Friday, November 16, 2012

Looking Back: Growing up with dirty hands (Updated)

Updated:  New comments at the end...

Today's post is going to be one of those where I look back to my experiences growing up and how that has influenced me.

I grew up on a small farm in eastern South Dakota.  I don't have any stories of traumatic experiences or a rough childhood that has influenced my later years.  Quite the opposite really.  I have loving parents who love each other.  My grandparents (Dad's side) lived on the same farm which essentially doubled the people raising my sister and I and gave us another set of incredible role models. 

Like most rural kids, it was natural to start helping with chores and working on the farm at a young age.  My parents operated a dairy farm, so many of my earliest "chore" memories were of mixing up powdered milk to feed bottle and bucket calves.  I recall having to walk the pasture to round up the cows for milking (pre ATVs) and generally just being around Mom and Dad as they were going about the chores each day.  As we got bigger, we helped out more. 

I was 12 and just to the point where I could actually do the milking myself when my parents decided to get out of the dairy business.  Why?  They tell me it just wasn't worth it any more.  They had the option of continuing to be tied to the dairy cattle day in and day out or let it go so they could be more involved with my sister and I in school activities and family outings like camping\fishing and whatnot.  I am thankful they went the direction they did. 

The operation now is mainly beef cattle and row crops (corn & soybeans).  I recall growing oats, barley, wheat, millet, buckwheat, sunflowers, sorghum (field and grain) and even popcorn at various times.  The cattle part of the operation is much bigger now then when I was on the farm.  I don't think that Mom and Dad ever imagined how much it would grow.  In addition to cattle, we raised pigs for a time.  I was really little but I even remember turkey's we had on the farm for a while.  I suppose they stand out because if you think about it, turkeys really are among the most intimidating (evil?) of poultry, especially from a young child's perspective. 

Job's I enjoyed:  Cutting hay, working/herding cattle, farrowing pigs, harvesting (combining and driving truck), calving, spring fieldwork, welding\repair work

Jobs I disliked:   grinding feed, baling hay, working pigs, fencing, cleaning grain bins

Jobs I despised:  Cultivating,  hauling bales, cleaning hog barns, hauling manure

Considering the many years of growing up on the farm there really are a ton of stories to tell.  I'll offer a few that stand out. 

Jessica and I often got the "little person" jobs.  That is jobs that required a small body.  For example, in springtime when it was necessary to prep the drill (small grain planter), Dad would have us crawl into the planter with a screwdriver and the shop vac to clean out the old grain.  Picture the bonding between a brother and sister (3 years younger) shared from the inside of a piece of farm machinery.  I recall on a few occasions when we were still milking that we'd be lowered into the empty bulk tank to scrub it down when required.  The smell of bleach makes me think of that to this day.  As I got older and capable, there was the occasional machine repair or welding job that needed to be done by crawling up inside whatever it was,  That's where my tall, skinny self came in handy.  It's also where I learned that the human body is a fairly decent conductor when welding from the grain pan\straw walker area of an International combine.   


Things seem to be much better for Dad now in regards to the dependability of the equipment we have on the farm.  But I recall an awful lot of breakdowns with what we had back when I was there.  I recall one year where I had to combine much of the corn with an International 715 combine without a clutch.  Basically what that means is I couldn't really stop the combine.  When it came time to unload, I had to rollup by the truck, time it just right and turn off the combine.  I could then take it out of gear and unload.  I'm not entirely sure this was ever fixed.  I think the combine is sitting there in the same condition with the line of other "retired" equipment. 

Springtime was always entertaining on wetter years.  I recall having a talent for getting tractors stuck when doing the spring fieldwork.  I recall one specific incident where I wasn't paying attention and I turned into a slough with standing water and totally buried the tractor.  Luckily Dad happened to be working the same field and had the opportunity to see this go down (literally).  As we drove to Carpenter to get extra chains, I distinctly remember that he was quite confident that we'd not be able to get it out until the slough actually dried up.  I recall it being difficult, but we did manage to get it out that day.

For some inexplicable reason I enjoyed doing square bales (straw, not alfalfa) in the fall.  Specifically haling and stacking them.  Maybe because it was they were like really big Legos.  It was also an opportunity to work for some other area farmers and earn a little cash.

I could go on and on and I probably will some other time.  There is another significant experience I want to mention as it has had a big impact on me.  The summer after my senior year, I needed cash.  After all I was going to be off to college soon and I needed a car.  So, even though I am sure he needed the help, Dad let me go to work for Tellinghuisen Construction (from Willow Lake).  I am of the opinion that everyone should spend some point in their life doing some type of construction.  Wayne was an intimidating boss, especially for a shy farm kid who never had a boss before.  I learned so much from Wayne and that group of guys that summer.  I have carried that forward and it has served me well.   It's also where I learned how good a cold beer was after a long hot day in the sun. 

Here we are, another long post.  Hopefully there has been some interesting things and people have made it this far.  Farming takes a special type of person.  Many that read this are from rural areas and know what it's all about and have similar stories to mine.  It's changed so much since I've grown up and left the farm.  I think about my kids and realize they will have a whole different perspective and set of experiences growing up.

At some point, Mom had to start working off the farm.  It's hard to sustain a family on a small farm income.  Like most family farms, there were a lot of tough years when it was either too wet or too dry.  Interest rates were too high and prices too low.  I can go on and on with stories, but I can't tell you of a single time where I was lacking anything I needed.  I know now just how tough some of those years really were, but my sister and I never knew.

They probably don't realize it, but I am constantly inspired by how hard my parents have worked to built the operation that they have.  I am my fathers son.  We are stubborn and set in the way we do things.  It's been that way all the way back when I thought I knew everything. (as opposed to now when I actually do)  I look back now and realize the frustrations Dad must have had trying to manage the work with a stubborn teenager.  I remember an awful lot of fights and arguments and what I can only call now is a significant amount of patience.  Patience is not a word often associated with a male member of Grann descent, Yet... there it was when it was needed.

Here we are now.  I am able to appreciate what growing up with dirty hands has done for me.  I know the what a hard days work is.  I know what it means to make your living using your body as well as your mind and the value of both.  I know what wealth truly is.  A farm teaches you early about the cycle of life and death.  You get to know the pride of creating something with your hands and the stress of things being totally out of control. 

As bad as I wanted to get out of there at the time; as sure as I was that the farming life wasn't for me; all I want now for my family and I is to go back home.  Had I not gotten sick, Andy and I would have probably returned to the farm by now.  I want for my kids what my parents provided for me.  I feel that there is no better place to raise kids then a on family farm the way I was raised.   Even though we've mentioned it to my parents, I don't think they ever took us seriously.

Maybe it's my damaged DNA talking, but I miss my dirty hands.

UPDATE:  In response to this post, my sister (Jessica) had to chime in.  This is, of course because of her ongoing need to refocus attention on her, but that is a whole different post.  It actually probably warrants its own blog.  Regardless,  here were her comments:

Jessica:  Here’s a picture for you (the drill picture above). I have fantastic boots and a shirt that is in no way too small for me. I can see why you were so jealous of me growing up.
 
Jon, do you remember cleaning the old chicken coop out. That was the WORST job I remember ever having to do and there were lots of terrible ones (cleaning pig gutters???). Or how about cleaning the granary in the white fence lot when the mouse ran up your pant leg. Cleaning those old wooden granaries was horrible, but the moment that mouse climbed your pant leg was priceless. It made my day. You were, after all, a terrific pain in my butt growing up.
 
 



Thursday, November 15, 2012

Family & Friends: Golfing

By no means am I a great golfer.  I just don't get out enough.  I do enjoy playing though. 

Back in high school we'd tend to golf in Clark.  It is still a favorite course since it's wide open and an easy play.  For a quick round I really like Keuhn Park in Sioux Falls.  I've had a lot of fun in Brandon and had my butt kicked by the Dell Rapids course.  

This summer when I was in Rochester I was just itching to get out and play.  I imagine it was mainly just to be outside and active after being cooped up.  I still had my Hickman port in my chest and the doctors cautioned against going golfing since it could pull the line out.  Regardless I got out a few times with no issues. 

I think the high point of my outings this summer was golfing with Ira (Andy's Dad) and several of his friends in Brandon.  It was the first time I had done 18 holes since the transplant and I was quite pleased that I was able to keep up with them.  Sure I golfed an even 100, but I was quite satisfied with myself.  It was the best round I put together this summer. 


 I'll remember this summer of golf because Alivia and Nevaeh showed interest in playing golf.  I picked up a few odd clubs that fit their size a little better.  Nevaeh picked up hitting a little quicker, but once Alivia got the hang of it she was a bit more consistent.    We did the driving range and they joined me on the course a few times.  I think they enjoyed driving the golf cart better.  Both girls were pretty good cart drivers. 

One of my favorite golf outings occurs every year around the Board family reunion we have in Carpenter.   A fairly large group (mostly Wicks') head up to Clark in the early morning for a quick 9 holes.  I really look forward to this outing.   I missed the golf this year but made it back for the reunion even though I was still within my 100 days of the transplant.  Hopefully I won't miss it this year.

Wednesday, November 14, 2012

UPDATE: Room Change

Hey all,  just a note for those thinking of visiting me at Sanford Hospital.  My room has changed to 6201.  Same wing different room.  

Turns out I have amassed enough reward points on my hospital stays that I've been upgraded to the high roller suite.  Mini bar is open.  All are welcome. 

In other news, my doctor all but confirmed that I'd been out of here by Thanksgiving regardless of where my counts are.   Not to worry, he's a cautious guy, he would not let me go if it was overly risky. 

Lots of visitors today.  Good news...  It's a good day. 

Obamacare Part II

So prior to the election I posed a few of my thoughts about the Affordable Care Act (Obamacare).  I kind of expected to catch a little flack about it, but received a lot of positive comments instead.  Most of the people that have talked to me about it have admitted they really don't know that much about what it includes.   

I did a fair amount of research prior to writing that post.  I too was unclear of what it meant from the individual or family perspective.  So much of the info I came across was focused on how it affects businesses or what it was going to cost the country.  With all the election rhetoric there were all kinds of articles that were conflicting or just difficult to understand.  Most failed to spell things out for the individual.

So I figured since I had done some leg work and since it appears due to the election Obamacare is here to stay, I figured I'd relay what I learned.  This may be one of the articles that I update or author additional posts as I learn more.  I'm not trying to make a case for or against Obamacare.  Time will tell if the program will improve our health care system or if it will become too costly.  The law has it complexities, but my goal with this post is to relay the facts of the law as it relates to the individual or family.  

Remember from my prior post, if you have insurance through your employer this law really won't affect you much.  The laws which was passed in 2010 has all kinds of provisions that phase in parts of the law all the way through 2020.  2014 will be when the most significant changes happen, but I'll get there.

First let's get caught up.  This is what has happened so far (the items affecting the most people, there are more):
  • Expanded coverage to young adults by letting them stay on their parents insurance until they turn 26
  • Eliminated lifetime limits on insurance coverage (Yeah for me)
  • Lowered cost of drugs for seniors on Medicare
  • Specified that insurance companies must spend 80% of premiums on health care and the remaining 20% for administration and profit.  This lead to $1.1 billion in rebates to consumers. 
  • Expanded free preventive care for all ages (Ex: mammograms, colonoscopies, wellness visits, immunizations)
In 2013 (High income earners start paying for some of this):
  • Individuals with an income over $200,000 or married couples over $250,000 have to pay an extra .9% extra tax on income above the threshold.  Ex:  someone that makes $210K pays an extra $90.
  • 3.8% tax on investment income but only if your adjusted gross income is $200K (individual) or $250K (couple).  This is only on investment (i.e unearned) income.  So someone that makes $50,000 per year on investment income where their total income is $250K would pay and extra $1900. 
  • There is also some goofy 3.8% tax hike when you sell your home but only if you make a profit of $250,000 (individual) or $500,000 (married couple).  This is only on the profit, not the sales price.  The 3.8%  is only paid on the amount of profit over $250K/$500K.  most "middle income" Americans would not run into this.  
  • We'll start seeing the total cost of our health care plans (not just what we pay) on our W2's.  It's just informational. Only companies with over 250 employees need to do this. 
  •  Flexible spending accounts will be capped at $2500
2014 (The new system really begins) - Remember though, this really only affects those that are uninsured or who purchase insurance on their own.  These are the major points:
  • Heath plans must be available for everyone.  Premiums can not differ based on health or gender. Individuals cannot be denied because of pre-existing conditions.
  • Each state must setup an insurance exchange.  Essentially this would be a marketplace where consumers could easily compare and purchase plans.  States can elect to do this themselves or let the federal government operate them.  Now, I think that it would be best for states to manage these exchanges for their own people.  States have until Nov 16th to tell the federal government which direction they will chose to go.  I feel somewhat uncomfortable that a state is going to turn this over to the federal government...in most cases, just because the governor of that state is Republican.  Wouldn't we be best served if this single most important provision was managed as close to home as possible.  Our governor has already stated that South Dakota will not be managing the exchange for South Dakotans. 
  • "The Penalty".  People without insurance will pay  $95 per individual or $285 per family, or 1% of income, whichever is greater.  By 2016 it rises $695 per individual, $2,085 per family, or 2.5% of income, whichever is greater. 
  • Individual subsidies will be offered to help people pay for insurance.  This will be based on income and what the current federal poverty level is.  For example, in 2012 a family of four with an income of $46,000 would pay no more then $235 for health insurance.  Additional subsidies will be available for lower income families to assist with deductibles and coinsurance.  The specific options someone would qualify for would be presented when shopping the exchanges. 
  • Medicaid expansion... This is another tricky one. This expansion is intended to cover millions Americans that have incomes up to 133% of the poverty line ($14856/individual or $30657/family of four) Many of these people don't currently qualify for Medicaid.  However the Supreme Court have ruled that a state can opt out of this.  The federal government is sending a significant amount of funding to the states that take the expansion, but states will have to pony up a bit more.  Once again states (predominately Republican states) are threatening to opt out of the Medicare expansion.  The problem is that the law was written so that these lower income people would qualify for Medicaid, but not subsidies.  So if a state opts out, these people with incomes between 100% to 133% of the poverty line will be stuck with no affordable healthcare option. 

2015 on....
  • There are a few other provisions that take effect but here is an interesting one. In 2017 a state can apply to opt out of many of the Obamacare reforms provided the state can come up with a better solution for managing the healthcare of consumers in the state.  The state would still receive the same federal funding, but a state can "innovate" and come up with a better solution if they can.  I actually think states can apply as early as 2014 to do this so they can come up with their own solution rather then implementing the exchanges just to change things 3 years later.  I really wish those that are calling for a repeal of Obamacare would just promote and pursue this option.  The law actually has the provision that essentially lets the states to come up with something better if they can.  Isn't that the goal anyway?

Just so people know I'm not making this stuff up, my source for much of this info has been Wikipedia and various news articles, especially a really good article in the November issue of Consumer Reports.

I realize that this whole thing is going to be expensive.  I don't have a lot of details on funding or things like that.  My intent here was to illustrate how the individual and families would be most directly affected. 

Consider, Social Security programs were quite unpopular then they were enacted, but they have served us for over 75 years.  And most people look back at FDR and consider him a great president and leader.  However at the time, many of his New Deal policies (including Social Security) were quite unpopular. As far as the economy went, things didn't really improve that much during his 3 terms in office.  Republicans love to talk about Regan, but tend to leave out he basically invented deficit spending and let that go out of control while he oversaw the largest and most expensive arms race in history.  I'd love to know if the generations then thought the system was as broken as most of us think it is now. 

I am a registered Republican.  I feel government should be smaller.  I think the recent Dodd-Frank Act which is a response to the Wall Street\Financial crisis is a gross overstepping of government powers.  Our current leaders have recklessly spent money and racked up debt that is unsustainable.  Running a country without a balanced budget should not be allowed.  I like my guns, the free market and I feel the private sector (or local governments) are better at spending money then the federal government.  Our current patent laws are dumb.

On the other hand... I am pro-life but I believe in a woman's right to chose.  Stem cell research should be allowed and research encouraged.  There should be more government funded research with all results, treatments, drugs and tech being public domain but allowed to foster private innovation.  Gay people should not be regarded differently in any way in the eyes of the government and that includes the right to marry. 

I hope I've been able to provide some useful information and insight to the world as I see it.  The interesting thing is I would have never looked this deep into Obamacare had I not been going through this fight with Cancer. 

Perhaps part of the problem may be that we're content to just say the system is broken but not educate ourselves about why.   

Tuesday, November 13, 2012

Looking Back: Pheasent Hunts

Most of my posts lately have been dominated by my current treatment.  I think I'll go off in another direction today.  I've intended to use this blog as a means to also capture memories of growing up.  It's fun to reminisce and down the road my kids can read this and know me better. 

Since it's fall, I think about hunting and being outdoors.  I am by no means a hard core outdoorsman or hunter but I do thoroughly enjoy pheasant hunting;  deer hunting not so much.  While the hunt is great, the social part is what I think I've always enjoyed the most. 

In South Dakota you can take your hunters safety course and get your license when you turn 12.  I took the classes with my cousin Jeremy in Watertown.  Nothing really stands out about the course until the final day when we went to the shooting range. 

Our final test was shooting 2 clay pigeons.  Dad was there that morning to watch.  I remember being nervous since I had never shot clay pigeons before.  I was provided a Browning semi-automatic (12 gauge) and went through the motions to get ready to shoot.  I was plenty excited when I nailed that first shot.  Even more so when I got my second.  I was the only person to hit both clays in the class that day.  Dad was so proud.  I think that's why it remember it so well.

I don't recall many specifics about those first years of hunting.  I started with a bolt action 20 gauge that belonged to Dad or Uncle Mike.  I don't remember hitting much.  A few years later I moved on to a old Browning semi-automatic of Dad's.   This gun had been in the family for several years.  At one point, prior to me using it, mud had gotten in the barrel and it had exploded.   It was repaired with this knarly looking barrel extension.  I really enjoyed this gun.  It was a heavy beast, looked bad-ass because of the barrel and had the tendency to go fully automatic.

A few years back, Andy was walking with us and the gun went off as I was loading a shell in the chamber.  Scared the crap out of both of us.  I retired the gun at that point and started using a 12 gauge pump that my dad had.  (We'd gotten him a different gun for Christmas).   So finally, after 22 years of using borrowed guns I broke down this year and bought a semi-automatic Browning Maxus (right).  Unfortunately with the current events, I've only been able to use it once so far.

Some of those early years of hunting Pheasants were amazing.  We'd typically have the legal limit of 20 people in the group.  Opening day would begin by meeting at our neighbor Scott's place to get organized.  Ma would usually have a pan of Lasagna in the oven for us to eat before we left.  Back at that time there were so many birds.  Our group was so large we'd typically chase the birds to the end of whatever field and then all hell would break loose.   Those were fun hunts and it was not unusual for us to limit even with that many people. 

At some point in the day Lee would break out the sandwiches and cookies he had prepared.  He's continued to keep us well fed during these hunts.  Opening day would end with everyone cleaning birds and then as much of a happy hour (or two) that we could fit in before heading down to the church supper.  The days that we limited early, tended to be those where we were in a bot rougher shape by the time we got to supper. 

Recent years the bird numbers have fallen due to tough springs, droughts and loss of cover.  So the hunts have gotten harder; limiting out less likely.  But for me it's still about going back to see all the old crew.  Other then the kids growing up, it's tended to be the same bunch year after year... going on now for over 20 years.  That next generation is starting to come of age. 

I think of a couple of old timers, Jack and Cal, from Michigan that would show up each year.  There is some connection between them and my mom's Aunt Dorothy.   These guys where characters and they were always fun to have around.  Unfortunately, their health prevented them from coming around this year. 

Very rarely growing up did we eat pheasant.  Dad has this thing about eating poultry so we really didn't have the opportunity.  In later year's however, I have become quite fond of the tasty little things.   The kids even like them.  They prefer when I make breaded pheasant strips.  Otherwise I like frying up the breasts with a little lemon pepper or a nice pheasant noodle soup.

I look back fondly on these hunts.  These are very happy days.  Maybe I'll manage to get out again yet this year.  Hopefully the girls and/or Jonah will take an interest some day. 

I don't have any pictures of any of our hunts.  Does anyone have pictures they can send me?

Monday, November 12, 2012

AML: The paths before me...

So I am getting a little better understanding of what my options will be from here. 

First things first, I need to get back into remission.  The good news in this area is that the blasts which were detectable in my blood a few weeks ago (indicating the relapse) are gone.  There are no detectable cancer cells in my blood.  A bone marrow biopsy will confirm that I am in remission.  We'll do that when my counts begin to recover. 

Once remission is achieved, I'll return to Mayo for a consult.  I have had little guidance as to what my treatment plan will be from here, but based on some research and conversation I will probably be presented with some or all of the following:

2nd bone marrow transplant:  Very risky the second time around especially considering I had to go with a mismatched donor to begin with.  I am not all that interested in this option. 

Lymphocyte Infusion:  I still have about 3 million donor cells on ice somewhere. Lymphocytes are the main immune system cells (natural killer cells, T-Cells, B-Cells).  Since I am already engrafted with the donor stem cells, they can infuse just the donor lymphocytes and jump start my new immune system to hopefully attack the Leukemia cells this time. 

Maintenance chemo:  Since my AML seems to be very responsive to chemo, they can give me a lower dose of certain drugs to try to maintain remission.  It means treatments are outpatient but would keep my immune system suppressed for extended periods. 

Do nothing:  We can just wait and see if this chemo (clofarabine) causes me to respond differently.  If I relapse again, we can just retreat again.  Being on a 4-5 month cycle wouldn't be that bad. 

Clinical trials:  There is all kinds of new stuff out there to try.  As a young guy, I'd probably be a good candidate for many.  I really would only be interested in this if I could be assured of receiving some kind of superpowers. 

I'd say I'm leaning toward the do nothing or lymphocyte infusion route at the moment.  Something seems to be nudging me that way.  I just want to give my transplant a little more time to work rather then continuing to flood my system with poisons on a regular basis. 

Meanwhile, back in Sanford hospital...  I've continued to have a steady stream of visitors.  My parents managed to get down, coworkers and neighbors have passed through and a lot of people from Church (1st Methodist) have been stopping by.   Andy and the kids have been up as well.   I've also had several blog followers reach out to me and offer encouragement.   I really enjoy hearing from those that follow along and visits, even short ones, really help break up the days. 

No movement on blood counts, but that should happen soon.  I have big plans to cook the Thanksgiving meal next week.  Hoping to make it happen.

Sunday, November 11, 2012

AML: Debbie Downer

I figured I'd better post again rather then let that last one set and fester.   As I said, there are ups and downs to this whole thing.  Getting all that off my chest has helped.   I know a lot of people follow this and for some reason it's easier this way.   I hope I didn't come off that I have given up on the world.  That's not the case.  I've just got a few bumps and bruises. 

We postponed the bone marrow biopsy.  My counts haven't started to recover yet so there would be little there to test.  We'll do it sometime next week.

I'm keeping up the good fight.  It's been a good couple of days. Good in that they have passed quickly.   The steady stream of visitors helps.    Halo 4 helps. 

I am still hoping to be out of here for Thanksgiving. 

My thoughts are with Becca today.  I have mentioned Becca before.  She is a fellow AMLer.  You can check on her at http://beccasweeney.wordpress.com/  She just underwent her second transplant.  This time it is from cells from 2 different umbilical cords.  Quite the amazing woman...  Please send a few prayers her way.