I’d bet if you took a survey in the US, you’d find most people are pretty happy with their current health care provider(s). Let’s face it, most people aren’t sick, and even when they do get sick, their own immune systems can fix most anything on its own. For most other ailments a visit to a primary care physician can easily diagnose and prescribe the necessary action to resolve the matter quickly.

So why do we even try to rate health care providers? I for one have never been a fan of health care provider ratings, because it can’t be done reliably. Health care is not an exact science. It is an art [of sorts], and trying to apply statistical measures to it are at best suspect.

Even trying to track the things that could be measured objectively, such as in patient infection rates, readmissions, etc. can’t be relied upon, because in a for-profit health care system, absent of regulation (like in the US), the incentive is to skew the data to produce positive results. And you sure can’t rely on data supplied by patients either, because most people aren’t knowledgeable enough about medicine, and are subject to personal prejudices.

Still that doesn’t stop people from trying. There’s a new website being developed by a multiple myeloma survivor, attempting to present data comparing survival rates of multiple myeloma patients by doctors, hospitals and regions in order to quantify the best in each category.

Despite the well intentioned efforts I’m sure this person has, I can’t help but ask myself why bother?

Certainly this information might be useful, but like I outlined above, you just can’t rely on the integrity of the data, especially, as in this case, when the data is being supplied directly by the doctors and hospitals being rated.

And even if you could rationalize the integrity of the data in this instance, the number of variables that exist [and not included] are endless, and difficult, if not impossible, to quantify.

For example, how far along has the disease progressed in a particular patient? How do we know if the health care providers, with the worst survival rates, weren’t just being inundated with the worst and most difficult cases? Identifying those health care providers as poor performers would not only be doing a disservice to the health care providers, but also to the patients who might steer clear of them.

And how do you quantify the aggressiveness of a disease? One thing I’ve learned throughout all this is, while there may only be one disease, there are numerous variants of each, some aggressive, and some not so agressive. Even if the doctors and hospitals were able to run all the tests necessary to categorize the aggressiveness of a disease (a cost which incidentally would be exorbitant), one has to keep in mind we are all different, and in any number of cases, those with poor prognostic indicators can perform extremely well, while those with good prognostic indicators can perform poorly.

Then there’s age to consider. How do you factor that into account? Are all 60 year olds in the same physical condition?

Just look at Joe Paterno. He died extremely quick after we first learned of his diagnosis. Do we really think he wasn’t receiving the best care? Should the hospital and doctor be penalized for that?

While I applaud the effort, simply because anything that keeps cancer survivors occupied, and not constantly worrying about their fate, has to be beneficial, I would be extremely skeptical of any of the ratings provided by this website, or any similar ones.

Posting on how to be better, more informed and proactive patients (one of the original goals of this blog), in my opinion, would be time better spent.

The only way to be sure we’re receiving the best possible care is to be knowledgeable of our disease. We’re not all blessed with being able to see a hematologist/oncologist that focuses solely on our particular disease, so asking the right questions, and supplying your doctor(s) with up to date information is absolutely vital.

Doctors are only human. They see many patients, all presenting differently. It would be naive to think any hematologist/oncologists has the ability to keep up with all the advances in the treatment of the myriad of cancers they deal with on a daily basis.

Staying informed and helping your doctor by supplying him/her with the latest information regarding your disease is something I have found every doctor I have had contact with to be very grateful for.

All you really need to know is, a proactive patient is a good patient, and the one who will likely survive the longest!

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After a recent email, and several exchanges on a few of the message boards I frequent, I felt is was imperative of me to reiterate my stance on the use of vitamins, supplements and herbal remedies.

As long time readers of my blog may already know, I am against the taking of all vitamins, supplements and herbal remedies. But I wasn’t always that way. Prior to my diagnosis I truly believed the taking of Vitamin C, E, Calcium, fish oil (and a few other items) were essential for good health. Obviously that didn’t work, and now I’m even of the opinion it was that belief which led to my diagnosis of MCL.

That’s not to say all of the hype is a complete fabrication. After all, I am a firm believer in the efficacy of EGCG, a by product of green tea. Nor am I saying maintaining proper nutrition isn’t important, because it definitely is. What I am saying is, if you can’t get it naturally, it’s probably not worth getting. And that’s a policy I adhere to religiously, taking no artificially produced vitamins, supplements or herbal remedies.

There have been no clinical studies authenticating or substantiating any of the claims made for the numerous supplements sold on the market. In my opinion, all the hype about many [most, all] of these products is simply a scam by the pharmaceutical and supplement industries to instill fear into the minds of consumers, and separate them from their money.

Worst of all, the supplement industry is not regulated. So buyer beware. Even if the claims were substantiated, there is no guarantee you’re getting what you expect when you purchase any of those products online or at the market.

Even Dr Oz, who I consider the biggest shill for the pharmaceutical and supplement industries, warned about this on a recent show.

So even if you don’t want to take my word for it, at least take Dr. Oz’s.

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It’s even more so when you’re immune compromised, such as myself, because I can never be sure if my immune system is up to the task of fighting off the illness. Plus I can’t be sure if I’ve just contracted the run of the mill cold, flu or whatever, or if it’s the result of my MCL.

I find myself spending an inordinate amount of time dwelling on how I feel, how soon I’m going to start feeling better, and constantly searching for any evidence of my MCL acting up, such as inspecting for enlarged nodes under my neck and arms.

And that is exactly what I am going through right now.  I started feeling more run down than usual about midweek, but after having a cup of hot tea with lemon, I felt much better. Unfortunately, it didn’t last that long, and today my throat is much sorer, I have a minor headache, and I’m just feeling generally bad.

I’ve always managed to recover relatively quickly, without any long lasting side effects, whenever I’ve gotten sick in the past, so I’m hoping this time will be no different. I only wish I knew in advance how it was going to turn out. It would certainly relieve a lot of stress.

There is one upside though, at least I picked a good time to get sick. It’s heavily overcast this morning, and will likely stay that way most of the day, plus the NFL playoffs begin today, so at least I’ll have something to occupy my mind most of the weekend, should I not feel any better tomorrow.

Of course if the Steelers lose tomorrow afternoon, that could result in another set of issues.

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WOW! We’re only 3 days into 2012, and already it’s not looking that good.

It actually started New Year’s Eve, when I thought my surround sound audio receiver was malfunctioning [Dolby Digital wasn't being displayed]. It took me 3 days to figure out the problem, which turned out not to be such a problem. Still it was stressful, especially since over the holiday weekend no one was available to contact for support.

Then yesterday the termite inspector came by, and said the house needs to be tented. Jeez, we just had it tented barely 16 months ago, and the termites are [supposedly] back already.

I’m not about to go through another tenting. It’s not the cost so much, which isn’t cheap at about $2K, as much as the hassle of moving out of the house for 3 days, costing at least another $500, dealing with 2 cats, plus having to double plastic wrap all the food and wine to boot. It’s just not worth the hassle. The termites can have the house!

So I contacted another inspector, who treats with Boric Acid (doesn’t require the occupants of the house to move out), and he’s coming on Wednesday to inspect the house. At least if he confirms the findings, and we do decide to treat, we won’t have to move out of the house.

And finally, I just heard that Terry Hamblin isn’t doing so well, and is in a local hospice in England. Dr Hamblin is the first specialist I contacted shortly after being diagnosed with CLL in 2002. He was one of the first to do research in the field of IvGH mutations, and was instrumental in recognizing I had MCL [not CLL], and in my decision to wait and watch, rather than jumping into treatment right away.

Dr. Hamblin retired a few years back, after being diagnosed with cancer, the type I can’t remember. I do know it wasn’t a blood cancer though. Still, he always responded to me personally whenever I had a question or concern, and to the questions of other patients on one of the message boards. He also provided great insight into some the latest treatment protocols and research being conducted on his blog, even when he was receiving treatment for his cancer.

I was fortunate enough to meet Dr. Hamblin for an examination, during the Christmas holiday in Bournemouth, England, in 2002. A visit I will not easily forget. My heart goes out to him and his family. He will be sorely missed.

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I don’t usually post about all the latest advancements in lymphoma research, mostly because I don’t keep up with it so much anymore (it seem’s I got a little burned out doing so much of it early on), but also because there just hasn’t been anything I considered to be of note.

This year though, seems to be different. I’ve started doing a little more reading and investigating of some of the latest happenings in lymphoma/leukemia research, and while there still isn’t much I’m encouraged about (anything that is truly interesting is still in early development or clinical trials), there were three reports I thought worth mentioning.

The first one was a phase 3 trial, showing that Maintenance Rituximab to be no better than Rituximab administered upon disease progression. While this may not seem so earth shattering to some, I think any research proving less is better, i.e. reducing the number and frequency of treatments, can only be beneficial, and lead to a better quality of life. (You might want to show this one to your hematologist, in case they haven’t seen it yet.)

A second study, just finishing stage 2 trials, suggests Obinutuzumab is better than Rituxan.

One of my biggest complaints about a lot of research conducted by the pharmaceutical industry is instead of trying to develop any new breakthrough drugs, they focus their attention more on already existing, effective and of course profitable drugs, so when their patents run out they can still retain their profitability.

Obinutuzumab, a glycoengineered, humanized anti-CD20 monoclonal antibody, is designed with exactly that in mind. It’s designed to replace Rituxan, a chimeric (mouse and human) anti-CD20 monoclonal antibody, and already proven to be very efficacious.

Still, anything that has the potential to be better than Rituxan, already considered a wonder drug, has to be encouraging.

The final study, and one that hits much closer to home, are from the results of a Phase 2 study showing great promise for a lymphoma vaccine. I could elaborate some on this article, but I think the link provided does a better job of explaining the results than I could ever do.

Yes, I know it’s only through Stage 2 trials, and the completion of a Phase 3 trial could be quite a few years down the road, I’m still encouraged by the results. I’ve always thought the application of a vaccine to treat cancer had the greatest promise for producing a cure with the least amount of adverse side effects.

Happy reading!

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Every time winter rolls around, I get into these funks. I have little or no energy.  All I want to do is either stay in bed, or just lay around doing nothing. Every ache and pain is magnified, and it’s all I can do to muster up enough energy to drag myself out of bed and do something.

Even the thought of blogging about politics, health care issues or the problems of others can’t get me excited.

And every year I wonder whether this time is different. I wonder whether it’s my MCL that is making me feel more run down, rather than the time of year.

For the last 9 years it’s always turned out to be just this time of year making me feel more run down. But what if this time is different? What if it’s not just the shorter days and colder temperatures?

How do [will] I know?

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