Our meetings with the doctors at Duke went very well. I'm much more impressed with them than the one at Rex hospital in Raleigh. I had a lot of waiting time at Duke (was there for about 5 hours) but also had a lot of time with the doctors. The first doctor was kind of young (early 30s), but really seemed to know his stuff. He sat with us for a solid hour (no interuptions) just answering questions and telling us about the group there. He then said it was time for the physical exam, but I told him I needed to go to the bathroom. He came back after about 15 mins and then spent another 30-45 minutes with us. I then had some more wait time until I saw the head of oncology (he will be my assigned doctor). Even as busy as you know he has to be, he spent 30-45 minutes with us with no interuptions. I've never had that much of a doctors time devoted to me. They didn't tell me anything new, and didn't give me any false hope, but I came away with a sense of hope that I could be around for a while. I never had any felling of hope with the doctor at Rex. I felt like with him that I might have 6 months and he was going to try to extend it, but no real hope. The doctors at Duke are not saying that I'll be around in 6 months or 2 months or 24 months, but they do say that they will work hard to give me good quality of life for as long as possible. I think their goals are more for the patient to have quality as well as quantity. The head of oncology, Dr. Hurwitz, said that his group as well as his colleages at Johns Hopkins (he said they talk at least every two weeks) have not seen benefits to outweigh the side effects of the extreme regimen that the Rex doctor wanted to try. He suggested we start the standard treatment (Gemzar) soon and see how it goes. He said that he has had good luck with Gemzar (said he had a couple of patients that were still stablized and going strong after two years. He said he couldn't promise anything because every case is individual. He said that in 10-15% of the cases they see shrinkage with Gemzar. 85-90% stablize. He said that he would prefer trying that due to the low side effects and step up to stronger medicines if this doesn't work or if it quits working. As I said before, I think they emphasize quality but still attempt for as much quantity as possible. They also said that in their studies, they've not hit a home-run yet, but who knows what's just around the corner. The thing that really sold me for changing to Duke was his approach to medicine.He said that he feels that a patient't treatment has three components and that no one component is any more important than any other. The components are: 1) Your spiritual belief and faith - no matter what beliefs you have, if you believe, then that faith will help 2) Your support group of family and friends 3) The medicine I've never heard a doctor with that philosophy. That was even before we asked the questions about spiritual beliefs. He also had a compassion and didn't seem patronizing like my previous doctor. Also had a sense of humor.... Karen asked him about working with the cat litter box (we had read somewhere that chemo patients should stay away from litter boxes the same as pregnant women). He said that there's no problem with litter boxes... Karen said "Thank you". He then followed on with "but you should refrain from doing things like vacuuming, and washing dishes and cooking and any general housework". We got a good laugh out of that. Another of Karen's questions was about limitations... she said "How about sex?". His response: "Well, if you're into swinging from the chandelier's, you may notice that you bruise easier than usual". I told Karen that means the wild stuff is out. He then said "And just remember, you don't have to give your doctor ALL the details". I just really feel good about this group. I know the odds are still stacked against me, but I feel like I have a chance here to possibly hang around until something comes along. With the other doctor, I felt like he had already written me off. Dr. H is looking into clinical trials around the country. He said they currently have some going on at Duke, but that I'm not in the right stage or profile to fit any of their current trials. I go back this Thursday for bloodwork, regular appointment, and start treatment. I guess that's about it.... I'm sure I've forgotten a few details, but that pretty much covers it. The main thing is that I feel good about the people that will be taking care of me.