Expiration Dates

True story: A few months ago, a plumber attempting to resolve a drainage issue in our main shower discovered something never before seen.

It turns out that the guy who did the original tile work on our then-under-contruction house, employing more creativity than…level-headed vision, jury-rigged a solution to a misalignment of the two pieces of the drainage thingie. (I clearly have reached the outer frontier of my plumbing and tiling knowledge.) Basically, the two pieces – a bottom installed by the plumbing contractor, a top by the tile contractor – are supposed to screw together to form a leak-proof single drainage…thingie.

The tile guy miscalculated. He left a gap and, I guess, the tile already was locked down. The two pieces could not reach each other. What to do? What to do? Let’s pause and take a sip of milk and…EUREKA!…he knifed off the top of the plastic milk bottle and used it to form a makeshift funnel to close the gap. Who would ever know? Only the poor slobs who bought that new house and nine years later learned that their milk-funneled shower drain was now well beyond its expiration date of…take a look for yourself at the photo…May 16, 2012.

Meanwhile, in other expiration-date news (this is what we newswriters call a slick transition), I promised a bit more detail about my newly predicted expiration date. Here are some facts and expectations.

Fact: The statistically accepted five-year survival rate for American men diagnosed with stage four metastatic prostate cancer is 30 percent. So, about one in three such patients make it beyond the five-year anniversary of that diagnosis.

That’s a raw number, in more ways than one.

Yes, it is sobering, but the calculation covers the entire affected population, including men even older than I am when they graduate to stage four (I’ll be 74 in July), men who were not promptly diagnosed and were found to have cancer that spread even deeper than mine (extensive lymph-node involvement and likely in the bloodstream), men who already were ill with other serious ailments (thankfully, we’re pretty sure that’s not me) and/or who died during that period from one of those other ailments, men who got hit by one of the metaphorical trucks mentioned by our oncology specialist, and so on.

OK, so the odds are fairly good that I could be among those lucky (?) one in three who get past year five, from the mega-statistical standpoint. Not great, but also not terrible.

End-stage cancer, but…thankfully. not at or within sight of the end of the end stage, if that makes any sense. Many truly fine people, including some associated with our synagogue, already have offered to set up meal-delivery rotations for us and things like that. We’re deeply appreciative, but we’re not there yet. (When that time comes, which is not now, I really like bagels, potato blintzes, bagels, Italian food, and pretty much anything with cheese, including bagels. Just saying.)

Where was I? Oh…expiration dates. Drilling down, we asked our lead specialist for an estimate of my personal use-by date. (A lot of people wouldn’t ask that question, and that’s fine, but the Merzer-Flemings are not built that way. Give us the facts, good, bad or ugly, and we’ll deal with them.)

Basically, I think in terms of Bagel Years. How many more years will I have to enjoy bagels? (And, of course, everything else and everyone else.)

The answer: Five to seven Bagel Years, perhaps augmented by new therapies that might come along.

Now, to be clear-eyed, that’s five to seven years of continuous treatment with an ever-escalating series of chemical therapies, all of which carry side effects. (More about side effects coming soon.) And there are no guarantees, obviously. The sudden onset of this crisis suggests that my merry molecular pranksters may not be playing by commonly accepted prostate-cancer rules.

But still, that ain’t bad for a guy my age. That gets me to a place where the grandkids are within range of adulthood, and it may leave Marion enough time to finally learn how to reset the modem. (I am SO going to get “The Look.”)

I told the doc: “My father and most of my male relatives died at or around 60. I’m almost 74. You get me five to seven years of decent-quality life, I’m a happy guy.” (That’s a lot of bagels, which, by the way, Mr. Rabbi Jack Romberg, as a reminder, should never be toasted unless they are not fresh. This is non-negotiable. If it is not in the Torah, it should be.)

Importantly and more seriously, this would be a much different story for a man in his 40s, 50s, even 60s. And it very often is. Five to seven years or fewer? With side effects that could be even more debilitating or discouraging or depressing for men of that age? Who still might have children in the household?

We’re on several prostate-cancer message boards. We read the accounts. We track the cases. We mourn the losses, especially the early losses.

Sorry to be a pest, but don’t be one of those men or one of those families. Glance again at the bottom of this blog: Men – make sure to keep track of your PSA through a blood test at least once a year. Women – don’t let them get away without doing this.

In a related development (another slick newswriter’s transition), the results of the bone-density scan came back – and they were disappointing. Something or another, maybe the cancer, maybe just advancing age, maybe both, has weakened the bones.

So…yep. Another injection of another drug, this time Prolia.

If you’re keeping score at home, the starting lineup now includes Firmagon, Prolia and Erleada, with Eligard called back up to the majors and soon to be batting cleanup.

This is not an ideal situation. One hears anecdotally of advanced cancer patients and the number and varieties of the therapies that keep them going and the attendant side effects and…well…I guess we’re just about there already. For starters, the belly inflammation and discomfort at last Monday’s Firmagon injection sites have outlived the welcome they never really had.

That third drug, Erleada, is the diamond-priced, bonus-baby rookie that our medical practice managed to get approved by the insurance company and funded by a foundation. The first doses should be available this coming week. I think it’s four large pills per day, every day.

A speciality pharmacy sends sequential 30-day supplies of that stuff straight to the house. I guess those folks don’t see a whole lot of upside in providing large volumes of those little jewels too far in advance, given, well, you know.

Oh, sorry. Did you ask about the sticker price of Erleada? Are you sure you want to know? I mean, really…really…sure?

Here we go:

$13,407.

For a 30-day supply.

Each 30-day supply.

If we understand what’s happening, and I’m not entirely sure that we do, we’re going to get it for free, thanks to our insurance plan and that foundation.

But as my friend/bro Larry Pintacuda says about that sticker price: “That’s just not right.”

9 thoughts on “Expiration Dates

  1. Our descendants – ok your descendants since I have none – will look back on this period of American history and view us as barbaric. And our health care “system” tops the list of whys.

    Liked by 1 person

  2. I love the milk funnel story, it gave me an early morning laugh. Hopefully, age is in your favor when slowing down the cancer. Nothing moves fast at our age! Thanks for my morning lesson.

    Liked by 1 person

  3. In reverse order of importance:

    1. I’m with Rabbi Jack, as you know. My Brooklyn-born father agreed that bagels can definitelybe toasted..
    2. Great milk carton story.
    3. $13,407!?! Holy crap. Clearly nothing wrong with our health care system. Here’s hoping your injection discomfort (understated?) subsides soonest.
    4. 5ish years, 10ish years. I choose the higher-ish numbers.

    Sending love and support to all of you always.

    Susan

    Liked by 1 person

  4. Marty, my words are so inadequate, but I have great admiration for how you are responding to your diagnosis. Once a newsman, always a newsman: Your remarkable blog is both incredibly readable and informative. Countless men will benefit from your straightforward reporting and compelling storytelling.

    May I express my gratitude to you for your courage and determination to be of service to others in the midst of this personal battle.

    We go back a long way as former Miami Herald colleagues. Among my fond memories: being present at Allie’s Bat Mitzvah and your 1987 attempt to travel from Dallas to Oklahoma City for my father’s funeral (blocked only by a major snowstorm).

    God bless and may you have miles to go.

    Rich

    Liked by 1 person

  5. Marty, have you ever thought of changing “Expiration Date” to “Sell By” date. I believe this is contextually more accurate 😀. There is still value after the Sell By date with the actual Expiration Date being up in the air: it is dependent on many factors, some known, some unknown. I’m sure there is an algorithm that can take your age, environment, illness, meds and the number of bagels consumed, both fresh and toasted, and estimate your Sell By date. I recommend Sid behind the Deli counter who always puts his hand on the scale to make you think there is more there than there is there 😜, Elon Musk is another possibility. If he can reuse a rocket, he can certainly repurpose you and extend your value.

    Like

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