Post surgery scan 6 months later

2

Comments

  • Eims
    Eims Member Posts: 423
    #22
    jknorth said:

    Good sleep is vital

    Its a little tougher sleeping as well as before, have til Dec for my first follow up scan. Right now my right hip bone is sore, my skull has slight flashes of occasional jolting pain, my leg and upper thigh muscles tense up so much its like constant nerve spasms, the lower gut area and groin has occasional pain jolts, left chest under rib cage has the odd pain spot. Way too easy to notice common pain points now that were totally ignored 3 months ago. Likely part of hitting 50 you guess but then you wonder if its maybe that SOB one gene that escaped. One that bugs me is the hip joint, its internal pain and bones are a prime target as you say. 3 cm mass took likely 3 yrs and thats the same as the hip pain. In Canada they are mega cheap on the MRI's and you can wait like 5 months for one. Wish I was back with Kaiser in the southwest, 3 weeks.

    jk its totally normal to feel

    jk its totally normal to feel like this....well i hope it is because its how i feel sometimes too!!  i think we can over analyse things too which is to be expected but as the lads here would say it keeps us vigilant.  it is easy to freak out and to be honest i think its better to do that than keep it all inside.....

    eims x

  • cjm11
    cjm11 Member Posts: 11
    #23
    JK, didn't they check for

    JK, didn't they check for mets as soon as you were diagnosed?  Usually, at least in the states, you get a chest x-ray and bone scan.  At least that  is what I have found from reading about rcc. 

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    #24
    DonMiller said:

    Texas-Wedge

    I have a few things I can't seem to get an answer on  and would appreacite your opinion.  I had a 11CM  T3A  grade 3 ( sinus fat and muscular renal vein invasion) clear cell tumor removed last October.  No one seems to know how long it was there, but even at grade 3 it had to take many years to get that large.  Why is it you are at such higher risk of a reoccurence in the first couple of years? 

     

    Don

    Texas-Wedge

    Don, you caught me at a frenetic time when I couldn't think clearly and by singling me out for an opinion you put me on the spot so I wanted time to consider your question which is a bit deeper in some ways than it seems at first glance.

    Your large tumor, with significant infiltration, will, for sure, have been growing for decades, even allowing for its being grade 3.

    I guess that understanding recurrence probabilities requires appreciating the mechanisms involved. For most maladies, passage of time increases, rather than decreases likelihoods - the longer we're around the more chances there are of exposure to infectious agents, for instance; the older we get, the weaker our immune resistance becomes; the longer that disease processes continue, the higher the risk (e.g. build up of atherosclerotic plaque, elevation of BP etc).

    With RCC it's totally different because we're talking about whether or not there has been a cure.  There are 3 ways that RCC spreads (I'll avoid getting into philosophical debates about CTCs, new primaries, molecular labelling and so on).  They are in one of the circulatory systems - blood or lymphatic - or by direct contact, as in your renal vein.   The hope is to catch everything with the scalpel - cutting back to completely clear margins should ensure that there is no local physical spread.  If the tumor has been caught early enough, while still fully encapsulated, there should be no circulatory dissemination either.  The proof of the pudding is in the eating.  If the op has not been wholly successful then the possibility for recurrence is there and there's no great reason why it won't start happening more or less straight away, which is why the first couple of years tell us a lot.  The longer one remains clear, the more likely it is that the op did the job.

    There are, of course other factors. We don't know enough yet about the micro-environment that disposes us to succumbing to recurrence - maybe someone with a very strong immune system will find it copes on its own with any residual cancer cells, whereas someone else isn't so lucky.   Generally, though, if there are nasties left there's no great reason why they won't try to go it alone sooner rather than later.  If the pathology is highly aggressive that can happen at electrifying speed and unfortunately for me I'm about the worst example you're likely ever to come across.  We thought we had clear margins in December but there must have been several invisible 'satellites' that weren't caught by my nephrectomy and so by March I had to have another major open op to remove the first of a now unending series of recurrences (all of which, alas, are inoperable).   The abdominal wall tumor I have grew from 2.5 cm to 5 cm in 23 days which accounts for it being fairly uncomfortable to live with, particularly in the past six weeks of obligatory break in treatment.

    If you have further questions you feel I  might be able to address, please ask.  I don't know whether what I've said makes sense but I hope it's of some use to you.

     

     

  • jknorth
    jknorth Member Posts: 44
    #25
    Mets....not sure

    They said they did a catscan, blood test and checked lymph nodes, I don't remember any type of bone scan. The surgeon said they found no evidence of spreading, but I thought the T1A designation tells all that, thats why its a T1A classification. Guess I'll ask in Dec on my first checkup.

  • MDCinSC
    MDCinSC Member Posts: 574
    #26
    cjm11 said:

    JK, didn't they check for

    JK, didn't they check for mets as soon as you were diagnosed?  Usually, at least in the states, you get a chest x-ray and bone scan.  At least that  is what I have found from reading about rcc. 

    In my case, ct, chest x-ray,

    In my case, ct, chest x-ray, blood work only! No bone scan.

    I'm in the Southeast US. 

    My Dx was T1b Grade 3 4.5 cm.  Still not a bad diagnosis all things considered. I'd have been happier with grade 2, but . . . C'est la vie. It is what it is and I'll do what is necessary.

    Pax!

    Michael

  • GSRon
    GSRon Member Posts: 1,303 Member
    #27
    jknorth said:

    Mets....not sure

    They said they did a catscan, blood test and checked lymph nodes, I don't remember any type of bone scan. The surgeon said they found no evidence of spreading, but I thought the T1A designation tells all that, thats why its a T1A classification. Guess I'll ask in Dec on my first checkup.

    Hi Don.. welcome to my (and

    Hi Don.. welcome to my (and some others) world.  You and I both had Renal Vein Invasion..  you don't want to hear this, but most likely mets are in your future..  I hope not.. but.. it is, what it is..  Nothing you can do about it overall.  But then a good renal / Cancer diet may be of help.. don't know for sure.  I really do not know why Renal Vein Invasion is not considered stage 4, the Cancer has al;ready spread outside of the one Kidney.  I guess that is because in some cases it does not come back. But to me, spreading is spreading.

    All that said.. there is so much that can be done now, that could not be done just a couple of years ago..  We just need to have hope and wait it out...

    Ron

  • TillieSOK
    TillieSOK Member Posts: 252
    #28
    DonMiller said:

    Texas-Wedge

    I have a few things I can't seem to get an answer on  and would appreacite your opinion.  I had a 11CM  T3A  grade 3 ( sinus fat and muscular renal vein invasion) clear cell tumor removed last October.  No one seems to know how long it was there, but even at grade 3 it had to take many years to get that large.  Why is it you are at such higher risk of a reoccurence in the first couple of years? 

     

    Don

    Hey, Don.  After reading my

    Hey, Don.  After reading my path report, I have the same stage T3a with a 6cm mass and a G2...we could be almost identical twins!!  (Except that I'm a girl and mine is CHRCC instead of CCRCC, but except for those little differences, we're 'zackly the same, right?). Mine had the renal vein invasion and the sinus fat thing also...which I thought it was rude to talk about my INSIDE fat, too.  How long do you figure mine had been there, fat and all?

    ps:  the spot on my liver, according to the last CT has almost doubled in size from the one in April, and appears to be a "complex cyst", which my surgeon also failed to mention, along with a very teensy spot on my left kidney midline.  Isn't this ride fun? NOT!

  • todd121
    todd121 Member Posts: 1,448 Member
    #29
    GSRon said:

    Hi Don.. welcome to my (and

    Hi Don.. welcome to my (and some others) world.  You and I both had Renal Vein Invasion..  you don't want to hear this, but most likely mets are in your future..  I hope not.. but.. it is, what it is..  Nothing you can do about it overall.  But then a good renal / Cancer diet may be of help.. don't know for sure.  I really do not know why Renal Vein Invasion is not considered stage 4, the Cancer has al;ready spread outside of the one Kidney.  I guess that is because in some cases it does not come back. But to me, spreading is spreading.

    All that said.. there is so much that can be done now, that could not be done just a couple of years ago..  We just need to have hope and wait it out...

    Ron

    Stage 3 versus Stage 4

    I suppose the difference is one or more tumors in other organs. I was Stage 3a. The tumor had invaded the veins, but microscopically. Now I thought the difference between 3a and 3b was whether the tumor had invaded the renal vein. Is that correct?

    My docs told me that I have a 40-50% chance of recurrence, whereas Stage 2 was more like 20-25%. Still makes me nervous when I say that.

    Does anybody know if that percentage drops if I don't have recurrence in the first 2 years? It must, otherwise why would they back off the observation after 2 years?

    In any case, I've stopped thinking about these percentages. They tell me nothing about what will happen to me.

    Todd

     

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    #30
    todd121 said:

    Stage 3 versus Stage 4

    I suppose the difference is one or more tumors in other organs. I was Stage 3a. The tumor had invaded the veins, but microscopically. Now I thought the difference between 3a and 3b was whether the tumor had invaded the renal vein. Is that correct?

    My docs told me that I have a 40-50% chance of recurrence, whereas Stage 2 was more like 20-25%. Still makes me nervous when I say that.

    Does anybody know if that percentage drops if I don't have recurrence in the first 2 years? It must, otherwise why would they back off the observation after 2 years?

    In any case, I've stopped thinking about these percentages. They tell me nothing about what will happen to me.

    Todd

     

    Statistics, prognosis and prognostication!

    I can't believe it's taken so long for the penny to drop for an intelligent man!  However, I'm yet to be convinced that you'll manage to stay away from those sorts of stats!  

    You're dead right when you say:

    "They tell me nothing about what will happen to me."

    I can make an observation, though - that you'll die of numeritis before you ever have the chance to die from cancer!  

    I feel I'm a part of the age of the Quantified Self and I'm always fascinated by numerical data.  However, the power of statistics is being constantly subverted and I commend to your attention this comparatively recent item from

    DataCrítica: International Journal of Critical Statistics, Vol 1, No 2 (2008)

     

    Numerosis and Numeritis: Twin Pathologies of Contemporary Statistics

     

    Karim F. Hirji

     

    Abstract


    Modern society suffers from two key afflictions: (i) the proliferation of quantification in all its facets (numerosis); and (ii) the production of volumes of dubious quality data, and widespread misuse and abuse of statistics (numeritis). Works that reflect on these afflictions generally portray a partial picture, have a built-in pro-corporate and pro-establishment bias, and do not account for the role of consumer culture, corporate power, and imperial nationalism in the entrenching them. By critically dissecting two books addressing these maladies, this essay seeks to promote an integrated, systemic perspective on the role and practice of statistics in society. While some critical analyses tend to foster a cynical view on numbers, this essay argues that humanity does need valid and relevant statistics to promote accountability, democracy, and social and economic justice. More than ever, people need to cultivate numerical literacy in order to combat the twin plagues of numerosis and numeritis.

     

  • GSRon
    GSRon Member Posts: 1,303 Member
    #31
    Texas_wedge said:

    Statistics, prognosis and prognostication!

    I can't believe it's taken so long for the penny to drop for an intelligent man!  However, I'm yet to be convinced that you'll manage to stay away from those sorts of stats!  

    You're dead right when you say:

    "They tell me nothing about what will happen to me."

    I can make an observation, though - that you'll die of numeritis before you ever have the chance to die from cancer!  

    I feel I'm a part of the age of the Quantified Self and I'm always fascinated by numerical data.  However, the power of statistics is being constantly subverted and I commend to your attention this comparatively recent item from

    DataCrítica: International Journal of Critical Statistics, Vol 1, No 2 (2008)

     

    Numerosis and Numeritis: Twin Pathologies of Contemporary Statistics

     

    Karim F. Hirji

     

    Abstract


    Modern society suffers from two key afflictions: (i) the proliferation of quantification in all its facets (numerosis); and (ii) the production of volumes of dubious quality data, and widespread misuse and abuse of statistics (numeritis). Works that reflect on these afflictions generally portray a partial picture, have a built-in pro-corporate and pro-establishment bias, and do not account for the role of consumer culture, corporate power, and imperial nationalism in the entrenching them. By critically dissecting two books addressing these maladies, this essay seeks to promote an integrated, systemic perspective on the role and practice of statistics in society. While some critical analyses tend to foster a cynical view on numbers, this essay argues that humanity does need valid and relevant statistics to promote accountability, democracy, and social and economic justice. More than ever, people need to cultivate numerical literacy in order to combat the twin plagues of numerosis and numeritis.

     

    Oh yes the statistics...  

    Oh yes the statistics...   those are just numbers... totally meaningless in the scheme of things... because the reality will be what is important... Even "IF" the odds were 99% against, if you are that 1% then the rest just don't mean crap...   In the end, a total waste of time... move on to something more meaningful in your life.  Yes life as in "living"...  we all have a lot of life left... go out and smell the roses.

    Ron

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    #32
    GSRon said:

    Oh yes the statistics...  

    Oh yes the statistics...   those are just numbers... totally meaningless in the scheme of things... because the reality will be what is important... Even "IF" the odds were 99% against, if you are that 1% then the rest just don't mean crap...   In the end, a total waste of time... move on to something more meaningful in your life.  Yes life as in "living"...  we all have a lot of life left... go out and smell the roses.

    Ron

    Vital and non-vital statistics

    A nice, succinct statement Ron.  With that philosophy, going into your current search for a soul-mate (and good lay!) , some lady is going to get very lucky soon, I'm sure.

    By the way, some of us don't have a lot of life left but that's all the more reason to go out and smell the roses!!   Yesterday morning I'd not been out of the door for days and when I did, after a drop of rain, the air in the garden was like wine. 

  • GSRon
    GSRon Member Posts: 1,303 Member
    #33
    Texas_wedge said:

    Vital and non-vital statistics

    A nice, succinct statement Ron.  With that philosophy, going into your current search for a soul-mate (and good lay!) , some lady is going to get very lucky soon, I'm sure.

    By the way, some of us don't have a lot of life left but that's all the more reason to go out and smell the roses!!   Yesterday morning I'd not been out of the door for days and when I did, after a drop of rain, the air in the garden was like wine. 

    Wedge Master...  thanks.. but

    Wedge Master...  thanks.. but I do think many of us go that route.. wanting to "know"  but in reality we don't know.   The numbers do not give us an exact date, or any date at all. 

    This reminds me of a story..  in the early 70's I met this guy.. He was in a wheel chair, yet he was able to drive and even ride a snowmobile.  He really wanted to be able to ride a motorcycle again.. a few of us built him a sidecar rig.. he then was riding with us.  But that is just the back ground..  One day I finally asked him about his legs.. or lack there of.  He smiled and even chuckled a bit as he told me his story.  He was in Nam, scared he was going to die..  and he slept with one eye open.  (I have heard a similar story from other Viet Nam Vets...)  But this guy came home without a scratch.. he chuckled again..  about 6 months later while crossing the street when a car ran the red light and took his legs out... Geeesh...  well then I asked how could he laugh..?   He said easy... when something bad happens you cad do three thingss...  cry woa is me.. laugh about it and move on, or shoot his brains out...  He chose to laugh and move on.   I will always remember him... an inspiration to me and many others..

    Another pal of mine in the early 80's.. a biker guy.. he retired from the Movie Industry, bult himself a nice log cabin and rode his bike to a lot of rallies.  I went with him a few times.. fun guy.   Then I heard about his accident.. on the way home from a rally about a mile from home, his bike crossed the cener line right into a big truck.. done..  I heard that the truck driver was pretty shook up,   An autopsy showed he had a heart attack and was likely gone before the truck hit him.. the truck driver was relieved...  Those of us that knew him smiled... he went riding his bike, likely all happy...  Another life lesson for me.

    So, it is possible that something other than K.C. will take me out... so me worrying about it won't fix anything..   That said, yes I have my moments..  I think we all do.   But I do try not to dwell on the ending.  Maybe I get too "preachy" and for that I do apologise.. 

    I hope we all have a lot of time left and enjoy life as much as possible...

    Ron

  • DonMiller
    DonMiller Member Posts: 109
    #34
    GSRon said:

    Wedge Master...  thanks.. but

    Wedge Master...  thanks.. but I do think many of us go that route.. wanting to "know"  but in reality we don't know.   The numbers do not give us an exact date, or any date at all. 

    This reminds me of a story..  in the early 70's I met this guy.. He was in a wheel chair, yet he was able to drive and even ride a snowmobile.  He really wanted to be able to ride a motorcycle again.. a few of us built him a sidecar rig.. he then was riding with us.  But that is just the back ground..  One day I finally asked him about his legs.. or lack there of.  He smiled and even chuckled a bit as he told me his story.  He was in Nam, scared he was going to die..  and he slept with one eye open.  (I have heard a similar story from other Viet Nam Vets...)  But this guy came home without a scratch.. he chuckled again..  about 6 months later while crossing the street when a car ran the red light and took his legs out... Geeesh...  well then I asked how could he laugh..?   He said easy... when something bad happens you cad do three thingss...  cry woa is me.. laugh about it and move on, or shoot his brains out...  He chose to laugh and move on.   I will always remember him... an inspiration to me and many others..

    Another pal of mine in the early 80's.. a biker guy.. he retired from the Movie Industry, bult himself a nice log cabin and rode his bike to a lot of rallies.  I went with him a few times.. fun guy.   Then I heard about his accident.. on the way home from a rally about a mile from home, his bike crossed the cener line right into a big truck.. done..  I heard that the truck driver was pretty shook up,   An autopsy showed he had a heart attack and was likely gone before the truck hit him.. the truck driver was relieved...  Those of us that knew him smiled... he went riding his bike, likely all happy...  Another life lesson for me.

    So, it is possible that something other than K.C. will take me out... so me worrying about it won't fix anything..   That said, yes I have my moments..  I think we all do.   But I do try not to dwell on the ending.  Maybe I get too "preachy" and for that I do apologise.. 

    I hope we all have a lot of time left and enjoy life as much as possible...

    Ron

    Thank you to Texas-Wedge and Ron

    Thank you Texas.  I didn’t intend to put you on the spot and I know it’s complicated presently unanswerable question.   From reading the Board I have come to respect your opinion.  I know I must have some sort of hole in my immune system.  Although I never took particularly good care of myself, I never get sick.  Never missed even a day of work.  I think this gave me a false sense of security over the years.

     

    Ron  Its ok I know what my future likely holds.  About a week after my surgery I met with my Urologist and he was arrogantly, almost smugly telling my wife and I how he “got it all” and I would only need scans as a precaution.  My wife was so excited and happy.  In the meantime I am reading the Pathology Report.  Now I don’t know crap about medicine, but I am a lawyer and I have had more **** tossed my way for 32 years than I can ever remember.  Why do these guys repeatedly say this to people?   The next Urologist who tells a patient “I got it all” really needs to get his **** kicked.

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    #35
    DonMiller said:

    Thank you to Texas-Wedge and Ron

    Thank you Texas.  I didn’t intend to put you on the spot and I know it’s complicated presently unanswerable question.   From reading the Board I have come to respect your opinion.  I know I must have some sort of hole in my immune system.  Although I never took particularly good care of myself, I never get sick.  Never missed even a day of work.  I think this gave me a false sense of security over the years.

     

    Ron  Its ok I know what my future likely holds.  About a week after my surgery I met with my Urologist and he was arrogantly, almost smugly telling my wife and I how he “got it all” and I would only need scans as a precaution.  My wife was so excited and happy.  In the meantime I am reading the Pathology Report.  Now I don’t know crap about medicine, but I am a lawyer and I have had more **** tossed my way for 32 years than I can ever remember.  Why do these guys repeatedly say this to people?   The next Urologist who tells a patient “I got it all” really needs to get his **** kicked.

    Attempted explanation

    Don, sometimes we feel confident we're making good sense, but other times not.  I hope my effort to answer your question about the changing probability of recurrence after the first year or two did make some sort of sense but please tell me, lawyer to lawyer (and no BS) did it help you to understand any better? 

  • GSRon
    GSRon Member Posts: 1,303 Member
    #36
    Texas_wedge said:

    Attempted explanation

    Don, sometimes we feel confident we're making good sense, but other times not.  I hope my effort to answer your question about the changing probability of recurrence after the first year or two did make some sort of sense but please tell me, lawyer to lawyer (and no BS) did it help you to understand any better? 

    complicated

    Hi Don.. I tend to think it is a tad more complicated..  Doctors are trained to heal people.. People want to hear they are healed.  Plus no matter what the outward personality of a doctor is..  I think it must wear on them to see patients die and nothing they can do about it...   I may be an odd duck, but I sympathize for the doctors.  They go through it daily and it must affect them in some way.  On the other hand the truth can be more painful..  I really can not say what is right or wrong.  Even though my Doctor gave a reasonable presentation, I was in denial.  That denial lasted almost a year when i found out about my Mets.   For me, it would not of been such a good year had I really known.  However we all are different..

    Ron

  • TillieSOK
    TillieSOK Member Posts: 252
    #37
    DonMiller said:

    Thank you to Texas-Wedge and Ron

    Thank you Texas.  I didn’t intend to put you on the spot and I know it’s complicated presently unanswerable question.   From reading the Board I have come to respect your opinion.  I know I must have some sort of hole in my immune system.  Although I never took particularly good care of myself, I never get sick.  Never missed even a day of work.  I think this gave me a false sense of security over the years.

     

    Ron  Its ok I know what my future likely holds.  About a week after my surgery I met with my Urologist and he was arrogantly, almost smugly telling my wife and I how he “got it all” and I would only need scans as a precaution.  My wife was so excited and happy.  In the meantime I am reading the Pathology Report.  Now I don’t know crap about medicine, but I am a lawyer and I have had more **** tossed my way for 32 years than I can ever remember.  Why do these guys repeatedly say this to people?   The next Urologist who tells a patient “I got it all” really needs to get his **** kicked.

    That sounds exactly like what

    Don,

    That sounds exactly like what happened with my urologist/surgeon and how I felt when I finally got a copy of my path report and my last CT scans.  Made me wonder if he read the same reports I was reading!  I'm with you on kicking some butt the next time he tells me " no worries, I got it all, and you are cured!" I call major BS on that!

  • DonMiller
    DonMiller Member Posts: 109
    #38
    TillieSOK said:

    That sounds exactly like what

    Don,

    That sounds exactly like what happened with my urologist/surgeon and how I felt when I finally got a copy of my path report and my last CT scans.  Made me wonder if he read the same reports I was reading!  I'm with you on kicking some butt the next time he tells me " no worries, I got it all, and you are cured!" I call major BS on that!

    As I think about this.

    As I think about this, I think I have developed different opinions of Doctors and Surgeons.  My surgeons were certainly experienced and skilled….but almost like the skill of a  video game player or something.  I have extremely limited experience but the three surgeons I have dealt with had almost comic delusions of grandeur.   On the other hand I respect and appreciate my oncologist and he seems thoughtful knowledgeable and pretty caring. My internist is just a great guy.

  • todd121
    todd121 Member Posts: 1,448 Member
    #39
    Texas_wedge said:

    Statistics, prognosis and prognostication!

    I can't believe it's taken so long for the penny to drop for an intelligent man!  However, I'm yet to be convinced that you'll manage to stay away from those sorts of stats!  

    You're dead right when you say:

    "They tell me nothing about what will happen to me."

    I can make an observation, though - that you'll die of numeritis before you ever have the chance to die from cancer!  

    I feel I'm a part of the age of the Quantified Self and I'm always fascinated by numerical data.  However, the power of statistics is being constantly subverted and I commend to your attention this comparatively recent item from

    DataCrítica: International Journal of Critical Statistics, Vol 1, No 2 (2008)

     

    Numerosis and Numeritis: Twin Pathologies of Contemporary Statistics

     

    Karim F. Hirji

     

    Abstract


    Modern society suffers from two key afflictions: (i) the proliferation of quantification in all its facets (numerosis); and (ii) the production of volumes of dubious quality data, and widespread misuse and abuse of statistics (numeritis). Works that reflect on these afflictions generally portray a partial picture, have a built-in pro-corporate and pro-establishment bias, and do not account for the role of consumer culture, corporate power, and imperial nationalism in the entrenching them. By critically dissecting two books addressing these maladies, this essay seeks to promote an integrated, systemic perspective on the role and practice of statistics in society. While some critical analyses tend to foster a cynical view on numbers, this essay argues that humanity does need valid and relevant statistics to promote accountability, democracy, and social and economic justice. More than ever, people need to cultivate numerical literacy in order to combat the twin plagues of numerosis and numeritis.

     

    Excellent Paragraph

    During my 20+ years in engineeing, I've seen accounts of management make some interesting cases for changing things and both were made using numbers in just this way.

    I'll discuss the first situation. When I started, each group of 4-5 engineers had an administrative assistant who made copies for us, typed documents, and did a number of other miscellaneous tasks. This was very helpful and let us concentrate on doing engineering. Sometime in the mid-90's management started making a case for getting rid of these people to save money. Today we have 2 administrive assistants for about 150 employees in our locaion. So today, I spend a good part of my time making my own copies, typing up and correcting my own documents, and doing other things I used to get help with. The company appears to have saved money by getting rid of those people, but, in fact, now they are paying someone about 3 times what they were paying before to get the same things done. (Similarly, we've had reductions in technicians, which means I as a software engineer am doing my own soldering- this is a really bad idea. I can do it, but I'm just not very good at it and when I'm doing it, I'm not doing software, which is what I'm good at.)

    The seond big trend I've witnessed was the outsourcing of engineering to India and China. A similar case was made using numbers to analyze salaries and accounting to explain how massive amounts of money would be saved. The things that couldn't be represented in numbers was pushed to the side (time zone differences, language and culture differences, etc.) and the decision was made to do this. Perhaps the jury is still out on whether this has been successful, but I never thought it was going to be successful. At least not the situation where managers and systems architects/engineers are in one country, while the "workers" implementing the code and building the circuit boards are in another. This is actually a complicated subject and probably needs to be broken down further into what has worked and what hasn't worked...

    Predicting the future in complicated systems is really a difficult thing to do.

    Todd

  • TillieSOK
    TillieSOK Member Posts: 252
    #40
    DonMiller said:

    As I think about this.

    As I think about this, I think I have developed different opinions of Doctors and Surgeons.  My surgeons were certainly experienced and skilled….but almost like the skill of a  video game player or something.  I have extremely limited experience but the three surgeons I have dealt with had almost comic delusions of grandeur.   On the other hand I respect and appreciate my oncologist and he seems thoughtful knowledgeable and pretty caring. My internist is just a great guy.

    My surgeon is one of the top

    My surgeon is one of the top surgeons around, specializing in daVinci and hand assisted robotic surgery.  Technically, the surgery he performed was perfect...I have no complaints on the surgery.  What I am complaining about is his almost blasé attitude and the fact that either he didn't read the path report OR the last CT report...or he didn't have enough respect for my intelligence or fortitude to tell me what was on the reports.  I had to get the reports from my family physician's office!  I think we all deserve to be told the truth so that we can make intelligent, informed decisions about our lives and futures.

    my surgeon said that all I would need was a chest X-ray after 6 months to make sure my lungs were ok.  I would never have gotten a CT scan post surgery if the oncologist my family dr sent me to hadn't written to the surgeon and told him I needed scans every three months for  the first year....

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    #41
    TillieSOK said:

    My surgeon is one of the top

    My surgeon is one of the top surgeons around, specializing in daVinci and hand assisted robotic surgery.  Technically, the surgery he performed was perfect...I have no complaints on the surgery.  What I am complaining about is his almost blasé attitude and the fact that either he didn't read the path report OR the last CT report...or he didn't have enough respect for my intelligence or fortitude to tell me what was on the reports.  I had to get the reports from my family physician's office!  I think we all deserve to be told the truth so that we can make intelligent, informed decisions about our lives and futures.

    my surgeon said that all I would need was a chest X-ray after 6 months to make sure my lungs were ok.  I would never have gotten a CT scan post surgery if the oncologist my family dr sent me to hadn't written to the surgeon and told him I needed scans every three months for  the first year....

    My surgeon is one of the top

    Doesn't it make you feel sorry for so many patients who don't have the articulacy or knowledge to stand up to the medics, challenge statements and fight their own corner?  Even highly intelligent patients can be gulled into false security by cavalier or blasé statements - you really do have to be a bit street-wise to appreciate how the system works - and where, at times, it doesn't do a good job.

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