Friday, March 2, 2018

I missed all of February

I managed to go an entire calendar month without a post.  Admittedly, I've been swamped for the past month, and I've had no time to even consider posting.  Even now, my time is limited, so this will be a short post, I think.

I think I mentioned in a previous post that my employer for the past decade or so was in trouble.  We closed our doors on February 2nd.  I had been searching seriously for a job for the past year and to be honest, was wondering if I'd ever find another job at the same level I'd been at.

I had been interviewing since early December with a local healthcare IT company.  But, the process just kept dragging out and I wasn't sure if I'd ever get an offer.  However, on the afternoon of 2/2, my last day at my old job, I got a verbal offer from this new company, and I'm now wrapping up my 3rd week as the Director of Technology for the new company.  It's an interesting job compared to previous positions I've held.

I really have no hands-on technical work as part of my job.  I'm truly a Director, with employees to manage, contracts to negotiate, and customers to satisfy.  Being a step removed from the technical work is a change for me, but I'm adapting.  Stuff that I would do on my own in the past I'm now supposed to assign to others.  But, it's working.  The new job is challenging - no doubt about that.  The organization has had some recent turmoil and lots of turnover.  My staff is young and two people are still very much in a learning phase, along with me.  I'm still down a person due to recent turnover, so I'll likely be hiring someone in the near future as well.

The biggest parts of the job seem to be managing vendor contracts and customer relationships.  This is stuff that I enjoy doing, so I think the job is going to work out well in the end, although my learning curve remains steep.

I took a week off between my old job and my new job, and my son and I did a road trip to TN to pick up a new Rhodesian Ridgeback puppy.  Her name is Ruby and she is just the sweetest puppy I could have imagined.  The biggest issue we've had is that our older dog isn't fond of the puppy and her lack of social skills, so their relationship remains tenuous.  But, it seems to get better day by day.  We discovered yesterday that if each of them has a new marrow bone to chew on, they get so focused on the bone that they have no time to growl or bark at each other.

Ski season continues to limp along.  At the beginning of the Presidents' Day holiday week, Sugarbush was 100% open and the skiing was amazing.  And then, it got warm.  In one week, we lost a lot of snow and every natural snow trail is now closed.  This past week has been warm again, and although it's snowing lightly now, it won't be enough to replace what we've lost this week.

Two weekends ago, I took a hard fall while working and broke my thumb on some advanced terrain.  So, I'm now navigating the Workman's Compensation system, as I need surgery on my thumb to reconnect the UCL to my thumb.  I'm scheduled for surgery a week from Monday. 

I hope the surgery doesn't get delayed.  The recovery time is about six weeks, and my surgery will be 4.5 weeks before trout season opens.  It's my right thumb that's messed up, and I need it healthy to cast on opening weekend.  Plus, I need it healthy to get back to lifting consistently.

I've been able to do some CrossFit since I hurt the thumb, but between the new job, tiredness caused by my cancer medication, and the injury, it's been easy to just take some days off.  I really need to get back to the gym at least 3x per week.  The last two weeks, it's been 2x, and that's just not enough time to stay fit.

The working part of ski season will be over in 16 days.  Well, I'll have to write performance reviews after that day, but I won't be working on skis any more.  Most seasons, I'd use the next month after work to get in some free skiing with my wife, but my thumb may dictate some changes to those plans for this year.

Hopefully, the surgery will happen as scheduled and I'll have a speedy recovery and get back to skiing and fishing very quickly.

That's pretty much it.  New job.  New puppy.  Broken thumb.  I guess I could have used this last line as my whole post.

Monday, January 29, 2018

There's No Hope Road

This is my last week at my current job.  Most other employees of the company are already gone.  I'm supporting our production systems through the end of the month and then shutting everything down by the end of the week.

I've been at my job for 11+ years in one capacity or another.  I started by doing some consulting work for the company while they were still in the tail end of a research project.  Then, I became a part time employee after the consulting contract ended.  When the company got their first round of venture capital, they hired me as the IT Director.  Four years ago, I became the Chief Technology Officer.

Looking back, I can see all kinds of things we should have done differently.  I should have fought to use a higher percentage of our funding for product development.  I could have done a few architectural things differently.  We simply needed to create more products and then find a way to sell the more complete product set.

In many ways, until the past year or so, we never had any competitors in the market.  But, we were a niche company, providing services to treat a small handful of chronic diseases, rather than a more full spectrum company that encompassed all of chronic care.  In some ways, we were too specialized and deep for our own good.

If a healthcare organization bought our product and used it properly, they saw more lab revenue, more primary care revenue, and healthier patients.  But, they also saw reduced emergency department revenue and reduced inpatient revenue.  The net effect was that fee-for-service organizations were presented with a product that would make their patients healthier but at the expense of lost profit on the bottom line.

Our fee for service model in the US is so perverted that more than one medical director basically told us that our product was a no-brainer, and that they should use it, but that the CEO would never go for a product that had a negative net effect on revenue.

We tried to sell this product through the beginnings of the ACA, when people were more focused on EHR implementations.  Then, those same organizations were more focused on something called meaningful use.  And, after years of being in business, and with the advent of Accountable Care Organizations (ACOs), we thought we finally had a window to succeed.  We integrated our product with two of the larger EHR systems on the market.

And yet, we never got any traction.  We have tried ceaselessly to find a way into at-risk organizations.  The customers that we have love our products.  But, we haven't sold the product to a new customer in years right now.  We haven't had a full-time salesperson in years.  We haven't had a full time CEO in years.  We managed to limp along for longer than we might have deserved, but finally, the financials simply made no more sense.  We are out of cash.

I will fail to see a large amount of money that the company owes me.  I'm not surprised, to be honest.  Others are going to lose even more money.

I feel like I've poured my heart and soul into this company for the better part of a decade, and now it's just over.  To say it's bittersweet is an understatement.  We probably made it further than we had any business making it, but it wasn't enough.

It looks like I'm going to land on my feet.  I will hopefully have a job offer in the next 24-48 hours, and I won't need to collect unemployment at all.  At my age, finding a new job has been extremely difficult, to be honest.  Age discrimination in IT is a very real thing, and I've dealt with it a lot over the past year or so.  Assuming the job offer I'm expecting does come through, it will be because I'm capable of doing the new job, but also because of my prior connections to people at the new organization - another case of who you know rather than just what you know.

I'm excited about the future and new opportunities.  But, after investing so much blood, sweat and tears here, it's difficult to see it all go away.

It's also been a good learning experience.  I took a position without benefits at a marginal salary vs. my job title and skills/experience.  I did it because I truly believed in what the company was doing, and I still believe that we were doing the right thing.  But, in the end, it's all about money, and no one rewarded me for "doing the right thing".  Next time, I'll be more careful.  The whole situation reminds me of the lyrics to a song called Hope Road by Anne Clark.  Here are the lyrics at the end of that song:

"Next time I'll be more cautions
Next time I Won't be fooled
It's another of those basic things
You're never taught at school
Let this be a warning
As you wander through the world
It makes no difference who you are
Be you boy or be you girl
Be very , very careful
When people seems so nice
It's not how that it's expensive
Later on you pay the price
There's no Hope Road"

Friday, January 26, 2018

Health Update

I was at Sloan Kettering on Tuesday of this week.  I had a CT scan that showed complete stability - no growth of the one tumor found last fall.  We will continue to do scans quarterly, but for right now, this is great news.

Overall, the expensive drug I'm taking, Ibrance, has a median progression free survival of about 18 weeks.  That means that half of the patients have seen no progression at 18 weeks and half of them have either died or seen progression.

I'm at about the 14 week mark and no progression has occurred.  There are some patients who have been followed for years with no progression.  The best predictor of long term stability is actually the first scan.  If the drug works right from the start, the odds that it will work longer term go up tremendously.  So, this is certainly good news.

The day before we left for NYC, I was informed that my last day at my current job will be next Friday, 2/2.  I knew the end was coming, but I honestly didn't expect it so soon.  In some ways, I appreciate that the company is shutting down sooner.  They are doing this while they still have the money to pay the employees for all the hours they've worked and vacation time they've accrued.  In the end, I will leave this job with the company owing me tens of thousands of dollars but I won't be the only one.  And, they made a good faith effort to pay us some of our deferred compensation.

While we were in NYC, I got a phone call from an organization I've been interviewing with for the past 6 weeks.  I've been selected as the one finalist for a final "pass/fail" interview with the state organization that funds the company I've been talking to.  So, if that interview goes well, I hope to have a new job before this job ends.  I should know more in the next business day or two.

Other than that, life is great.  I'm feeling strong in the gym, although I'm sore this week from heavy front squats on Monday.  Tonight's heavy deadlifts are going to be a challenge, to be honest.

Skiing is going great as well.  I've already skied as many days this season as in each of the past two years, and I'll be skiing into April this year.  I should easily double my total ski days from the past few seasons.

Right now, despite a few job worries, life is pretty good.

Monday, January 22, 2018

I'm starting to think that no news is good news

I've been posting a lot less recently.  I think that's mostly because my life has been more free of drama in some ways.

Well, to be honest, maybe I'm just in denial about the drama.  The company I've been working for for almost a decade is about to go under.  Despite my best efforts over the last six months, I still haven't found a new job.

I'm a finalist for one position right now, and I had a phone interview for another last Friday, but jobs at my experience level and salary level in healthcare just aren't that common in Vermont.  I could very easily be unemployed for only the second time in my career very shortly.  I have expanded my search circles recently, looking outside of healthcare, looking at jobs that pay way less than my current position, etc.  I guess that would be called desperation.

The only other time I was unemployed was in 2001.  Because of federal laws, my company had to give me 90 days of severance pay, and I found a new job before my severance pay ran out.  This time, there won't be any severance pay, and the truth is that the company is likely to owe me close to $30K as it goes out of business.  I have no way to recover that money, so I could end up drawing unemployment for the first time in my life.  Considering that unemployment pays less per week than I make in a day currently, I'm terrified by the thought of being out of work.

Medical expenses have really taken a toll the past few years and we simply don't have the savings to fall back on right now.  I hate to admit that, but it's regretfully the truth.

At the same time, I know I'm doing everything I can to find a new job, and my best will have to be good enough.  It is almost unfathomable to me how we would deal with me being unemployed, to be honest.

There isn't much new on the personal health front.  I was supposed to go to Sloan Kettering a few days ago, but due to snow and sleet, we missed our train.  I am now going tomorrow instead and we have bad weather in the forecast again.  So, this time we are heading to Albany the night before the trip, so we have a very short drive to the train in the morning.  The trip to Albany tonight might be a bit difficult due to weather, but we won't have any time constraints tonight, like we would in the morning.

Otherwise, life is great.  I'm skiing every weekend and enjoying my new job at Sugarbush.  I'm in the gym at least 3 days every week.  It usually takes me 6 weeks or so of skiing before I'm physically able to make it to the gym 4x per week, ski 2x per week, and not feel constantly beat up.  This winter, I haven't had a single week of 4 days in the gym.  It's just taking me a bit longer to adapt to doing both activities.

Because I'm going to take a day off of skiing next weekend, I'm hoping I make it to the gym 4x this week, if my schedule allows it.

Wednesday, December 20, 2017

Time for that first skiing post of the season

I've actually been skiing for the past three weeks, and I just realized I hadn't written anything about it yet.

This year, which I think is my 18th season at Sugarbush as an instructor, is going to be different than any other seasons in the past.  Back in October, I was sitting in a waiting room at Sloan Kettering, waiting for the CT scan that would tell me if I'd be healthy enough to ski this year, when my phone rang.

It was one of my supervisors from Sugarbush, and I was glad to hear his voice.  I told him that I'd been meaning to send him and my other boss an email, letting them know what I hoped to do this coming winter.  My goal was to teach younger kids this year.  There were two reasons for this.  First, it would give me more good experience with younger children, which is helpful for a certification exam I hope to take this season or next.  Secondly, in case I struggled at all physically, I thought that skiing with the younger children would be easier.

But, that phone call changed everything.  It turned out that one of my supervisors was gone from the mountain and the other was taking over the program where I work.  And, he needed an assistant and thought I was the right person for the job.

I told him I needed to finish my day at Sloan Kettering before I answered, but that I was definitely interested.

And so, it happened, and after 17 years just teaching and minding my own business, I'm now a (low level) supervisor.  I am essentially in charge of the coaches who teach the youngest kids, so I'm getting my wish to work with the smaller children.  But, a lot of the coaching I'm doing is with other instructors, rather than the public.

Two plus weeks ago, I did my own day of required pre-season training on a Saturday.  The following day, I got to ski with some friends for the day - something I don't get to do very often.

One plus week ago, I spent the weekend training the instructors who are reporting to me this winter.  We have a lot of new instructors, and I was very impressed at how good they all were.  Some have taught skiing before at other mountains.  Some came through our intern program at Sugarbush.  And, others had experience with young children (various outdoor camps, whitewater rafting, being a nanny, etc.).  So far, they've all done a great job.

This past weekend, we started teaching our students for the season.  As usual, we had some hiccups the first weekend, but nothing too major.  It's always a challenge with the younger kids to group them appropriately, and we still need to move a few students to different groups. 

But, I was very impressed by the work I saw from my new charges, and I'm very optimistic about the season.  I spent the weekend skiing from one group to another, offering tips to the coaches to help with opening weekend issues.

At their young ages, the very first thing we want to work on with the kids is balance.  And, balance starts with stance.  We want the skiers to be tall in their stance and also forward.  It's amazing how much you can change a child's skiing just by getting them to stand up taller.  Children who were in wedges constantly suddenly come parallel between turns, even though they may resort to a spontaneous wedge through the turn itself.  For the first weekend, that was the majority of what we worked on.

From there, we will move on to other balance drills the next few weeks, as we give each child the chance to get their "ski legs" back.  It's important to remember that most of these children are very young, have skied a limited number of days in their lives, and we were seeing them on their first day on skis for the season.  It simply takes some time for what they've learned in the past to return.  So, the goal is to make some tiny adjustments, and let the little guys get in some mileage.

As we get to the point where balance is no longer an issue, we have all kinds of things to work on.  But for now, we are just starting and it's all about the balance.

Hopefully, the forecast is wrong and we won't be skiing in pouring rain this coming Saturday.

Wednesday, December 6, 2017

Wow - long time no post

My life can only be described as crazy right now.  I can't believe it's been so long since I posted.  At this time of year, I don't really expect to post on my fly fishing blog, but this one normally gets some attention.

Healthwise, everything is holding steady.  I got through my first round of Ibrance just fine.  I did have a mild head cold at the end of the round, and it's lingering a bit, but it's been pretty mild.  My neutrophils count at the end of the first round was good enough to head straight into the second round.  Other than a few minor issues - hair thinning a bit, some nausea, and a bit of fatigue (really a need for more sleep), I'm doing OK on the medication.  I'll finish round 2 this weekend, get my blood work done on Monday, and then hopefully start round 3 the following weekend.

On January 9th, I will make my next trip to Sloan Kettering to see how the drug is working.  If I've had no growth in my one small tumor, we will simply stay the course.  If the tumor has shrunk or is gone, I'll be ecstatic.  And, if things are still growing, we will discuss other options that I have.  And, there are plenty of remaining options.

While this is going on, I've been swamped at work.  In the past 18 months, I've made IT Security a major focus of my work.  We are a small company, but we still handle protected health information (PHI), and we are bound by the law known as HIPAA.  We had done OK on a a self-assessment tool a few years ago, but I knew that this was not the  same as a full security assessment performed by an outside agency.

But, earlier this year, our biggest customer was purchased.  That organization is now owned by a company, that is owned by a company, that is owned by one of the largest insurers in the country.  Because we use PHI associated with the owned organization, we have to meet the security requirements of a company with annual revenue close to $200B.  Yes, that's a B, as in billions.  We don't even have a million dollars per year in revenue right now, so this is a daunting task.  Many of the things that we were missing were policies.  Those are easy to deal with - write the policy and then enforce it.

But, we are also missing all kinds of tools that monitor systems, looking for bad actors.  I don't have the full costs yet, but my current guess is that we are looking at $25K in upfront costs, and then at least $5K per month in additional charges.  To be honest, this exceeds our profit on this contract, so doing it out of our own pocket is prohibitive.

We are currently working with the big company and our customer to explore alternative ways to pay for this improved security.  I don't disagree with the need to do it, but we simply don't have the money right now.  And, it's been a very good exercise for me.  I have learned so much about IT Security in the healthcare world in the past year, and I am now a better prospective employee for other organizations.  I imagine that I could help to improve the security at most healthcare organizations in the country right now, and I've updated my resume to tout these new skills.

I must admit that our company is struggling a bit right now.  We have only a few paying customers, we have no recent sales, and we have one grant that we are working on.  To be honest, we are losing money at the moment, and this is with most staff going unpaid or working reduced hours.  After 10 years with this organization, 8 of them full time as the head of the software development department, it honestly looks like we might not make it more than a few more months.

So, I've been looking for a new job, and I think everyone in my company is either already employed elsewhere, is planning to retire, or is looking like I am.  I am still working hard to try to keep us afloat, but it honestly feels like a few people have already given up really trying.  If we don't make it, I will certainly be sad.  I've devoted almost 1/3 of my career to this company, I really believe in what we do, and I'd hate to see our products fall into disuse.  But, without one or two new sales very soon, it's hard to see a financial path forward.

This is the first time that I've actively looked for a job since 2006, and the world really seems to have changed in that time frame.  So have I.  I am now officially old in the IT field, and I've clearly hit some age discrimination.  In at least two cases, I failed to get an offer when I was clearly well qualified for the job, and I was stunned by the lack of an offer.  Before I turned 50, an interview always seemed to result in an offer.  Since turning 50, I have not gotten one job offer.  In some ways, this is to be expected.  I'm more senior, in IT leadership, and I have a higher salary.  The higher the salary, the more difficult it is to get a commensurate job.  But, I think age has played a role in a few cases as well.

Currently, I have three options out there.  Only one of them is in health care, so I'm hoping that this situation works out.  In some ways, I think I have an inside track on this job, based on my prior career experience with some of the people at the new company.  I will know more by the end of the week.  The others are in different problem spaces, but the companies seem very committed to doing things the right way, using modern development methodologies, and I am very interested in them as well.

On the workout front, things are moving along just fine.  Since returning to CrossFit at the end of July, I've had four very good months of consistent training.  In three of those months, I tied or exceeded my previous best number of CF workouts for that month of the year.  The yearly calendar does affect how many classes I can get to (holidays can reduce the number, for example) in a month, but the last 4 months have been pretty good.

The only downside is a slight overuse injury that is affecting my right knee.  I am seeing a physical therapist for the knee, and things are improving slowly.  I was unsure how the knee would do with skiing, but I skied both days last weekend with minimal complaints from the knee.

That takes me to my last topic of this post - skiing.  This will be my 18th season as a ski instructor, and I was promoted to a supervisory role this winter.  Rather than teaching children how to ski, I'm going to be a mentor for our younger instructors, training them, skiing with them and their groups, and trying to help them to become better instructors.  I'm excited to be doing this work.  It will be an interesting change from my previous years, and an opportunity to have more influence on the quality of the program where I work.

I do have a trip to Sloan Kettering in January.  I have to hope that the Ibrance is working, and if it is, I'll be free to ski the rest of the winter uninterrupted by any other treatments.

All in all, life is a bit stressful due to the job situation.  But, at the same time, there are changes afoot, and I'm looking forward to some new challenges.  I don't ever want to feel like I've become too old to excel in a new opportunity.  I think I still have a lot to offer in my career field, and I'm likely to get that chance soon.

Thursday, October 26, 2017

A week with the new medication

I've been taking Ibrance for a week right now.  I'm still shocked that my insurance company approved it so quickly, given that it's primarily a breast cancer drug, and not a liposarcoma drug.  But, they approved it and I've been taking it.

After a week, to be honest, the only side effect so far is some nausea right after I take it.  I'm taking an anti-nausea medication with it, and that seems to be working just fine.

I know the side effects tend to be cumulative, although some people see problems with white cell counts fairly quickly.  I am going to have a blood test done next week (CBC), just to make sure that nothing extreme is happening at the two week mark.  After that, we will do the test monthly, just before I start each round.

My local medical oncologist was surprised at the decision Sloan Kettering made when they gave me Ibrance.  She seemed to think that Yondelis or Halaven, both approved specifically for liposarcoma, even though Halaven is also a re-purposed breast cancer drug, might have been better choices.

But, I think she also understands that Sloan Kettering is calling the shots these days, and she didn't try to talk me into anything different.

I've noticed no effects in the gym so far.

I have been fighting a minor injury in the gym.  I have a few "knots" in my right quad, and they seem to be causing my knee to track improperly.  So, my right knee has been sore, mostly at the top of kneecap, but occasionally at the bottom of the kneecap as well.

I had been seeing a physical therapist to work on compensating for having lost most of right psoas muscle, but I think we are done with that aspect of therapy.  I'm doing abdominal work in the gym with very few problems, and the movements that were really troubling me in July and early August, such as running, burpees, rope jumping, and box jumps, are all better now.

So, I'm still seeing the therapist, but now we are focusing on the knee.  She's using a combo of dry needling, massage, ultrasound and Graston tools to work on releasing the knots.  On my own, I'm biking more before CrossFit, to loosen up the quad.  And, I'm using a barbell to roll over the knots in my quad.  It hurts like hell, but things seem to be getting better.  To be honest, the dry needling is the most painful of the treatments, but it seems to be helping, so I'm just going along with it.

I need my quad and knee to be better by the time I'm on snow for the ski season, and that could be just over 3 weeks away, although the long term forecast doesn't look great for snowmaking.

I'm hoping that just a few months of uninterrupted training will be enough to have me ready for the ski season.  I have a new job at the mountain this year, and I expect to ski a lot more this winter than the past two years.