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Advice for an IR professional from a patient's perspective | A Patient's Perspective: From the Other Side of the Glass
Advice for an IR professional from a patient's perspective | A Patient's Perspective: From the Other Side of the Glass
anxietychaptercomplicationsdoctoreducateelevatedextenderfeellookedmonthsmoodpatientpatientspneumoniascan
Understanding what helps a patient feel comfortable - Anesthesia options | A Patient's Perspective: From the Other Side of the Glass
Understanding what helps a patient feel comfortable - Anesthesia options | A Patient's Perspective: From the Other Side of the Glass
anesthesiabiopsieschemocomfortablelabslidocainemarrowpatientpatientsprocedurescansedation
Supplements and over the counter medication and cancer | A Patient's Perspective: From the Other Side of the Glass
Supplements and over the counter medication and cancer | A Patient's Perspective: From the Other Side of the Glass
aspirinbreast cancercancercancerschapterdecreaseendometrial cancerfailureibuprofeninternetliverliver cancerpancreatic cancerpillsupplementstherapytraditionalwebsite
Exercise is the new chemotherapy | A Patient's Perspective: From the Other Side of the Glass
Exercise is the new chemotherapy | A Patient's Perspective: From the Other Side of the Glass
breastbreast cancercancerchaptercolon cancercomplicationsdecreaseddecreasesdepressiondiseaseexercisefatiguefeelmortalitypatientsrecurrencetreadmill
What supplements do you take? Cancer and liver failure | A Patient's Perspective: From the Other Side of the Glass
What supplements do you take? Cancer and liver failure | A Patient's Perspective: From the Other Side of the Glass
chaptercombocysteineliverliver failureliver toxicityneuropathyneuropothyorleanssupplementstoxicity
Transcript

so a couple a couple of ground rules first of all I'm a fish out of water I'm not your stereotypical position and I always say that uh that that's how I ended up in New Orleans because you can get lost in New Orleans if you're crazy and I said I didn't get I didn't go to

that course where they inserted this stick in your rectum in medical school so I am not politically correct okay and I don't know if any of you know the Jimmy Valvano story but um you know he got up there in front of everybody and

said I got a hundred and fifty holes in my bone so I want to see a little red light blinking what are you gonna do to me and well I'm similar to that if I'm not politically correct and you're offended I would please leave now

because there's nothing you can do to me because I'm on my way out anyway so it doesn't matter but and it's really funny that I just walked in when Vicki marks was talking and I think I'm a product of the early days of interventional because

we would do cases for eight hours and get eight hours of flora back to back it was that when we learned in tips when we were learning and after you read oral and we just take our badge and throw it and and I swear that that's the reason

why I ended up with myeloma anyway so some of this stuff I'm going to talk about I always like to insert humor so it does so it's not morbid and there are slides sometimes I'm you know being Italian I'm

kind of a wuss I cry at raindrops and and some sometimes I cannot get through the slide because it brings back kind of kind of crummy memories but anyway so I entitled this from the other side of the glass and I actually Photoshop that's me

looking at me getting treated in CT so I

come from a humble Italian family if you guys notice that's the Sopranos in the background most of my family died from acute lead poisoning this is so one day I'm riding around having a good time

it's a beautiful flora today that turned dark real quickly I I was doing a CT procedure and I had had pain for a long time and getting older I thought you know it's just I'm working out it's just this pain and they took a CT scan and

this is what they saw at no c4 vertebrae so everybody runs in the room lay down on the ground ball ball you're gonna piss yourself all this kind of crap and and I turn on my turn white and my wife was actually the nurse and it was pretty

scary there for a while but this is what happens you have to hear this you have cancer I don't know if anybody in the room is has heard this but it's pretty it's a pretty lousy statement to hear and I went from James Caridi now a

medical record what you see their date and an insurance United Healthcare so you go from a human being to basically a number this was me before I'd like to be the prankster in the group and then you know a couple of days after the

diagnosis this is what I look like for a long time and so I call it from the other side of the glass now I'm looking in on people and I'm and I've had a lot of experience being a patient and this is my patient

resume I was supposed to be dead about four years ago and you can see I can I can read off a whole bunch of these but I've had liver failure for two years which is really hell in New Orleans okay when everybody when you go to angio

Clubman is 49 drunks and you and but I but other things you know and I I've had a sub massive PE that I was supposed to die from I've had five episodes of sepsis I was supposed to die from so it goes on and on and on and here's my

non-political joke okay so um so I had five skin cancers because the drugs you're on are actually worse than the disease and sometimes and so of immunosuppressed you get you get you get other cancers so they had to take my

eyelid off and I joke that they they reconstructed it with my foreskin and you you can see that some of these things here are really horrible to have but the worst thing to have is to be a radiologist and be cockeyed you know so

there's some good things about having cancer and it's you know you can get free good parking you park close and then you know everybody feels sorry for you to come up and they visit you and it's really nice to have a couple of

nice-looking women come up and say hey how you feeling oh I'm really sick you know and then but I'll give you my experience okay and this is both for patients and doctors and and and and extenders and

it's really important and something I learned if you're a patient or if you're

an extender you don't want to dabble you want to know what you're doing and you want to do it well I had the experience with a cancer group that raises money

for cancer to go to the Oscars and I and I lived with them for five days and they all had cancer and I was like candy and a candy shop they kept asking me questions and stuff but we have gurus who get up and talk about like why 90

drug-eluting beads and those guys do do it every day and they do several every day and they're excellent at it and they have great results but these pay these people that are with went to community hospitals where they did one or two a

month and each one of them had a complication and you need to seek out who the people are who do this on a regular basis and if you and if you're the one who's delivering the care and you're not doing it enough you shouldn't

be doing it so I always this is another one never be afraid to get a second opinion and if you look here and it says no offense but I'm gonna seek a third opinion or even a third opinion and I

did that you know you go around because and people talk to call me and ask me and it's amazing how different doctors feel about about how to treat somebody and you really got to get the one that is tailored to you not one of the things

I teach my residents and fellows is you don't shotgun you don't cook book everything you do is tailor to the patient the first contact I learned real

quickly when I get to the infusion room that if I didn't matter what mood I was

in if I was in a good mood or a bad mood but when that extender comes up to you and they say I'm having the crappiest day in my life we had to do this we had to do that and you immediately get you're already in kind of a lousy mood

and then it just takes you right down and you when they when you see an extender they should look like this how are you today how how day going it's going to be fine we're gonna happen and all of a sudden the

patients spirits are elevated and when the patient's spirits are elevated they have less anxiety less anxiety less complications and they can get through the day a lot better call the patient by their name you know we go in the room

and we go miss mr. but if you tell the patient you call him by their name they feel important they feel like you've looked up their labs they've looked at the if you looked at their chart now I'm a radiologist right so my doctor left to

go on some so I had a another doctor come in and this is when I had fungal pneumonia so I'm sitting there and I'm shaking and this guy sits on my bed his physician and he goes I just want to tell you we looked at your cat scan

which I had already seen because I was in I got the cat scan and I looked at it first because it has white blotches on it and we call that pneumonia and I and I I wanted to use this Chevy Chase line ru EFT in the head I'm the chairman of

radiology you know so how does that make you feel if you're a patient when you walk in and they've done it and they don't know your name you know so call patients by their name they like it okay I contact it's gone I take my son as

juvenile rheumatoid arthritis the pediatrician doesn't even look at him all he's looking at is the computer and it's horrible I say that that the eye is the is a portal to the soul you can my mother

being Italian you got to look somebody in the eye you can read them you have to look the patients in the eye they feel so much better this guy and so this is what we typically see nowadays because everything is on the computer this

gentleman and this is just a joke while your cholesterol is really worried me and she goes well you want to turn around and look at the patient you know you have to they don't do that anymore and it really is a shame and you got to

try to look at the patient so they feel better about it this this gentleman actually has a website that he put up because he couldn't stand the fact that every doctor he went to never looked them in the eye and he said I feel like

screaming hey doc I'm over here but some doctors don't look him in the eye you really need to do that to make the patient feel at ease I mean these patients go in there feeling horrible already whatever you

can do to make their day better this is one of them compassion this costs nothing I put in all the lines for like I'll get through this later no no procedure is a mundane quick procedure that you know should be relegated to

somebody else just because Oh everybody doesn't and the compassion costs nothing I'm put in for rhesus lines I put in the dialysis catheters and when I put in the freest lines for people who have what I have

and similar things I bend over I give them a kiss they all love it they feel good and it costs nothing and it makes their day they smile some of them cry and it's really nice to do and it doesn't doesn't take any effort

whatsoever but it can make the patient's day communication when I when I went to see my doctor I brought my son and my wife and you're when you hear you have cancer you're like a deer in the headlights you know you look you look

like this maybe you don't look like this you look like this and you know people say a picture's worth a thousand words but I turn that around when somebody says you have cancer a word can be a thousand images you get brain fog you

well they're talking you're saying how long am I gonna live what about my kid how much pain am i gonna go through what are the drugs I'm on you're not listening I got home from from my meeting with the doc and I know all

about this stuff right and I sat down I go what did what did he say so you can only imagine an average patient going in there and hearing this when they get home they have no clue what you said to them none so I always encourage

participation have somebody with the patient so that they can relate when you get home and and and inform them of what the doctor said or what the nurse said and then educate them you educate the patient as to what's going to happen

anytime you can lessen their anxiety you can lessen the complications and you can make them feel at ease and I stole this but don't lose your sense tomber okay I like that we there's a there's a whole line of cancer-related

jokes and and I believe that humor is the anesthesia for the soul the best one I've heard was nurse came in to me and said you really got it you called mr. X and he said he hasn't peed in three days and I go he hasn't peed in three days I

wasn't even near that button I got all nervous and I called the guy and I said I said mr. Smith they said you haven't paid in three days and said all the instructions you gave me said I can't lift anything over ten

pounds so so don't lose your sense of tumour okay and here's one that really rankles me we as interventionalist we don't tell people you have three months you have six months you have nine months the oncologists love to do that you

can't take away somebody's hope I started out in pediatrics and I worked with a pediatric icon an older guy from the sticks who was great and he said if you label somebody they grow into the label you tell somebody they have six

months they're gonna live six months you never give you never take away their hope well I was I was give you know quasi given three years I'm on year seven and and if I had if I had given up at three years I would have lost a lot

of interesting things over the last four years you know so you never give up hope so I put this slide in to emphasize that this guy married Beyonce so you and then

this this is another one that really gets me okay exam day I lived through

this and I see a lot of other people ice my wife can pick up that I'm going from my labs or a scan a week ahead of time because my whole mood changes because that scan or those labs can change your whole life I'm going I'm actually going

through that right now I they screwed up I mean I'm I'm chief right and chairman I don't look to be VIP and everything but I can't tell you how many times things get screwed up my labs got screwed up I have to wait another

to find out if I have to go for more chemo and more this but those people are hanging on that at least a week ahead of time and we call it scan tissa patient scans ID and then they get there and somebody says all the glucose is low oh

the platelets of this oh this we're just gonna cancel you do you know what that does to a patient now they go home for another week at least and they're still anxious and then they gotta wait for the labs you're talking about a month of

anxiety nobody needs to go through that that's torture you know so if you can do the patient I don't care if it's at the end of the day or you have to do something fancy don't cancel the patient it's the worst thing you can do make

sure they're comfortable yeah you guys know this we throw them on the table they're exposed to the world when they when I had I'm when I had my PE they put me on the table I go I said you know JC this is freezing cold how did we get fat

people on this table you know and I was bitching and moaning until they knocked me out but it's like it's hot it's horrible it's it's really horrible what we do and just try to make the patient comfortable cover them make it discreet

try to warm up the gel all those things really count and in local anesthesia this says I thought I told you three times if the novocaine had taken effect the one thing I see residents and fellows not do is use enough lidocaine

they take a cc of lidocaine they put it in an end of patients like lidocaine is not liquid gold it's cheap and it really works I've had three bone marrow biopsies two of them they gave me sedation the one they

didn't give me sedation the guy used only lidocaine and that's now that's how I do my bone marrow biopsies numbed up the periosteum I felt nothing so use lidocaine liberally don't be afraid to use too much and it really it really

makes it if you can start off and the patient is not in pain he's very comfortable and the rest of the procedure is good again you start off with pain anxiety more complications make sure you sedate the patient

appropriately and I use social anesthesia would I go in there like you like my lectures when I go do a procedure I joke with the patient I say to the patients I tell I tried to tell him jokes I'm gonna I'm gonna curse here

but one of my patients said to me said doc just don't say uh-oh I say I never say uh-oh I say oh shit you know so you don't have to but but they laugh and in fact I had one time I was singing and the patient threw up and I said what was

that from the versed and the patient said no it's your singing so but you you can really distract the patient when you go in there and you talk to me how many children do you have that where you're from and they they're not focusing on

what you're doing and the procedure goes much more much more easily and this is

what I was alluding to before no procedures a slam dunk a breeze a piece of cake or a snap you know you you can't you can't take for granted what you're

doing even though like like oh it's just another g-tube oh it's just another line I'm I'm chairman of the department I'm the chief of her interventional and I do I do the lines because widely in the audience no well one of you want to be

people Wylie I had him put my line in and he's because he was the best two days later it got infected so no no it happens you know it just happens you can't take all this stuff for granted my oncologist sister had dialysis and they

were removing a Quinton and she got an air embolus and died of 32 it was it's like you can't take this stuff for granted every procedure you think it's just a routine procedure but it's to a patient who it's their lifeline or it's

their it's it's the most important thing to them so you can't take any procedure lightly because any procedure can go wrong and then side-effects if sometimes it's not the tumor that gets you it's the it's the it's the side effects like

the massive PE that I had was from one of the drugs I was on so you have to at least alert the patient that they may have side effects and and here's another one of my things to make you laugh but I had my bone marrow transplant

and I thought my side effect was that my flatus didn't smell anymore and I was informed by the people in the room that it wasn't the flatus it was my nose that didn't smell anymore but I got to do all the UM I got I get to do all

the abscesses now because I have I lost my sense of smell right in fact this was an appendiceal abscess and it really everybody left the room but me because I was the only one who couldn't smell it and I got out there and we do in CT and

I asked the tech I said what the hell does the appendix do anyway and she said oh it hangs there and does nothing I said well after my bone marrow biopsy I have two of those now so waiting for

results they'd actually did a study and

they said that most patients want to hear results in the study it said two and a half days but figure three days but what happens a lot of times this goes to this room then it goes to another doctor goes to Nutt and you talk

about that scan xiety now you wait in a week it's not fair to the patient you know you really have to get and let the patient know as soon as you can haven't let the patients know about follow-up you know so that they're aware of what's

coming and then this is another one there are some days like I have I feel like my grandfather I have a row of pills you know that I every Sunday I put all this crap out there and I look at it and then you have this over here and not

over there and some days I just want to take a bat and just hit it because it just gets frustrating but you want to when patients are sick the last thing we want to do is be reminded that they're sick okay so the if you can minimize the

tubes if you can make the tubes more you know flatter or more conducive or whatever you can do to not so that they don't wake up and go oh I got it and it just reminds them that they're sick and they don't and and it makes things worse

so it's like if you haven't have a g-tube and you can do this and so they're not reminded it really helps

then supplements I often get the question about supplements and what that my take on the supplements is that um if

it's if it doesn't detract from traditional therapy what the hell why not right I take one pill it's 21 days one chemotherapy pill it's 28 000 bucks so if I buy supplements for 20 bucks a

month big deal right in fact I was in liver failure for two years got three biopsies get all this all the stuff done they couldn't get me out of liver failure and I read some stuff on supplements and I take these 3

supplements my livers been normal since so you can't convince me that they don't work so as long as it doesn't take away from traditional therapy you can go ahead and do it I have a website on our website I have a Facebook page and I

scan the internet every morning and put up put up articles that relate to cancer all cancers you know and screening what's new you know different drugs and lately aspirin ibuprofen caffeine and even even CBDs have been shown to be

effective in certain in certain cancers and we have to keep our eye on that ibuprofen and aspirin actually have been shown to decrease in Demetrio cancer liver cancer caffeine there was a 50% decrease in liver cancer and those

patients who drank a lot of caffeine it also is supposed to be helpful in preventing pancreatic and Demetrio and breast cancer so you just have to keep your eye on this but this is this is my

soapbox and I could do a whole lecture

on this I call it the new chemotherapy it's exercising when I go when I go through these articles during the during the week the two things that you you really have to do is maintain normal weight and exercise and then when we say

exercise I'm not talking like to be Adonis but if you do 20 minutes a day or 20 minutes three or four times a week they have shown that the mortality for breast cancer and the recurrence of breast cancer is decreased up to 50% the

mortality for colon cancer decreased 50% and people who did minimal amount of exercise several times a week it's I don't know what it is that that causes that I don't know if it's if it's a

psychological thing but it has been shown to be effective and then here's here's some of the things that you that I wrote down about exercise first of all when I even when I feel the crappiest if I get up in exercise it increases the

endorphins and you feel better about yourself this less depression it strengthens your bones you feel better physically you look better when people come up to you like last night when I was at the UM at the Galen people come

up and go hey you look pretty good that makes you feel like a million bucks knowing that you're sick and somebody says you feel good you know but also the it decreases fatigue and mortality but one of the things it does do I have a

lot of friends my age who who don't exercise had they had that PE or some of the complications I had they'd be dead so prepares you for the complications not of the disease necessarily but of the of the that the treatment for the

disease because the treatment for the disease is a lot of times worse than the disease itself so I'm when I'm doing the lines and or biopsies or whatever I'm doing on on the patients I always tell my said don't go home because they just

got the diagnosis I said don't go home and lay in bed you're gonna die go home exercise even if you happen even if you crawl out of bed crawl out of bed get on that you know an ellipsis eyes or you know you know a treadmill just do

something and the other thing it's good for is cancer related fatigue cancer related fatigue is horrible they don't know if it's related to the cancer they don't know if it's related to the drugs they don't know if it's related to the

depression but people are tired some days I just I'm dragging and you and if you exercise and and doesn't take a lot you can decrease by that by seventy to a hundred percent and when we were treating patients for liver cancer and

put them on Sarandon one of the things is is very fatigued causing and we would get the patients up and they would feel so much better that just to do just to be on a treadmill and get out of and and get going so it's really important to

stress exercise and this is just some facts that I put in there about how exercise on prospective studies has actually decreased mortality the Cree's cancer related fatigue and decreases recurrence I encourage

patients to live the snapshot with that my son named that because this was me on the way of New Orleans for my daughter's wedding and and you know I look like Oh looked at this guys having a great time going

to the bathroom Mississippi you know but four days later four days later I almost died from from from fungal pneumonia and and then this is another one these women here this is when we went to the Oscars and this is a snapshot seven of those

women died within the next year there's a lot of hurdles and your patients will tell you about hurdles you know like oh and they come up you know repetitively the other day I woke up with a knee effusion where it came from I had no

idea but you have to talk to the patient and tell him not to throw in the towel and then I had a cousin who's female but she was she was rough around the edges than I am she and she said she she used a few expletives and when I called her

up one time I said I'm tired of that jump and the hurdles and she said you don't have to jump the hurdles you can go under him and and that's what you have to tell your patient you know the hurdles come up but you get over it and

you can keep living and then I stole this from Jimmy Valvano you tell you patients you got to have a Jimmy Valvano day you got to laugh you got to think and you got to cry and I always had you have to dream and you

have to pay it forward and I'm I'm into the growing up Italian in New York I'm one of my idols is rocking although it's sophomoric a lot of the stuff he said relates to cancer and it's a greatest glory is not in falling but it's rising

every time we fall and tell you patients at the you know yeah it's one step one punch one round at a time and going in one more round when you don't think you can do it that's what makes a difference in your life and you can win and you can

change you the people in this room have the ability to have this appearance you have cancer if you treat your patients right and push them in to this these are the same people and this is the snapshot I've

been looking good after you take care of me and it's not how hard you hit but it's how hard you can get get back up and keep moving forward how you can take take it and keep moving forward that's how winning is done

and thank you for the opportunity to share just remember every champion was once a contender that refused to give up thank you

are there any questions for dr. Corey D just don't run to the sa sa RA BR and

say this guy was just so politically incorrect I missed the last part of that they won't use more than one or two cc's of white okay that's crazy how do you tell your pas why you just

ask him ask him what ask him why they were only using one or two cc's well I I was with an interventionist yesterday yeah I'm not you say day before yesterday and we were talking about how he's an old guy like me and we used a

lot of lidocaine and I said when I do my bone marrows I use 10 cc's he says I use 20 you know it's it's not going to hurt them you know and it just makes it you you know how it is it makes it so nice when the patient's laying there and

they're not feeling anything and you know what's gonna wear off over time and to have them comfortable talking to you and it's no anxiety it's it's right now the the fellows and residents they think that it's almost like they give a couple

of drops you know and and the patients are like it's just not fair that's why that's my practice well their practice is wrong I mean I don't if you have an attending and you some of the attendees I like that to know sometime well one

time I do get in a little bit of a I do get in a little bit of an argument is a nurses don't want me to put the lidocaine in until they until they give the meds but it's like well I'm giving numbing medicine you know it's like I

don't I don't I don't really want to wait and I get lidocaine all the time and it's yeah it burns but it doesn't burn from very long but one or two cc's does nothing there's a microphone too if

you want to see

because I know that we have the same problem in our practice they're always worried about the lidocaine toxicity I have one doctor who numbs up really really well and uses like the 2% and and then there's another doctor who will

like use 1% and very little so it's it's really well you can ask him where I asked them where the lidocaine toxicity problem is coming from I know it's in those guidelines from from the standards it comes from those books but I'm

wondering if there's like a a different kind of lidocaine that you can give more because I read up on that light Oh with epi you can actually get more but then you risk the tachycardia and stuff so yeah I use i don't use epi and i use one

percent lidocaine and it seems to work fine how can i use plenty of it especially like for ports you know i'm digging around in the boy nobody likes to have their chest dug around and you know so i I numb it twice i number two

start get access an annulment again you know and having a patient lay there and talk to you is so much nice and it happens squirm and complaining you know the only time I hey lieutenant I got really angry because some of these

patients you give him lidocaine they scream and want to come off the table and this was this giant guy and and I couldn't take it anymore because every time I touch him with lidocaine you scream that I

said to my go I said how did you get those tattoos on your eyelids you know and he said oxycodone yes yeah we I've

gone through that phase a couple of times and then all of a sudden they're not giving it anymore

and then I have to remind the nurses to police put the bicarb in there and then they then they stop doing it I don't really know I tried it on myself I didn't feel much difference yeah if I recommend you do it you know anything

you can do to make somebody feel better I recommend even if it's you know it's 50% of the people you know

thistle NS until cysteine and turmeric I take a ton of tumeric

I'm not I'm not advocating that so if anybody goes in home and has an allergic reaction to American dies it's not my fault but ya know it was it was frustrating as hell I'm you know I my labs were worse than the patient's I had

25 000 platelets and I was just getting frustrated and you know especially living in New Orleans because really in New Orleans you know everything no matter what you start drinking at seven o'clock in the morning you know and and

I am so I sat down and I've read a bunch of articles and I started doing it and it worked for me and it worked right away I mean within two months and everybody was saying oh it's just coincidence I said well then give me

more coincidence but then my son has JRA and he was on methotrexate his liver enzyme started going up we started him on the same regimen bump then went right down so I mean if it works for you it works for you you know an asset feels

cysteine it's it's you have to what's that an acid cysteine it's what they use for liver toxicity when somebody comes in with Tylenol toxicity so I actually worked with a with a met a medical doctor and we came up with the combo and

and it's worked for me but you know turmeric works for for for some people it doesn't work for other people you know a but but well the bottom line is if somebody thinks it's working don't you know I have I have people say

doctors go well that's just crap well I'm very lucky because the medicine Amman causes neuropathy which is horrible you know I don't know if anybody's had neuropathy but it's so it's like your hands are your hands are

in pain your toes are in pain so I like I'm beefed up on B vitamins you know and I and I hear all the other people complaining about neuropathy and I'm fortunate that I don't have it and if it's the b-vitamins great if it's

if I'm just lucky I don't care but I'm taking the B vitamins for eight bucks a month you know what I mean you know it's it's different supplements work for different people you know but just don't deprive them

don't there's some guys who just use supplements oh that's just crap you know that's not fair to the patient you you mentioned it

will you talk about your website that you have no it's not really isn't it no

no I just what I do is and you know it's like I said you try to pay it forward give back so every morning I just scan the Internet and I put articles that may be of interest like you know it could be about skin cancer it could be about

colon cancer I can tell you that I don't know if you're aware of this but a lot of the cancers are going down right the incidence for the Millennials I'm talking people who were twenty and thirty years old because they're on

their phones a lot of them are obese the incidence of colon cancer has jumped up 25% in those people these are 30 year olds with a kid or two kids will get an advanced colon cancer and so those are the kind of things I put up there you

know and then if a drug is taken off the market and this new thing about roundup you know I put that so you can just go to it's called one I am club and it's on Facebook and it just has when I got sick the thing that and nothing against

breast cancer but breast cancers like sucked up all the old marketing you know and there's so I have a logo that includes 28 ribbons because there's 27 other cancers that have a ribbon that don't get as much play so it was like I

wanted so the website address and not the website but the Facebook page addresses all cancers because you know there's childhood cancer that like this was colon cancer month last month was cervical cancer month and so whatever I

can put on there I do some of the articles are I try to scan the articles I guess it's censoring but because I don't want BS on there either you know because there's the thing that Frost's me I gotta have to tell you is when like

what's named from jeopardy when a star gets cancer all of a sudden the Internet is like Oh Tribeca cancer Trebek got cancer proud and and and it just sickens me because

how many people have cancer who are not Trebek pancreatic cancer right you know and then I'll get like one stars mother gets cancer and there's eight articles on that it's like they forget about the people who were out in the public you

know and and so I try to just put that up there so just for educational purposes that's all what it's one I think it's one spelled out I am and it would it what I originally had it was for one-in-a-million because you want to

be that one in a million you know so I hope you enjoyed it thank you [Applause]

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