TheList 5485

The List 5485 TGB


Some more for Monday 20 April

To All,

This morning I sent the Following to the Bubba List which is a subset of the list that usually just contains Aviators. Streak Chanik and a couple others have suggested that I send it to the Full List because it is an excellent piece of work by Padre. Meanwhile Padre went back through the original and made some updates and corrections and sent to me a few minutes ago. So here is the slightly updated and modified version.

skip



Subject: Prostate health and Prostate Cancer

Good morning TR and the Bubbas in San Diego and elsewhere,

TR, I hope that our phone conversation was of some help to you last week..

Since there is a lot of information out there, some very good, and some not worth reading, it is best if I condense what I learned from my experience and that of some close friends, and put it in writing..



I'm not a doctor….and after reading this through, it is not very condensed either.



There are some great sources of information on prostate cancer, so perhaps skip the links, read my text first, and come back to these links and the links at the bottom of this email later.



Johns Hopkins Hospital, Baltimore: https://www.hopkinsmedicine.org/prostatecancer/https://www.hopkinsmedicine.org/brady-urology-institute/specialties/conditions-and-treatments/prostate-cancer/prostate-cancer-questions/



Memorial Sloan Kettering, New York: https://www.mskcc.org/cancer-care/types/prostatehttps://www.mskcc.org/cancer-care/types/prostate/treatment/radiation-therapy



M.D. Anderson, Houston: https://www.mdanderson.org/cancer-types/prostate-cancer.html



Mayo Clinic, Rochester: https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087



Cleveland Clinic: Do a search.



UCLA and Stanford. Do a search.



American Cancer Society: https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087



There is no reason to read 'forums' and anecdotes, or WebMD or any other www sites besides those above.



And don't believe these two common thoughts:



(1) The finger wave doesn't give a doc any information so it is a waste of time.-- My GA doc wanted to forego them "since the gov't said they were not useful." (My GA doc's words).
They do tell the intelligent doc a little about your prostate. For instance, size and any tumors that are on the surface or close to the surface will be a little harder tissue and perhaps a bulge.

(2) If you have prostate cancer at an "elderly" age, don't treat it, something else will likely kill you before the prostate cancer will. – That is just bad advice. Surely the insurance companies started that bit of information to save costs.



My situation:

PSA was between 5 and 14 (the high) since 2004 or so. I had BPH and because of the enlarged prostate had to run to the back of Home Depot or the front of Costco for years to get to a head before my bladder went to overload. Had 2 X yearly PSA tests and 3 biopsies in 15 years that were clean. At some point took an Rx (Finasteride aka Proscar) to shrink the prostate which lowered the PSA about 2-3 points but caused weight gain and the joints in my hands to swell and hurt, so I quit the Rx on the advice of my GA doc. Never took a volume measurement before and after so never knew how much shrinking it did. The drug didn't help with the runs to the back of Home Depot to the head.

My PSA in early April 2019 was 14, but had dropped to 10 point something in late April 2018 when the 4th biopsy was completed and turned up cancer, one tumor in the upper hemisphere of the prostate.. My prostate then was measured as volume of 92 cc (about 4.5 cubic inches naval orange size). The normal for a young fighter pilot is 25 cc (the size of a walnut).

In 2017 my PSA Level 2 blood test (more about Level 1 vs. Level 2 tests later) showed odds of cancer 20% YES and 80% NO. One year later the PSA Level 2 blood test showed odds of cancer 80% YES, 20% NO.
The volume went from 92 to 98 cc between April biopsy and August surgery.



Aside: I never liked the odds of 20% cancer…..one in five ….to begin with.



The 60 year old Athens, Georgia doc briefed me that I had two choices after the cancer was diagnosed:



Cryotherapy (look it up, it involved Nitrogen injections to freeze the tumor) or surgery with complete removal of the prostate. He highly recommended the Cryotherapy route.

The first red flag was that this doc said that he "was not very good" at Robotic Surgery but could cut me the old fashioned way if I insisted He did not seem enthused about cutting me open.

He said I was not a candidate for seeds (Brachytherapy) due to the size of my prostate (common theory is no seeds if volume size is greater than 50 cc). He also said that my Gleason Score showed my cancer was "moderately aggressive."

This was supposedly "the best" Urology Clinic in Athens, GA to use and one of two docs in the clinic to use.



Since there were two choices given, and overriding that was the fact that it was the "Big C", wifey and I decided on a second opinion from a reputable hospital, the requirements being that it was:



(1) Known nationwide by reputation.

(2) Had a dedicated cancer wing of the hospital.

(3) The hospital had an ongoing research department.
(4) Was not in Alabama, Mississippi, or Georgia.



I chose to call Johns Hopkins (JHH) in Baltimore and M.D. Anderson in Houston, mainly because they were more convenient to Georgia than others. I gathered up my records from the Georgia doc's office.

When he found out where I was going for the second opinion, he was pissed off. That was the second red flag. He was missing out on $$ from the surgery.

Both hospitals required two weeks to look at the records with an appointment following. Johns Hopkins could see me much earlier than MD Anderson, to I got to Baltimore in mid-June.
I liked the doc, the hospital, and everything we saw there. The earliest JHH could sked surgery was August 6, 2018, nearly 3.5 months from the biopsy.



That is what we did.



JHH has 31 urology surgeons, 28 only did robotic surgery, 3 did robotic or a big incision. My robotic surgery was 4-5 different small holes from dime size to less than a quarter size.

I have no clue how my prostate came out through those small holes.
Surgery was about 2 hours with 3 hours in recovery and 2 nights in the hospital. JHH said 1 night was standard but I could insist on 2, which we did.
Care was top notch and personal, food was ordered by phone, and they put air pumps on my legs immediately to avoid blood clots.

I was walking the corridors for exercise the first night. JHH was perfect.



I had a urine bag and catheter for 10 days post-surgery. No problem, took the tube out of Mr. Happy myself in the shower at home on day 10.
On day 3 post surgery, I walked 1 mile. On day 4 walked 2 miles. No pain anywhere.



Was told to have a PSA blood test every 90 days for two years then taper that down.
At the 20 month mark, the PSA tests are coming in at less than or equal to 0.1 which is what it is supposed to be with no prostate.



Rather be Lucky than Good:

I had a 12 needle biopsy, through the anus and 1 needle hit the tumor. After the surgery the JHH doc told me that my prostate cancer had spread to cover the entire upper half of the prostate and had moved into the "margin" meaning the outside edge, like the surface of an orange. It was about to make the jump to other tissue, bones, scrotum, etc. all that nasty stuff that can happen. And this was with a Gleason Score of "modernly aggressive" cancer, not "aggressive" cancer.
My Gleason Score was 4+3. A score of 3+4 is not as aggressive, and a score of 5+4 is nasty aggressive..
So, I was lucky to have the surgery when I did.
Read up on Gleason Scores if you have a biopsy and have the cancer.



Problems now:

I am incontinent except when driving, sitting, or horizontal on a sofa or bed. Diapers and clamps take care of that when skiing, snowshoeing, hiking, biking, etc. Swimming is much more enjoyable now for obvious reasons.
I'm used to the incontinence. VA or Tricare will take care of supplies.
Mr. Happy is unhappy. ED does not mean Extra Duty now. E'nuf said.
JHH doc says the incontinent issue is due two things, the shut off valve inside the prostate is missing as it gets tossed out with the prostate.
The huge size of my prostate meant the two ends of the urethra had to be stretched to cover the missing 4 to 5 inch piece when the ends were sewn back together.
So I'm down to one shut off valve further down the pipe instead of two. BTW, women are born with one shut off valve.



Right here is where for full disclosure, the seed implants should/might prevent these two problems, but read the bottom part about seeds implants (Brachytherapy).
I would not change a thing and go for cryotherapy over the removal and even if the size were within parameters for seeds, would still have opted for surgical removal to head off a return of the cancer.

Of course, nothing in this deal is guaranteed and the cancer could come back, but I feel my odds are better after the surgery than doing the seeds.
Your thoughts and your mileage may vary…



If you have this cancer, be sure to understand what your Gleason Score means; here is a primer: https://www.pcf.org/about-prostate-cancer/diagnosis-staging-prostate-cancer/gleason-score-isup-grade/
The Gleason Score is telling you how lucky you are …….is the cancer fast moving aggressively or not? That link also has good information on the other tabs/pages.



My worrisome thoughts after the surgery:



What if I had the biopsy in 2017 based on the high PSA blood work then, but the cancer had not turned up in 2017? Clearly I would not have a biopsy two years in a row and would have not had the 2018 biopsy that detected the tumor.



What if the inaccurate way the Georgia doc chose to conduct the biopsy (through the anus, not through the "t'aint", without an MRI to guide the needle, more on this later) and the 1 needle had missed the tumor?
Then, all 12 needle biopsies would have shown clean and I would happily have thought I was cancer free.



The JHH doc in Baltimore told me that I was NOT a candidate for Cryotherapy. What if I had chosen to take the easy way out and travel one hour from my Georgia house to the Georgia doc for nitrogen injections instead of going to Johns Hopkins?





OK, the above is my lucky story and I'm sticking to it.

Now some advice/thoughts after the surgery is 20 months behind me:



1. Start with a great, not a good, urologist. If you are diagnosed with cancer and live near one of the major hospitals on my list above, go there, If you have to drive/fly to a great hospital, drive there.



2. Only get PSA Level II (2) blood tests. They give much more information than PSA Level I (1) tests. The VA hospital I use in Asheville NC only gives a Level 1 test. Don't accept a Level I test.



3. Get a PSA blood test every 6 months forever.



4. What to watch for is the "Delta" – the change in PSA level. For example 3.5 to 4.5 is jump of 29%.



5. Know the volume baseline of your prostate in cc. It is measured by an ultrasound or by an MRI. For golly gee whiz, Google will convert cc to cubic inches.



6. Know that the amount of measurable PSA antigen increases with the size of the prostate. The walnut size of 25 cc will not have as high a PSA level as a 92 cc sized prostate.
Docs don't tell you this. That is why my PSA was never below 7 for 10 years and I did not have cancer.
You can worry less if you prostate is huge with a high PSA then if it is small size with a high PSA. Now take a look at #4 again.



7. For a biopsy: They come in several flavors, 12 needle is the most common, but 18-24 needles (a "saturation" biopsy, like an Alpha strike biopsy) is also an option.
I had my first biopsy completed while I was awake, felt like a Colt 45 going off in my a*s 12 times.
Never again, the next 3 biopsies I chose the anesthesia route. One guy's "mild discomfort" (doc's words) is another guy's "Holy Sh*t that smarts" kind of pain. Your mileage may vary.



8. For a biopsy, there are two types, in layman terms they are: Through the anus or through the "t'aint" (docs call it the perineum. Choose the perineum for these reasons:



The anal route (medical term:Transrectal/TR) means feces on the needle pushed into your prostate. Greater chance of infection. The docs give an Rx of antibiotics to prevent this, but why take a chance?

The prostate sits squarely (roundly?) over the perineum, so the standard length needle reaches further into the upper half of the prostate and covers more area. (Medical term is Transperineum/TP/TTPB)
This is very important is your prostate is huge.
Going anal (!) the needle is not long enough to go into the prostate at an angle and cover as much area. Fighter Pilots don't do anal. E'nuf said.



9. For a biopsy: Guidance of the biopsy needle into suspected tumor areas is the goal. This is best achieved by a COLOR contrast MRI done in days prior the biopsy. Suspected tumors will show up as a different color than less dense normal prostate tissue.

The other cheaper method is a BLACK AND WHITE ultrasound of the prostate. With either one the doc performing the biopsy will use the image to control the biopsy needle into the suspected tumor.
Choose the contrast MRI every time. The RF-8 drivers will tell you color photos are better than black and white photos.



10. Choices: I chose surgery. Something bad was in my body; remove it and throw it away.



The other options are seed implants (brachytherapy), cryotherapy, and do nothing. What I know about seeds is from a couple of docs and the reputable www sites and a few friends, and my Dad who had seeds implanted.



When the prostate is removed surgically, the PSA level should be at zero, period. They call it "less than or equal to 0.1" but it is zero.

After surgical removal, if your PSA is anywhere above 0.1, you have cancer. That is a line in the sand between 0.1 no cancer and 0.2 cancer.



Don't know squat about Cryotherapy.

But the gouge on seed implants: Your prostate is still there producing the PSA antigen. There is no line in the sand for cancer or no cancer recurring. Your PSA could be zero or it could be 1.5 or greater. To find out if you have cancer of the still remaining prostate, in for another biopsy you go. Have read on one of those reputable www sites that the prostate organ will begin to attach itself to other tissue after seeding. Removal then is technically difficult or near impossible. The only anecdotal story I am putting in here at this point is that my closest friend at Flying Tigers was told by his UCLA doc that the prostate with seeds becomes brittle like a light bulb and cannot be removed for that reason. Never saw that in writing and I'm read pages about this stuff online back in 2018 and 2019 looking for answers. My Dad had seeds, and died of lung cancer 5 years later though he was not a smoker. Related or not? No one knew or bothered to find out – that is Louisiana medicine in a small town.



Another close relative, my brother-in-law, had seeds implanted at age 50 and at age 60 died of recurring prostate cancer. He died at a Scripps Hospital in San Diego, Encinitas Branch.



Sloan Kettering did publish a paper that I searched for and could not find now, disputing a Washington State hospital report touting seeds.

The bottom line on that paper is that with seeds, the odds of cancer returning are much higher than straight surgery.
Seed implants can also involve chemo and radiation at some point in the treatment, but not sure of whether before or after the seeds.

If you have seeds implanted, and the surgery returns, the next step is only chemo and radiology treatments. I never had faith in seeds.
Others do and went the seeds route successfully. It was just a gut feeling on my part. So don't reject seeds based on my gut feeling, I'm not a doc.



More links: Now that you have the background of the text here are some links worth a look, some technical, some elementary. And of course the links at the top are worthwhile to spool up on gouge



Transperineal Biopsy: Medical term for the one going through the "T'aint."



https://www.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/tests-diagnose/transperineal-template-or-targeted-biopsy



Johns Hopkins on MRI targeted biopsy:



https://clinicalconnection.hopkinsmedicine.org/news/targeted-biopsy-a-smarter-way-to-take-prostate-tissue-samples



Transrectal vs Transperineal Approach: Sez technically what I said in Fighter Pilotese: Go in via the perineum. If you don't want to read the dissertation, I copy/pasted the important parts under the link.

https://www.renalandurologynews.com/home/news/urology/prostate-cancer/structured-investigation-of-outpatient-transperineal-prostate-biopsy/

"The most pressing concerns with traditional TRUS-B involve the accuracy of making a PCa diagnosis and associated secondary procedure-related complications, including hemorrhage and sepsis. From a cancer diagnosis standpoint, TRUS-B is imperfect because over diagnosis of clinically indolent cancers and underdiagnosis of biologically aggressive disease continue to be common events.3, 4 The recent application of multiparametric magnetic resonance imaging (MRI) to the prostate to identify areas of greater suspicion, combined with MRI/ultrasound fusion-targeted prostate biopsy, has mitigated some of the problems associated with cancer diagnosis, but issues with infectious complications remain. Up to 7% of patients who undergo TRUS-B suffer an infectious episode, and sepsis occurs in up to 3%.5With emerging resistance to antimicrobials—particularly the commonly used fluoroquinolones—the incidence of infection after TRUS-B is expected to rise.6"



"The transperineal (TP) approach to prostate biopsy has recently been adopted at many centers as an alternative to TRUS-B and may be able to address some of these concerns. For example, TP may improve PCa diagnosis by allowing easier access to sample the entire prostate gland, particularly the anterior prostate.7 Moreover, reported rates of infectious complications associated with TP biopsy are exceedingly low, with hospital admissions for infection approaching zero in most accounts.8 Together, the potential for improved PCa diagnosis and reduced risk of complications elevates the importance of a structured investigation of the TP approach for prostate biopsy."



"Conclusions: Cancer detection rates for TRUS-B and TP prostate biopsy are similar, and either approach can be combined with MRI to enable more accurate targeting of suspicious lesions. A major advantage of the TP approach is a reduction in post-procedural infectious complications. The overall sepsis rate of 0.08% using the TP approach is an order of magnitude lower than the 1%–3% rate seen with TRUS-B. As bacterial resistance patterns emerge, antibiotic stewardship will become increasingly important. Moreover, several outpatient TP biopsy series using local anesthesia alone have recently been reported abrogating the often criticized requirement for general anesthesia. Given lower rates of infectious complications and greater feasibility of an office-based procedure, we expect that TP prostate biopsy will be increasingly adopted as the preferred approach for PCa evaluation."

Transrectal vs Transperineal Approach and MRI: Another article on Transrectal vs. Transperineum and MRI Guidance. In case it has not sunk in, see copy/pasted text and highlighted red font from the link..

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503965/

"As an extension of traditional random prostate biopsy, the transrectal approach is far more commonly used for MRI-targeted biopsy due to its convenience. However, in the context of today's increasing multi-drug resistance of rectal flora, the transperineal approach is being used more often due to its lack of septic complications. In addition, only a first-generation cephalosporin, not a fluoroquinolone, is required as antibiotic prophylaxis. Evidence shows excellent detection rates of significant prostate cancer using magnetic resonance imaging (MRI)-targeted and/or systematic transperineal biopsy (TPB). "



"MRI-targeted TPB is an excellent option and should be performed wherever available and feasible."



"However, in our opinion TRB has serious disadvantages, which are becoming increasingly important. In TRB the biopsy needle must pass through the rectal wall. If only targeted biopsies are performed, this may be as few as twice, but if saturation biopsies are performed as well, it could be more than 24 times. Each needle passage risks inoculating the prostate and its rich blood supply with rectal bacteria. As a "dirty" procedure, prophylactic antibiotics are necessary and fluoroquinolones are currently recommended as the antibiotics of choice (1,13). However, there are three major concerns regarding the widespread use of fluoroquinolones in TRB."



Brachytherapy: We are the government and we are here to help:



https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/brachytherapy



Brachytherapy, UCLA's take: Information on various www sites indicates Brachytherapy not a good option for prostate size greater than 50 cc. Another reason to know your volume size.



https://www.uclahealth.org/radonc/prostate-cancer-brachytherapy



Johns Hopkins Prep Sheet and Post Biopsy Care Notes:



https://urology.jhu.edu/patients/docs/Perineal%20Prostate%20Biopsy%20Preparations.pdf



Final thoughts:

Not one person of the two dozen that I spoke with or traded emails with who are members of the "club"…..that is the prostate cancer club….. had a situation that was the same as my situation or the same as anyone else's. Everyone had a different take on their disease and how to combat it. Lots of variables come into play medically, physically, emotionally, and general outlook on life. Just study as if it were an exam, get at least two opinions, four if you choose. Don't think because you are in the great city of San Diego, that the docs and hospitals there will cure and save you. Remember a few paragraphs above that my brother-in-law died at Scripps Hospital in Encinitas at age 60.



OK, there you have what I learned in two years of docs/quacks and online reputable hospital links.



Take care out there and Check Six!



Kindest regards, Hud'n, Hud'n,

padre



Don Priest



Email Condo Rentals: utahski@earthlink.net

International Calls In (Cell): 435.659.1467









Check Six!



NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN



This Day in Aviation History" brought to you by the Daedalians Airpower Blog Update. To subscribe to this weekly email, go to https://daedalians.org/airpower-blog/



April 19, 1967

Air Force Maj. Leo K. Thorsness received the Medal of Honor for protecting a mission to rescue downed Airmen in North Vietnam. Flying an F-105, he shot down one MiG-17, damaged another, and drove off three more. Enemy forces, however, shot him down, captured him, and held him as a prisoner of war until March 4, 1973. Read the citation HERE.



April 20, 1923

The first aerial refueling took place over Rockwell Field, California, via a rubber hose extended through the air. Two DH-4s, directed by Maj. Henry H. "Hap" Arnold, run a rubber hose between them in flight, and demonstrate the viability of gravity-flow air refueling. Arnold was Daedalian Founder Member #2182.



April 21, 1926

Secretary of the Navy Curtiss D. Wilbur directed that beginning with the Class of 1926 all Naval Academy graduates were to complete a 25-hour course on flight instruction during their first year of sea duty. To provide for this instruction, the Navy would establish flight schools at NAS Hampton Roads, Virginia, and NAS San Diego, California.



April 22, 1981

The 81st Tactical Fighter Wing, an A-10 Wing at RAF Bentwaters, United Kingdom, set a U.S. Air Force record by generating 533 sorties in a single day.



April 23, 1956

The first flight of the Douglas C-133 Cargomaster was on April 23, 1956.



April 24, 1909

Wilbur Wright made five flights in Centocelle, Italy, with King Victor Emmanuel III of Italy present. During one flight, a Universal News Agency cameraman accompanied him and took the first motion pictures from an airplane in flight. View the video HERE.



April 25, 1922

Pilot Eddie Stinson made the initial flight of an ST-1 twin-engine torpedo plane built by Stout Engineering Laboratory as the first all-metal airplane designed for the Navy. The aircraft possessed inadequate longitudinal stability, but its completion marked a step forward in the development of all-metal aircraft. Eddie, along with siblings Katherine, Marjorie and Jack, are the namesakes of Stinsons Flight 2 in San Antonio.



NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN

Thanks to Al

Monday Morning Humor and More--Staying Well and CopingLet's start with some good music and thoughts…



Submitted by Al Anderson:

A beautiful duet by a father and daughter singing "The Prayer" at https://www.youtube.com/watch?v=cqFCbtRz1Z0



Submitted by Susie DeHardt:

40 days and 40 nights in the ark, Noah's family was confined in a boat. There were no windows, no balconies, no terraces, no internet, no phone, no TV, no YouTube, Facebook, or Netflix. They only heard the rain. They spend their time praying, loving each other, and caring for the animals. God the Father took care of them as Noah was a man of faith and obeyed His word.

Remember even though there is out there an ocean of viruses and life seems like a stormy ride, our God is watching over us. Do not be afraid. Be faithful to Him and wait patiently. The rain will stop one day. A rainbow will shine and all be well again.



Listen to Andrew Lloyd Weber lead a virtual orchestra play "All I Ask of You" from Phantom of the Opera at https://www.youtube.com/watch?v=o04ECIpQFi0



Listen to a virtual remake of "We Are the World" at https://www.youtube.com/watch?v=0MWNW_a35oY



Listen to an outstanding performance of "Hallelujah" by Pentatonix at https://www.youtube.com/watch?v=LRP8d7hhpoQ



Submitted by Alan Krause Jr.:

If you're a Queen fan, some beautiful music by Brian May, Roger Taylor, and others playing instrumental versions of:

"Love of My Life" at https://www.youtube.com/watch?v=n_MwTQUYZoc

"We Are the Champions" at https://www.youtube.com/watch?v=ZWB4uGrUa8E



"Some Good News" with John Krasinski at:

Episode 1 - https://www.youtube.com/watch?v=F5pgG1M_h_U

Episode 2 - https://www.youtube.com/watch?v=oilZ1hNZPRM







…and now for some humor…



Boy, have things changed…

Border patrol just seized two tons of toilet paper hidden in cocaine.

The casinos are now offering curbside pickup. Call ahead and they come out and take your money right from your car.





Submitted by Dave Harris:

Day 16 of the quarantine: My wife called out from the other room and asked if I ever get stabbing pain in my chest like someone has a voodoo doll of me and is stabbing it.

I replied, "No."

She responded, "How about now?"



My house got TPed last night, it's now appraised at $875,000.

Day 17 of quarantine: Preparing to take out the garbage…so excited can't decide what to wear.

Remember laughing at Michael Jackson wearing mask and gloves. Now y'all out here looking like you wanna be starting something.

Does anyone know how long toilet paper will last if you freeze it?

You thought dogs were hard to train? Look at all the humans that can't sit and stay.

I hope the weather is good tomorrow for my trip to Puerto Backyarda. I'm getting tired of Los Livingroom.

My body has absorbed so much soap and disinfectant lately, that when I pee it cleans the toilet.

I don't know who needs to hear this, but today is Monday.

Homeschooling day 18: They all graduated. #DONE

Saw my neighbor Tammy out early this morning scraping the "My Kid is a Terrific Student" sticker off her minivan. Guess that second week of homeschooling didn't go well.

We are all gonna become so bored by the end of this everybody will know how to fold a fitted sheet.

Suppose I should get out of bed before I'm late getting to the living room.

Watched a documentary on mushrooms last night…that's probably how I'll watch all documentaries from now on.

I found that I have been happier since I changed from coffee in the morning to orange juice. My doctor explained that it's the vitamin C and natural sugars but I really think it's the vodka.

I swear my fridge just said, "What the he!! Do you want now?"





Submitted by Mark Logan:

How long is this social distancing supposed to last? My wife keeps trying to come in the house.

So are the dating site profiles going to start sounding like…Man with 84 rolls of toilet paper seeks woman with hand sanitizer. Or, single man with Purell and Lysol seeking single woman with toilet paper for good clean fun.

I need to practice social distancing from the refrigerator!!!

I asked a Walmart worker where I could find the nuts. He said in the toilet paper aisle.





Submitted by Al Anderson:

The buttons on my jeans have started social distancing from each other.

Stepped on my scale this morning and it said: Please use social distancing, one person at a time.



Submitted by John Hudson:

I went into another room and actually remembered why I went in there. It was the bathroom, but still…

I washed my hands so many times, I found the answers to my college social studies test.

Thoughts and prayers going out to all the married men who've spent months telling the wife, "I'll do that when I got time."

Home schooling Day 30: They all graduated yesterday.

This quarantine has me realizing why my dog gets so excited about something moving outside, going for walks or car rides. I think I just barked at a squirrel.

If you see my kids locked outside today, mind your business. We are having a fire drill. #HomeSchool

Until further notice the days of the week are now called: thisday, thatday, otherday, someday, yesterday, today, and nextday!

You can either have a nice day or you can help your child with their math homework. You can't have both.—Coronalations 3:30

If somebody isn't social distancing behind you…just pass gas!





Submitted by Barbara Hunt:

I don't think anyone expected that when we changed the clocks we'd go from Standard Time to the Twilight Zone.

This morning I saw a neighbor talking to her cat. It was obvious she thought her cat understood her. I came into my house, told my dog…we laughed a lot.

Quarantine Day 28: Went to this restaurant called THE KITCHEN. You have to gather all the ingredients and make your own meal. I have no clue how this place is still in business.

Day 32 of home schooling: One of these little monsters called in a bomb threat.





Submitted by Ernie Smith:

We are 20 days into self-isolation and it is really upsetting me to witness my wife standing at the living room window gazing aimlessly into space with tears running down her cheeks.

It breaks my heart to see her like this. I have thought very hard about how I can cheer her up. I have even considered letting her in--but rules are rules.





Submitted by Mike Ryan:

Tomorrow is the National Homeschool Tornado Drill. Lock your kids in the basement until you give the all clear. You're welcome!

I was so bored I called Jake from State Farm just to talk to someone. He asked me what I was wearing.

2019: Stay away from negative people. 2020: Stay away from positive people.

You think it's bad now? In 20 years our country will be run by people home-schooled by day drinkers.

Do not call the police on suspicious people in your neighborhood! Those are your neighbors without makeup and hair extensions!

Since we can't eat out, now's the perfect time to eat better, get fit, and stay healthy. We're quarantined! Who are we trying to impress? We have snacks, we have sweatpants--I say we use them!

Day 7 at home and the dog is looking at me like, "See? This is why I chew the furniture!"

Does anyone know if we can take showers yet or should we just keep washing our hands???

I never thought the comment "I wouldn't touch him/her with a 6 foot pole" would become a national policy, but here we are!

Me: Alexa what's the weather this weekend? Alexa: It doesn't matter--you're not going anywhere.

Can everyone please just follow the government instructions so we can knock out this corona virus and be done?! I feel like a kindergartner who keeps losing more recess time because one or two kids can't follow directions.

When this is over…what meeting do I attend first…Weight Watchers or AA?





Submitted by Dave Harris and Mark Logan:

The economy is so bad that....

 My neighbor got a pre-declined credit card in the mail.

 CEO's are now playing miniature golf.

 An exotic dancer was killed when her audience showered her with rolls of pennies while she danced.

 Exxon-Mobil laid off 25 Congressmen.

 If the bank returns your check marked "Insufficient Funds," you call them and ask if they meant you or them.

 McDonald's is selling the 1/4 ouncer.

 Angelina Jolie adopted a child from America.

 Parents in Beverly Hills fired their nannies and learned their children's names.

 A truckload of Americans was caught sneaking into Mexico.

 A picture is now only worth 200 words.

 When Bill and Hillary travel together, they now have to share a room.

 My cousin had an exorcism but couldn't afford to pay for it, and they re-possessed her!

 The Treasure Island casino in Las Vegas is now managed by Somali pirates.

 I was so depressed last night thinking about the economy, wars, jobs, my savings, Social Security, retirement funds, etc., I called the Suicide Hotline. I got a call center in Afghanistan, and when I told them I was suicidal, they got all excited, and asked if I could drive a truck.





Some internet fun…



M*A*S*H and the Coronavirus at https://www.youtube.com/watch?v=L5CNHDeF2xA

Parents help son celebrate 21st birthday at https://www.youtube.com/watch?v=DNMKDQimjVs





Hoping this finds you well and coping,

Al



NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN



Thanks to Mugs

Latest from a FedEx pilot via Retired General

From a retired General who headed up the California Air National Guard. Lends more credence to the anti-China rhetoric that is flowing.

Latest from a FedEx pilot, US Media is sniffing around this but seems to be Stonewalled fairly well ----Very definitely something to keep our eyes on.



Presently in Osaka going between here and Shanghai for a few more days.
Just FYI... this is starting to turn a lot more political. China recently
changed their screening process here to give the test to all aircrew
entering. And of course they immediately declared 5 of us as "COVID-19
Positive". Company did a great job getting them out of here and back to the
US for real tests... all 5 of them are negative. The political piece of
this is that China is now doing that to a lot of people trying to claim,
"See! The virus came from the US... not us!" (75% false positive rate). So
much so that our leadership is trying to revise our China flights to no
longer have layovers in China. Everything is now converting to "out and
backs" through China ultimately terminating/overnighting somewhere else...
so we don't have to go through customs there. People need to be aware that
China is in a desperate attempt to (1) cover up how many MILLIONS of people
in China actually died from this (I've heard as many as 2.5M), and (2) shift
the blame on this to some other nation/nations.



NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN