In the Chemo Room: Out with a tumor

I'm sitting at my computer on the day after a thoracic surgeon, John D. Mitchell, took out a relatively large colorectal tumor from my trachea, and I've been left wondering if all the muscle soreness in my body (as if at age 64 and totally out of shape I had just played in a two-hour pick-up, touch football game) is the result of not taking the heavy pain killers they usually give you after a major surgery?

Is that the pain they are trying to kill? Is it pain that results from full-body anesthesia? No matter where the surgery?

Because that's most of the pain I am feeling today on the day after. A mild sore throat, and little chest pain, but they pulled the tumor (literally) from the wall of the trachea and kept me overnight at the University of Colorado Cancer Center to make sure they didn't also pull out a hole in the trachea wall, which would have caused me further problems.

They did the work with a bronchoscope and had they accidentally pulled open a hole in the wall of the tube from my throat to my lungs, they would have had to split open my chest to go in and repair it. That's why I am home today; they did not open a hole, and I was released this morning as my over-all-aching increased by the minute.

But this has been the latest chapter in my fight from the Chemo Room against this four-and-a-half- year-old case of colorectal cancer.

The tumor grew in my throat while I was enrolled in a clinical trial testing a drug that had mild-to- moderate side effects and held most of the rest of the many tumors in my lungs and chest in check during the test. But then I started coughing badly, they ran a CT scan and looked closely, and ordered up the bronchoscopy.

So now I've been dropped from the trial because it was clear the drug I was receiving and have written about here before wasn't doing as good a job as we were thinking it was doing. But the trachea is a strange place for colorectal cancer to matastisize, so you can probably blame my individual cancer for the unexpected response to the drug.

The good thing is they found the tumor before it stopped my breathing altogether; they learned a little something about the drug; I'm breathing better now and no longer coughing as much. The bad thing is the tumor could grow back from the place where it was taken from, and the rest of the cancer mets (metastases) remain in my lungs and chest cavity (lymph nodes) and must be dealt with.

So you could call this chapter of In the Chemo Room, 'In, Out and Back Into the Chemo Room' because that's where I'm destined to return. As soon as all these aches and pains go away and my body heals from the surgery.

Dr. Wells Messersmith, my oncologist now, said he'd find a new way to treat me, which probably will involve a new clinical trial. But that's what the Cancer Center has come to be known for nationally in a very short time.

And that's why Mitchell, one of the nation's best thoracic surgeons I am told, is working there on patients like me. You can't say I'm not getting the best of care. And so are hundreds and hundreds of others who are passing through the center's gates.

Precision toolmaker wants to keep hiring

Patrick Stacy has hired five new employees, including an engineer, in the last three months. "I'm a toolmaker," he said. "My mentor used to say a toolmaker's job is never done."

Stacy Machine & Tooling in Broomfield has grown over 30 years from a  a one-man shop in Boulder to a $2 million, computer-aided-design and computer-aided-manufacturing shop with 21 employees and an owner who wants to make it bigger.

Stacy is one of those small-business owners defended by Republicans who argue against any increase in taxes by saying it will keep small businesses from hiring new people.

And yet Pat Stacy, who reached the ranks of the wealthy business owner only in 2011, his best year ever, still plans to expand and grow if only banks will help him finance the growth.

He says he has plenty of demand. "Global warming's been very good" to the instrument manufacturers that supply the research industries around Boulder, Stacy says. "Demand is coming from funding through the government," he added. "NASA contracts, Department of Energy contracts, Department of Defense contracts, all of these special research projects that are going on for the green stuff. We don't see a lot of green or solar; but we're just starting to see some of that."

Testimony, I guess, to the effectiveness of the stimulus spending that has been denigrated for three years of the Obama administration.

But Stacy's very success meeting that demand has now put him on President Obama's "hit list," he said. His income and profits this year will push through the $250,000 level that has long been considered a break point for increasing taxes on the wealthy.

"I'm finally getting to be where the politicians start taking aim," he said. But he said that's a problem 30 years in the making, and one most small business owners would welcome as a mark of achievement. It forces them to make decisions, however.

Most business owners struggle all their lives to get to a point where their business generates a little personal wealth -- "the time you're almost successful and actually get to be a player," Stacy said -- but then the "compromises" every business owner makes get a little more complicated.

Do you take a tax break that gains you the $60,000 you might plow back into your business for a new employee or a new piece of equipment? Or do you take it as a bonus or a raise, and bump up your tax liability.

"Growing a business, you're always making compromises," Stacy said. And growing his business, even after 30 years, is still Pat Stacy's primary goal for Stacy Manufacturing. His current plant at 2810 Industrial Lane in Broomfield is leased to buy, and the property has plenty of ground for expansion.

But banks for the past three years have not been willing to lend small business the money they need to to expand, he says. "These banks are all paralyzed. They will not loan money."

"Until they can get the banks to let go and finance people like me and people like a lot of other people who are highly leveraged in their business ...," Stacy says his voice trailing off.

"I'm up to here in debt," he said, "I've always been up to here in debt." But his business and others "still survive" and he believes "the rules have to change a little bit" to allow a real recovery to gain any momentum.

Pat Stacy got his degree in political science so he watches the way political winds blow, and he's not afraid to express his opinions.

"I love history, politics and all the other things of the world," he said, and it would seem some of those wider interests keep firing the childhood mechanical curiosity that lured him into the precision tooling business he has created. Hear the poetry in this description of one machine's operations:

"This eight-thousanths diameter copper wire, it cuts this underwater, deionized water.... you program it, you make a little fixture, you put it up there and you watch that little wire go cut it underneath the water with a beautiful blue flame, a blue arc."

Or in this position on Wall Street financiers vs. small business owners:

"If you're a stock broker and you're making deals and never get out of your seat and you make a quarter million dollars or a million dollars, should that be taxed a little different than maybe the money I make as a manufacturer, or as a farmer would make, or another kind of small business guy?"

Or: "Now you can put motives into the banking industry, whatever your want. You can put motives of: 'Hey, they're not lending money because they want to see Obama fail ... ' (but) the bottom line is the banks have money, somebody has money, and they're not lending it unless you're so rich you've got money coming out of your pockets."

There is a table in the front lobby of Pat Stacy's manufacturing plant; it's crowded with stainless steel and titanium parts he says he and his employees have made that now fly in space or rest in the joints of people who have had body parts replaced. On a wall nearby is his company's ISO certification, and you can tell Pat Stacy is pretty proud of the business he has made.

You can tell, too, that if he gets some financing he's going to make Stacy Manufacturing bigger by filling out his current second shift or by buying some newer machine to replace some of the "ancient" 1991 models his workers now use.

You can tell that because, even if he has made the politicians' "hit list" and his hard-earned "wealth" remains always at risk, Stacy believes what his mentor taught him long ago:

"A toolmaker's work is never done." 

Online startup: Colorado Business Express

The state this week launched Colorado Business Express, an online business registration service where budding business owners can file the state documents required to open up shop.

John D. Conley, executive director of the Statewide Internet Portal Authority, which overlooks the official website for Colorado, said five new businesses jumped on the service the first day it went live during a soft launch before Monday's formal start.

"People found it without us doing any type of advertising, which to us shows the demand is there," Conley said. "Especially in this economy, people are creating their own businesses, starting their own businesses" but "not being able to afford a business-filing attorney, (they) are trying to get through it on their own."

Conley said it took nine to twelve months to launch the service, which reversed the approach to online filings offered by three state agencies -- the Secretary of State, the Department of Revenue and the Department of Labor and Employment -- from an agency perspective, where forms served the agency's purpose of data entry, to the perspective of a user.

"That's why we went with the wizard approach," he said, "where the small business owner for the first time only has to focus on answering the questions. They don't have to understand the regulatory language or the red tape, if you will."

I tried the wizard briefly and found it takes you nicely to the places where you want to go, including the Internal Revenue Service for a tax ID if you need one. Once you move off the state pages, however, following things like IRS instructions remain as traditionally confusing as ever.

But state documentation remains easy. You have to have an already established business or trade name to follow the wizards, but if you don't have that, the Express will take you to the Secretary of State's website to get one for $1. The site's functionality so far allows you to apply for a state sales-tax license, an employee wage withholding account and an unemployment insurance account, and may, in the future, integrate other functions as well, Conley said.

You may have read in the Denver Post about a shake up in the Colorado Office of Economic Development and International Trade that is intended to sharpen the state's focus on retaining and attracting jobs in Colorado.

Small-business hiring has always been a critical driver of state employment, so the Colorado Business Express, if it paves a way for faster business startups, serves that agenda well. Check it out.

In the Chemo Room: Integrative medicine

I'm in a clinical trial of a drug alphanumerically designated by its maker Genentech Inc. as MEHD7945A, as if it were a star or a galaxy.

The drug  has shown some benefit to me so far. It has reduced my lung tumors slightly, and kept other tumors stable. That, besides some moderate side effects, is the drug's benefit.

But my enrollment in the trial is a result of past chemotherapy treatments losing their effectiveness. Standard treatments no longer control the growth of tumors in my lungs and lymph nodes in my chest cavity; the new drug seems to be doing that.

But even as I take the drug and monitor myself for its effects, I have always been interested in what are called alternative or complimentary treatments for my cancer. They include diet, physical exercise, reduction of stress, spiritual and psychological exercise, dietary supplements and just about anything else someone might suggest to a cancer patient.

The suggestions can be overwhelming and an oncologist often will poo poo them as unscientific and not worth your bother.

But I listened to a 90-minute Colon Cancer Alliance webinar called Integrative Medicine: Wellness Throughout Treatment and Surviorship earlier this month and heard something I have wanted to hear ever since I began my own scattershot research of alternatives to chemotherapy.

Mary Hardy, a doctor and medical director of the Simms/Mann UCLA Center for Integrative Oncology, finally put an end to across-the-board dismissals of alternatives:

"I like to choose interventions from this arena that have scientific evidence where it is available," Hardy cautioned from her own scientific background.

She added, "The evidence base for what kind of diet, for what kind of supplements, for what kind of effects, is much smaller than it is for the chemotherapy medications that you'll be offered. But there is a body of evidence and it is growing, and when people are making recommendations for you in this area, they should be aware of this evidence, aware of these studies, and use them appropriately."

Hardy went on to share what she knew of the most-talked-about alternatives, first saying: "The best wellness plan is one that is tailored to you."

She suggested finding a knowledgeable coach to help you craft your own response to your disease, and she said to inform your oncologist of what you are doing so he or she can respond as well. Some chemotherapy drugs can be rendered less effective by certain dietary supplements.

Her basic components of a plan were simple:

• Optimize your diet.
• Exercise regularly.
• Maintain a healthy weight.
• Practice regular stress management.

Hardy's presentation -- you can listen to the whole show by clicking on the link above and then clicking on "Launch Presentation" -- was actually the second part of the webinar.

Anne Coscarelli, a clinical professor in the Department of Psychology at UCLA, opened the session speaking of the mental and emotional toll a cancer diagnosis takes on a patient, their family and their caregivers, and offering "mindful" techniques for patients to dispel fear and anxiety.

"Colon cancer, like other cancers, comes with a measure of uncertainty," Coscarelli said. "It really can change a person's life both physically, mentally and spiritually." It also can disrupt a patient's physical function, their social network, their sexual and reproductive health, their financial and work status and their spiritual and psychological outlook.

"Stress and anxiety become imprinted on us,' Coscarelli said. "They become imprinted on our brain."

She added that fears of the spread or recurrence of the disease can be spiked by news coverage of the latest medical or research developments, by surfing the Internet for more and more information about your disease, and even by anniversary dates: of surgeries or disease-free scans, or other markers in a patient's fight for life.

The webinar, jointly hosted by the UCLA Center for Integrative Oncology and the Colon Cancer Alliance, is one of a series of "Conversations about Colon Cancer" held on the CCA's website. Check it out for more information about living with the disease.

The entertainment value of occupying Wall Street

John Hendrickson of the Denver Post logged into the Occupy Wall Street stream of consciousness over the weekend with a post on the newspaper's website and in the printed pages of its Sunday entertainment section, providng a little extra to what he calls the "spectacle" of the occupy movement.

If you have any sympathy at all for the occupiers' cause, ... er causes ... at first blush you would think Hendrickson's piece was a 1960s parent's cynical take on hippies.

But when you read the piece a second time, you realize that Hendrickson is merely pointing out that everything nowadays is captured on some camera and posted on the Internet for everyone to see.

Hendrickson implies such multiplicity of images detracts from the protestors' message, and he complains that the news consumer is left to fend for himself or herself when it comes to interpreting a meaning from the raw reportage.

In other words, the gatekeepers of broadcast and mainstream journalism are not around to guide you while you sit at your computer or stand in the middle of the street looking down at your mobile device to brush up on current events.

Hendrickson's publisher, William Dean Singleton, predicted as much years ago when he suggested reporters in the future would carry cameras and voice recorders to capture the news not only in words but in video and sound. But now everyone is a reporter; all you need do is upload your recorded experience to the Internet.

Then the gatekeepers have to sort through all that chaff to edit images they think suggest a meaning in it all.

Hendrickson's piece seems more a tired complaint than a commentary. But it was entertaining; I guess you could say the writer did his job.

Occupy Denver: future middle-class calls for help

Corporate America is finally getting treated to its Arab Spring. Will it listen?

"Occupy Wall Street" is an informal movement of young people (college graduates without jobs commensurate to their education; activists without any other cause to jump on; victims of a Wall Street-induced financial crisis in 2008 for which no one has been held accountable but foreclosed home owners) gathering in a Manhattan park over the past two weeks to protest everything in their lives that makes them miserable.

And the movement is spreading as it should across the nation. The Denver Post wrote a short story about a demonstration held here yesterday that gathered 50 people at Broadway and Colfax, and then marched to the Federal Reserve building on the 16th Street Mall.

I've written about the growing efficacy of peaceful demonstrations around the world. And I've written about how the American poor and lower middle class gained nothing from the boom times that preceded the 2008-2009 Great Recession, but were the first to be punished for it by banks that recklessly lent them starter-home money just to collect the fees charged during a home purchase.

The Occupy Wall Street movement is a reflection of young peoples' dissatisfaction with President Barack Obama's cautionary approach to fulfilling his campaign promise of "hope and change."

If we're lucky, it may spread and grow through Election Day 2012, but unlike the Tea Party, set the country on a correct path out of our economic problems: taxing Wall Street millionaires who ripped off the country during the boom; passing a jobs act that puts more middle-class tradesmen and women to work and keeps teachers in their classrooms, and firefighters, policemen and other first-responders on the job; and offers small businesses tax credits to stimulate hiring.

America deserves the Occupy Wall Street movement on so many levels, it should only be happy its young citizens are taking to the streets to speak to power. If it accomplishes its amorphous ends, the movement will have provided the X- and Y- and Z-generations of Americans their own versions of the Peace and Civil Rights movements of the 1960s youth rebellion in these United States.

Have at it kids. It's your time.

The down low on Denver/Colorado

The national buzz is all about creating jobs nowadays, but is metro Denver and Colorado a hot commodity among people who sell cities and regions to worldwide companies as a place to expand or relocate?

Only one of nine business site selectors who were wined and dined over the past three days by Denver economic-development recruiters cited the metro area and Colorado as a current hot spot. And that recruiter suggested the alternative-energy industry -- shaky ground during the current economic downturn -- is Colorado's strongest calling card.

But the site selectors were not brought here to pat Colorado and Denver on the back. The Metro Denver Economic Development Corp.'s annual site-selection conference traditionally seeks out the weaknesses of the area's attractions to national and international corporations in order to improve regional prospects for recruiting a corporate expansion or relocation in the future.

And why should small business in Colorado care? Because big business generates small business growth in an area where it operates. When a big company comes to Colorado and hires 100, 400, or 1,000 new employees, it also must look for local suppliers, construction contractors, maintenance firms and other service businesses -- sometimes even venture partners and bankers -- to accomplish their work.

And new jobs put money in the pockets of dry cleaners, sandwich shops and caterers, landlords and professional sports franchises, gas-station operators, home builders, teachers and government workers.

So what was the lowdown on site selection shared by the experts?

• Outsourcing is being reversed. Companies that sent work to China and India are bringing it back to the U.S., using domestic call centers, data centers, and distribution centers to better serve their customers.
• Companies are collaborating with each other to reduce costs of business services provided by third-party vendors: human resources, legal, some information technology, employee retention.
• Consolidations and mergers and acquisitions are causing longer decision-making cycles, up to 18 months, but when a company decides to "pull the trigger" on a move or an expansion, they want a winning-city bidder to act quickly, sometimes within 30 days, to accomplish what they've promised in their bid.
• Tax breaks and other incentives to lure businesses are being eliminated by some states, mostly for budget reasons; adjusted for different industries by others; and supplemented with cash funds, often under the control of a governor, to close deals in the hottest recruiting states. So the competition among states for new business is fierce. Colorado incentives are still graded a C- to D+ by most economic developers.

And no economic-development organization should assume current local businesses are not being recruited by other states. That's another reason small- to medium-sized businesses should pay attention to what these business-recruitment experts have to say about Denver and Colorado every year.

"You need to be in touch with your local businesses all the time," said Ann Harts, a Kansas City principal of Hickey & Associates, a national and international site-selection firm based in Minneapolis.

Another of the experts, Angelos Angelou, of Angelou Economics in Austin, Texas, said he visits Colorado and other states frequently without notice and when he hears a company has not been visited by its local business-development specialists, he wonders how his own client might be treated by that state if it chose to move or expand there.

"Colorado has never won a project on incentives," Angelou said, based on his experience working within the state. But he said Colorado can compete with any other state based on the talent of its workforce. "Focus on talent. Focus on the business proposition," he suggested to the 400 people in the audience.

Then, referring to Gov. John Hickenlooper who had spoken to the crowd to open the breakfast meeting, Angelou said Hickenlooper's vision of Colorado as a "pro-business" state is as competitive as any of the arguments of hot-spot recruiting states.

"Take the governor to places," Angelou said, "and let him speak." He seemed to think that might be Colorado's sharpest tool in its shed.