific tests. It often shows up in CT scans for back pain, for example.

Discovered tumors also tend to be smaller than eight years ago, and the rate of partial nephrectomies has gone up as a result. Partial nephrectomies certainly lead to a better post-operative experience for the patient. Do I think that RCC is increasing in the population on its own? I'm not certain - I suspect that given better diagnostic tools, we may just be finding it more often, and earlier. The relatively lower increase in death rate I think can almost certainly point to better treatment options. It's a cliche, of course, but I think "living proof" applies here.

This beautiful piece of abstract art arrived at our house yesterday. It's an untitled work; perhaps it should be called

CAUTION: Remove hat before placing head under mower.

Saint H's beloved beat-up straw hat was knocked from his head by a low tree branch while he was mowing the lane yesterday. We suspect duct tape will fix it right up.