Wednesday, June 3, 2015
Friday, March 27, 2015
If you have spent much time with me, you know that I really have three passions. In no particular order they are software, personal finance, and Purdue. If I hadn't graduated from college with a Computer Science degree just as the world wide web was born, I very likely would have pursued a career related to personal finance. While my early influence on the subject came from my father (he bought me 10 shares of Novell as a graduation gift along with a subscription to the Wall Street Journal), my real education came from a nationally syndicated radio host named Clark Howard. For those of you unfamiliar with Clark, he is a consumer advocate and personal finance guru that hosts a daily radio show for over 20 years helping people save more, spend less, and avoid getting ripped off. The thing I respected most about Clark is that he has never taken money to endorse a product or company (if you know anything about how radio works, you realize that he is leaving millions of dollars on the table in advertising, but that's the price of credibility and independence). But, that also means that his opinions are not bought and paid for. Only in the past several years have I realized that the vast majority of financial advice is not intended to benefit the investor quite as much as it is the advisor/broker/salesperson/company providing the advice.
Recently I was able to checkoff one of my bucket list items by meeting Clark in person. I had been in contact with his Exective Producer, Christa DiBiase, via email and she extended an invitation for me to come in for a tour and spend the day with the Clark Howard Show team attending an actual broadcast. It was an incredible experience that I will never forget. The highlight for me was Christa's suggestion that Clark actually interview me about how following his advice over the years has made such a difference in my life and that of my family. You can listen to my entire interview (which aired 3/13/2015) just by clicking this link.
Clark asked me during the interview the 3-4 financial moves I made that have had the most dramatic impact on my life. But since I've been listening to Clark for 10 years, I realized that it would be interesting for me to collect the dozens of pieces of wisdom I have collected from the show and implemented over that period and share them in a blog post (along with a few I picked up from Dave Ramsey and a few I figured out for myself). I'm sure that some of these will be controversial to some people, but I suspect that with a list this long no two people on the planet would agree on everything. I categorized the advice into sections, but I colored the most important elements in red (for those of you who prefer to browse rather than read). I hope they are as useful to others as they have to me.
The Basics (If you read nothing else, read this section.)
- Act Your Wage
- Live on less than you earn. I know this sounds trite, but it is truly that simple. While this may be unrealistic for those near the lowest rung of the income ladder, it shouldn't be a problem for anyone making a median wage. I know far too many people who make over 6 figures and still live paycheck to paycheck. Keep reading to learn how!
- Eliminate Debt
- If you have any debts that accrue interest above 5% use the extra money at the end of each month (from Acting your Wage) to eliminate these debts first (usually credit cards). Don't worry about mortgage debt or auto loans that are small and manageable with low interest rates for less than four years. Pay those off as agreed.
- Emergency Fund
- Once the debts are paid off, with the extra money that you have at the end of each month by "Acting your Wage" start by saving up 6 months of basic living expenses which you keep in a separate bank savings account. This money is not to be borrowed for vacations or purchasing a boat or any other purpose. It is for emergencies only (e.g. extended unemployment, medical issue, critical car repair, or any other unexepected emergency!
- The Next Dollar
- Once you have built your emergency fund up to the 6 months of living expenses you can now redirect your monthly surplus to other saving and investing opportunities. The key is to build a plan for each "next dollar". That is "if I had one more dollar saved, how would I use it?" Typically, you will want to save/invest for retirement first and if you have children, a 529 college savings plan next (your kids can always borrow for school, but you cannot borrow for retirement so max your retirement options first). Both have great tax advantages. Here is my personal "next dollar" investment list : Roth401k, Roth IRA, Georgia 529 College Savings Plan, taxable investment account with Vanguard (all index funds).
- Saving vs Investing
- If you have extra income and are trying to decide what to do with it, you need to understand whether than money is intended to be used within the next 5 years. If the answer is yes, then you should be saving that money in a bank account or CDs. If the answer is no, then you can look at investing that money to make it grow (see Investing section below).
- An amazing tool available via web as well as apps for phone/tablet. It provides a single view of your entire financial life. Current balances for all banking, investing, credit cards, retirement, and every other account you may have along with detailed transaction logs for all of those accounts. Best of all, it uses crowd-sourced intelligence to automatically categorize your purchases based on the merchant. For example, if 90% of people categorized purchases at Starbucks as "Coffee" then it will default your purchase in the "Coffee" category. You can easily see what you spend and how/where you spend it. It also has budgeting and has recently added online billpay. Best of all, it requires almost no manual effort because it does almost everything automatically (stop using cash and use debt card to increase automation). Oh, and it's FREE! You can't manage what you can't measure; so sign up for Mint.com today. Tip: Combine Groceries & Household into one Mint category to simplify categorization so that you don't need to split out how much you spent on detergent vs milk for example.
- Transaction Review
- ALWAYS review your transactions in Mint.com to look for anything suspicious. This used to be a pain but with Mint.com providing a single list with all of my transactions across all credit cards, checks, ATMs, debit cards, etc. it's quite easy (takes 5 mins/week). You have only 60 days to contest invalid credit card charges with your card provider. My wife and I once gave someone a $26,000 Christmas present on our American Express without our knowledge. That was easy to spot, but what if someone is just milking you for $30/month and you never notice.
- Budget Spreadsheet
- Have a budget spreadsheet based on your mint.com data for planning (here's what I use). And review the budget from last year comparing it with the actual spending from Mint.com at the beginning of the following year. Adjust budget as necessary.
- Spending Limit
- Agree with your spouse to NEVER spend over $X without discussing it first and NEVER spend it before 24 hours have passed (typical buyers remorse timeframe)
- Item-Specific Savings Accounts
- CapitalOne360 (formerly INGdirect) allows you to create unlimited checking/savings accounts with no extra fees. This makes it extremely useful for creating savings for something specific (vacation, car, etc.) and track your progress independently of your other savings. This is also very useful for accruing money to pay for recurring expenses that only happen every X years (e.g. house painting).
- AVOID Checks
- They are the most dangerous way to pay for anything! You have just shared your routing number and account number with anyone who sees that check. I could present your bank with an electronic draft and empty your checking/savings account tomorrow with just that information. Use your credit card or debit card instead.
- AVOID Monster Megabanks (Bank of America, Citi, Chase, Wells Fargo)
- It's not a matter of IF they screw you, only WHEN. Instead see CapitalOne360, Simple.com, Ally, and your local credit unions.
- Millions of people in the U.S. do not have checking accounts. Today, many banks require you to have a certain credit score to get a checking account (even if you aren't asking for any credit)! Without a checking account you cannot do many things in our digital money culture (e.g. direct deposit, depositing checks with smartphone, etc.). The best alternative is provided by American Express and sold exclusively through Wal-Mart. It is called BlueBird and it provides almost all of the features of a checking account and has VERY low fees.
- Portable Level Term Life Insurance
- Each spouse needs to consider what their income needs would be if their current partner were to die unexpectedly. Generally, I recommend 10x the annual earnings of the person who is being insured. You want separate policies for each spouse. Also, don't rely purely on an employer-sponsored plan for your health insurance. What happens if you were to develop a terminal illness and then need to quit your job? Some employer-provided term life insurance policies are portable (meaning that you can continue the policy after you leave if you are willing to pay the full cost of the premiums). If you have an employer-sponsored policy, find out if it's portable. Make sure your policies are LEVEL (your premiums do not go up) and TERM (death benefit only, no investment vehicle).
- Disability Insurance
- You are 4x more likely to become disabled during your working lifetime than to die during your working lifetime. However, few people spend the money for disability insurance. Disability insurance typically comes in two flavors : Short term and Long term. As you might expect, the short term provides benefits for you for a short period of absence from work (e.g. 6 weeks) and is not as important if you have a fully-funded 6-month emergency fund. The Long Term Disability policy generally provides you a paycheck (often between 50% and 66% of your pre-disability income) if you are disabled for a longer period of time (up to the point you can return to work, you retire, or you die). BUY THIS!
- AVOID Variable Universal Life
- Extremely high fees and commissions for the salesperson. Awful track record for consumers. note: Unless you are making over $350K/year in taxable income you should not be looking at ANY insurance product as an investment. The supposed tax benefits for everyone below that threshold do NOT work out in your favor.
- AVOID Return of Premium Life Insurance
- Again, this is just another way for the insurer to collect more money from you and hope that you opt-out of the policy and they get to keep the extra premiums. Just get simple LEVEL TERM life insurance. Nothing more.
- AVOID Annuities
- Annuity is a curse word on the Clark Howard Show because they have extremely high fees and commissions for the salesperson and are generally awful for the consumer who purchases them. There are only 2 types of annuities that are EVER appropriate and they are called "Immediate Payout Annuities" or "Lifetime Annuities" and you should ONLY consider those options under the careful guidance of an independent hourly-paid financial advisor from the Garrett Planning Network (See Investing -> Financial Advisors).
- Amica Mutual Insurance
- Highest rated insurer for customer satisfaction on Auto and Home insurance. They aren't the absolute cheapest, but the point of insurance is to have them step up when you need them. They are an actual mutual company that works like a co-op and sends me a check at the end of each year that represents my portion of the profit they made.
- Financial Advisors
- Financial advisors are taught by their employers that they are looking out for your financial interests and they believe it to be true. But they are educated by a company whose primary interest is looking out for their own profits. Therefore, much of the advice you receive is filtered by the advisor's employer and tends to provide the maximum commissions and profits to the advisor and their employer. Much better (independent) advice can be had for much less (the hidden cost of biased advice is incalculable). Find a financial advisor who does not profit from your investment choices and does not hold your accounts that you pay an hourly rate for advice (I pay $210/hr for 60-90 minutes twice per year). The best source I have found for finding a financial advisor who works on this system is The Garret Planning Network.
- Tax Advantaged and/or Tax Free Investing
- Employer Matches for 401K/Roth401K (FREE MONEY!)
- Regular & Roth retirement accounts (401K/IRA/etc.)
- 529 College Savings Plans
- If the primary provider works full time and the household can operate on that single income. The spouse can work part time and make just enough to cover maxing out a 401K. It makes a HUGE impact on retirement savings. My wife worked part time for 10 years and has allocated 100% of her income to her 401K.
- Index Funds
- Index funds are were the genius idea from the founder of Vanguard, John Bogle. He realized that the sophisticated mutual fund managers who bought/sold stocks within a mutual fund on behalf of the fund's investors weren't very successful at it. And worse, they charged the investors a heavy management and commission fee to invest in the fund. Index funds eliminate the human element and they just mimick the performance of an index like the S&P 500. This means that they tend to have MUCH lower management fees and much less turnover (amount of stock/bonds bought/sold inside a fund) than traditional mutual funds which benefits investors over time.
- Targeted Retirement Funds
- For the average investor, trying to determine the appropriate investments in their 401k or IRA is incredibly difficult. Each account may have limitations on what investments they have to choose from. However, a new type of mutual fund has been created that is based purely on the year that the person wishes to retire. The fund slowly migrates the investments from more aggressive to more conservative as that year approaches which eliminates the need for constant rebalancing. Look for targeted retirement fund options in your 401K and IRA especially ones with very low fees (e.g. Vanguard 2040 fees = 0.18%).
- AVOID Precious Metals
- Buying precious metals as a "hedge" is a joke. The only people who think it's a good idea are the people who are selling them to you or has a vested interest in you buying them. There is a reason that this is sold on late-night TV alongside the ShamWow!
- AVOID Beating the Market
- Trying to beat the market is a fool's game (the pros can't do it either). If the "financial advisor" in the strip mall on the corner could actually consistently beat the market (for his clients or himself) he wouldn't be in a strip mall on the corner. He would be on his own private island. It's just like Vegas. At any given time a certain number of the investors/advisors are ahead of the casino and they look like they are geniuses, especially those who are up over a 3 day stretch. But in the long term, nobody beats the house unless they are cheating, and that will get you locked up. Highlighting this fund or that stock (like Jim Cramer) is simply calling out the names of those who are currently ahead of the house. It's not genius, it's entertainment. Don't fall for it. Read John Bogle's (Vanguard founder) books on the subject and save yourself (e.g. Don't Count on It!). You can make lots of money over time just matching the market with index funds; you don't have to beat it!
- AVOID Complex Financial Instruments
- If you cannot fully explain the investment in 5 minutes to an 18 year old and have them repeat it back to you accurately, then it has been engineered specifically to screw you in ways that the regulators have not yet been able to stop. Your goal is to make money, not to make your investment strategy as complex as possible. Think Credit Default Swaps in 2008 ;)
Debt and Credit
- Financial Peace University
- If you are deep in debt and need a path out, do NOT call one of those late night debt consolidation TV ads. Sign up for Dave Ramsey's Financial Peace University and follow his "baby steps" program. There is no better step by step guide on the planet that is better designed and has had more success than this. If you can't scrape together the fee then start by borrowing from the library his book "The Total Money Makeover" for inspiration until you can attend his class or purchase his DVDs.
- Freeze Your Credit
- Identity theft is rampant and you are at risk. The most common form of identity theft is where someone applies for credit in your name (e.g. store credit, credit cards, etc.) You can stop this from happening with 15 minutes of effort and between $0 and $30. Just freeze your credit with each of the 3 credit bureaus. Each credit bureau will give you a PIN number that you can use to temporarily unfreeze your credit when you wish to apply for a loan or need a credit score pulled. Works much like an ATM pin. Do it now!
- Credit Cards as First Payment Option
- Credit cards offer the best consumer protections of any payment type including a maximum liability of $50 for consumer cards (business cards are different). If you can't get a credit card use a check card if necessary (but only if you get to swipe it and it never leaves your site because if someone steals from your check card the money is already gone from your account). Avoid using cash so that Mint.com can automatically categorize your spending for you. Also, get a credit card that gives you the best rewards by checking out Credit Card TuneUp. Obviously, ONLY use this advice if you have the self-discipline to pay off your credit cards EVERY month (no exceptions). My old primary credit card was Delta Skymiles Amex (when I was a frequent flier), but I now use a 2% unlimited cashback credit card to get the most out of my purchasing.
- REFINANCE YOUR MORTGAGE!
- You will likely never see rates this low again in your lifetime. And try to get a 15 or 10 year mortgage because the rates will be lower and you will pay less interest on your house over time. If you can't afford the house on a 15 year mortgage at 3-4% then you cannot afford that house anyway. AVOID PMI (private mortgage insurance) by paying 20% down or doing an 80-10-10.
- Disposable Credit Card Numbers
- Get a credit card that offers disposable temporary credit card numbers that can be authorized for a single purchase. Great for paying a merchant you do not trust or a merchant that might try to continue billing you monthly for something you wanted one time. Amex used to offer this called Private Payments. Call your credit card companies to see if any offer it. If not, get one that does.
- Avoid Debt (some debt is worse than others)
- Exceptions for mortgages, education, and possibly your very first car (future cars should be purchased pre-owned with cash whenever possible)
- Especially avoid revolving debt like credit cards
- Worst possible debt is payday loans and title loans (ridiculous interest rates!)
- AVOID taking out private student loans. Their lobbyists have written laws that are truly outrageous that make them incredibly toxic. Stafford loans and PLUS loans are the way to go.
- AVOID Credit Monitoring
- Complete waste of money (e.g. LifeLock). Use credit freeze instead (see above).
- Look at the depreciation rate of automobiles and you will notice that in the first 3 years the value drops like a rock, and then it levels off. Purchasing a 3 year old vehicle that has already incurred the drop in price but still drives like new is the sweet spot of value. I've never owned a new car in my life, but a $300 detailing job on my pre-owned car makes it smell/feel brand new! Be sure to take the car to an independent mechanic for an inspection before the sale is final. You don't want surprises!
- I used to do consulting for Carmax and I must admit that I really respect their business model. They have eliminated the haggling from the automobile purchasing process. They have also separated the trade-in transaction so that you can be sure that you are not getting a great price on the car, only to get screwed on the trade-in value (a common tactic among car dealers). They only sell vehicles which meet strict requirements (age, mileage, repairs, etc) and sell off any trade-ins that do not meet those criteria in a wholesale auto auction (to the other used car dealerships in the area). Carmax is not the way to get the absolute top dollar for your trade-in nor to get the absolute lowest price for your automobile. However, it is a place I trust that I will not get ripped off...and that's really what most people are looking for.
- AVOID Car Leases
- Understand what a lease is. The leasing company is calculating how much the car is worth today and then subtracting how much they estimate the car to be worth when your lease is up (e.g. 3 years). That is the amount of depreciation in the vehicle during your lease. They then loan you the money for the depreciation amount at a certain interest rate. You are paying for the most expensive years of depreciation (years 1-3) and you are taking out a loan to pay on that depreciation on top of it! Buy used with cash!
- Rental Cars
- Always take pictures with your smartphone of any damage on a rental car before driving off the lot with your rental car. The pictures are timestamped and provide evidence when a rental car company tries to screw you (Fox Car Rental...I thank you for proving this point for me in San Francisco).
- AVOID Buying insurance and Extras
- ...at the car rental counter. Know your own coverages from your existing insurer and be sure to use a credit card when paying because they often provide insurance coverages. I use American Express for all of my rentals.
- If you do finance a car, be sure to line up your financing at a local bank or credit union BEFORE you head to the dealership. If the dealer can beat your deal then great, but usually the dealer will have more expensive interest rates.
- Never finance an automobile for more than 48 months. If you cannot make the payments for a 48 month or less finance plan, then you cannot afford that car.
- If you can avoid financing and pay cash, then drive that car until it chokes. I haven't had a car payment in over a decade and I really don't miss it at all!
- Available online and on your smartphone. Make smart purchases while you are still in the store by looking up the reliability and value of your purchases before you buy.
- Return Policies
- ALWAYS know the return policy BEFORE purchasing ANYTHING! Simple, but amazing how easily you can get ripped off. I once paid a $870 restocking fee for returning something one day late (caused by the fact that they listed the wrong email address on their website for initiating a return). Lesson learned the hard way.
- AVOID Contracts
- Cable/satellite, mobile phones, gyms, home security, etc. If you don't have the ability to walk away on a month's notice, they have no incentive to provide the service you expect. All of these can be done on a month-to-month basis.
- Costco, Sams Club, BJs Wholesale
- Just do it! All of them will save you money if you are self-disciplined. Costco is my favorite because it has a maximum markup of 16% on all products/services! And even if you are NOT a Costco member you can save LOTS of money buying your prescriptions from them (no membership required).
- Online Travel Deals
- Kayak.com, Priceline.com, and Hotwire.com are your best travel deal sites. Try Kayak's price alerts (you have to sign up for a free Kayak.com account) if you have a desire to go somewhere specific but are flexible on timing. Also checkout Kayak's Explore feature if you want to get away but haven't chosen somewhere to go yet. Hotwire is a great place to find cheap rental cars. And Priceline is obviously the king of the online travel bidding sites (submit several bids over a period of days to maximize your savings).
- Mobile Phones and Service
- The U.S. mobile phone and mobile service markets are undergoing a complete transformation. The old model was to sign a 2-year contract with one of the big providers (Verizon, AT&T, Sprint, T-Mobile) and have them subsidize the cost of your new mobile phone by overcharging you for your monthly service. They protected themselves from losses by instituting an early termination fee which basically paid for the phone if you decided to leave your carrier early. Now, the market has changed and most people signing up for mobile phone service are NOT signing contracts and instead paying month-to-month. This means that they are typcially paying the full-freight cost of their cellphones as well.
- The big 4 mobile phone carriers in the U.S. resell their service through companies like Cricket, MetroPCS, Boost Mobile, etc. These companies are called MVNOs and many can save you lots of money. The most expensive carrier today is Verizon, followed by AT&T, and then Sprint & T-Mobile. All resell through MVNOs but many (like Verizon) do not offer their 4G/LTE data speeds to their resellers.
- My favorite service today is called Republic Wireless. It runs on Sprint's network and it has a nifty feature that it uses your local wifi connection instead of a cellphone tower whenever possible. This means that when I am at home or at work I get an excellent signal always. Republic saves money by not using as much cellular bandwidth and pushes those savings back to the consumer. The only downside is that it requires me to buy a Republic Wireless phone. Luckily, they have some great Motorola models!
- Craigslist and Ebay
- Learn them and use them. They can save you thousands!
- AVOID Paying for anything on Ebay or Craigslist with Western Union funds or GreenPack money. Huge red flags that these are scammers.
- Try the generic/store-brand of every item in your grocery cart once. If you can't tell the difference, start buying the generic. If you don't like the generic/store-brand, then don't buy it again. Over time this saves thousands.
- Most products are created and priced by marketing departments who are trying to segment their market for maximum profits (I've participated in many such meetings myself in my career). You may see the same item in many different "grades". Typically the top grade is price purely for fools who have more money than sense (obviously avoid). The lowest grade is priced purely to get you in the door and as a result the product has been hobbled/cheapened so badly that it isn't worth your money. Look at one step up from the lowest grade. That is typically the sweet spot of price/value.
- Understand the average margin of the product you are purchasing. The greater that margin, the more room for negotiation. Extremely high margin items are furniture and jewelry. If you want to understand the margin on a piece of jewelry, tell the jeweler that you really want this piece for your spouse and you are willing to pay cash as long as you can have a 24 hour refund policy in case she doesn't want/like it (get it in writing). Then walk over to another jeweler and ask him/her what he/she will give you for that item. Of course, then go get your money back. Or just purchase your jewelry at Costco and you are assured that you are never paying more than 16% markup!
- Deals come to those who are patient. And the lazy will always pay top dollar.
- When shopping online, put things in your cart and wait a few days. Merchants are very aware of their browse/buy ratio. You will often receive an email coupon for one or more of those specific items within a few days. It will seem like great luck, but it's not luck. They are trying to "save" the sale and you benefit.
- Amazon Prime
- Worth every penny! 2-day free shipping and unlimited movie/tv streaming included (like Netflix) !
- AVOID Debit Holds
- Never use a debit card at a gas station or hotel (they put a huge hold on your cash for days which can cause you to bounce checks)
- AVOID extended warranties
Odds and Ends
- If you have kids you need a will. If you or your spouse were previously married (and especially if either of you have kids from that marriage) you need a will. Wills are more expensive as they get more complex. It's painful to spend thousands of dollars on something that you don't want to think about. But bite the bullet. Spend the money. Secure your family's future by ensuring that your final wishes are well-defined.
- Free Credit Report
- Get a free copy of your own credit report at AnnualCreditReport.com (NOT freecreditreport.com) and check it for errors. You are eligible for one each year from each of the 3 credit bureaus so you can get one every 4 months as you rotate through Experian, TransUnion, and Equifax. Also, apply for a credit card from a company who provides you your FICO credit score for free each month (my Citibank Mastercard does this, I believe Discover does too).
- Home Telephone
- It's really not necessary for most people these days. However, if you really want a home telephone and you have high-speed internet access consider Ooma. It's basic service is free for life and it's enhanced service is less than $4/month. One time purchase. I love it and it powers all of the phones in our house. It even integrates with Google Voice.
- WiFi Mobile Phones & International Travel
- When travelling internationally purchase wifi in the hotel and set your smartphone in airplane mode. Then enable wifi on your phone and use GrooveIP and Google Voice to make/recieve calls over wifi. Some phones can do this without GrooveIP and Google Voice (e.g. Republic Wireless). Also, download the google maps for your area into your phone while you are in the room and then turn on GPS. You will be able to navigate and use ZERO roaming data!
- ALWAYS understand exactly how anyone providing you service, products, or advice get compensated. If you fail to know this you are automatically at a disadvantage and will likely end up getting taken advantage of. Wonder how your financial advisor is providing all of this advice for free? If you don't know the difference between A-shares, B-shares, and C-shares, you are the one losing.
- Sending Cash
- If you need to send cash to someone quickly and cheaply check out Wal-Mart money center. You can send up to $900 for just $9 from any Wal-Mart to any other Wal-Mart. That's 1%. Moneygram, Western Union, and all of the other services are complete ripoffs by comparison.
- AVOID High Pressure Sales Pitches
- Any pitch that includes "today only!" is a good clue. Think about it. If I walked in with cash tomorrow and the salesperson would refuse it then he is an idiot. If I am not willing to wait 24 hrs to hand over that amount of cash, then I'm an idiot. The most common of these are timeshares and buying clubs.
- AVOID Timeshares
- The market for timeshares is completely broken. Most of the cannot be given away for free! The price of the timeshare is almost completely absorbed by the marketing costs and sales commissions. Avoid like the bubonic plague!
- AVOID Monthlies
- Review every monthly bill you pay. Do you really need that Hulu subscription? What about those magazines? XM-Sirius radio? A lot of times we just keep paying for subscriptions to things we no longer really use. Looks at what monthlies can be replaced by one-time purchases (e.g. replace Vonage with Ooma or replace cable with an HD antenna).
- AVOID Telephone Solicitation
- Never give any money to anyone who calls you on the phone out of the blue. You have absolutely no idea whether this person is who they claim to be from the organization they claim to be. Caller ID can be easily spoofed so don't think that this provides evidence of the caller's identity. If you want to contribute, have them send you info through the mail.
- Online BillPay
- Use online billpay and automate as much of your bill paying administrivia as possible! I used to use Bank of America for this, but I am closing my BofA account and moving my billpay to Mint.com so that I can easily switch banks anytime with no interruption to this important service.
Friday, January 16, 2015
As I reflect on my surgery I am disappointed that I missed so many opportunities to catch the cancer before it caused my large intestine to rupture. My annual colonoscopy was delayed by a few months because I was switching gastroenterologists (strike ONE). I had an MRI scheduled to happen 5 days prior to the rupture that was cancelled because I tested positive for C-DIFF (strike TWO). I had the opportunity to be admitted to the hospital 2 days prior to the rupture (Friday), but my new gastro said that I must leave immediately in order to get to the hospital before she left for the weekend. Given that my wife was at work and I had two kids that wasn't an option (strike THREE!). If any one of these circumstances had been different, we would have likely found the tumor and had a planned surgery rather than an emergency ruptured bowel that spilled all kinds of filth and bacteria into my abdominal cavity (causing a level of pain that I didn't know existed). As hard as the surgeons tried to flush my abdomen, it's impossible to get all of bacteria cleaned out. As a result I spent two months fighting post-operative infections with IV antibiotics and multiple drains and countless CT scans & MRIs. During that time my doctors were focused entirely on the infections and the cancer continued to grow and spread quickly. By the time I started chemo on November 6th, the number of tumors in my liver had grown substantially and the size the existing tumors had doubled (based on a comparison with the original CTs/MRIs). My liver had 20+ tumors ("lesions") the largest of which was about the size of a baseball. Apparently, my cancer is very aggressive with regards to growth and spreading. The upside is that chemo drugs work best against cell that divide quickly and mine certainly seem to be doing that!
Once we had the post-op infections under control my wife and I went about interviewing oncologists and found an amazing doctor, Steven Szabo. He put me on a chemo regimen called FoxFol 5-FU + Avastin that required me to have a port installed in my chest to deliver the chemo drugs. Every other Monday I spend 7 hours in an infusion center getting the chemo drugs pumped into me and I leave with a pump that infuses me for 48 hours. I then go back in the following Wednesday to get the pump removed. The chemo symptoms have gotten worse over time. Some of them are well known like nausea and fatigue, but some are bizarre like the fact that coldness on my fingertips or in my mouth/throat feels like an electric shock (kinda like a 9-volt battery on your tongue). On January 7th, I had a PET scan that was compared against my baseline PET scan (taken prior to chemo) and we learned that my tumors are shrinking and that there has been no further spread of cancer to other parts of my body. They expect me to be on this chemo regimen for another 3 months or so before I transition to mostly oral chemo meds.
My current symptoms consist of the chemo side-effects mentioned above plus severe back pain caused by the liver tumors pressing on the nerves in my lower back. I've been on oxycodone for a couple months and it does a pretty good job of managing the pain usually, but takes a while to kick in once I realize I'm in pain and take one. I've also purchased a Tempurpedic adjustable bed (split king) that allows me to adjust my position to alleviate pain without waking my wife. For the first couple months after surgery I really struggled to eat. I didn't eat for 22 days before and after surgery and lost about 32 pounds (which I didn't have to spare) so I'm down to about 150 lbs. Eating more than a small snack resulted in sweating, nausea, and discomfort. However, over the past 3 weeks or so I've been able to eat regular sized meals and have gained back about 3 pounds! I'm on the "consume as many calories and as much food as possible" diet...which annoys everyone around me who is trying to lose or maintain their weight :)
For the last 18 years my career has been a huge part of my life and my self-identity. It provided a life that has taken us from Connecticut to Richmond to Charlottesville to NYC to Atlanta. I work for a relatively small software company called Pivotal that was spun out of VMware and EMC. I cannot say enough about how helpful and understanding they have been through this. I have learned more than I care to about employment law, social security disability, short/long term disability, HIPPA, and benefits. My employer continues to provide health insurance and long-term disability insurance during this extended absence (which they are not required to do by law). I cannot imagine how difficult this kind of experience must be for those who must endure crushing financial hardship along with the physical and emotional toll of cancer. I am incredibly fortunate.
I've had a bucket list that I created long before my cancer diagnosis which included taking my wife to Paris (check), skydiving (check), and many other things. I've added a bunch of travel lately. While I'm not sure that I'll be healthy enough to do everything on it, I've decided to plan it and adapt as necessary. Our first trip was to spend 9 days over Thanksgiving driving through Indiana visiting friends and family. I wanted to attend a Purdue football game this year (yes, I'm a glutton for punishment) and my wife was able to arrange for us to sit in the skybox during the game . She also managed to get us a ride on the Boilermaker Special train which included a ride around the stadium, then right through the gates to the south end-zone where we were escorted to the skybox. AWESOME! However, my kids expectations are now completely ruined because they now believe that's NORMAL :) After new years, the family headed for 3 days of fun at Disney World. I had to take a break each day after lunch while Kristen took the kids on a few rides without me, but overall it was fantastic. It turns out my kids (ages 6 & 9) are thrill ride fanatics! And with the Disney's FastPass+ system we spent less than one hour in line over the entire 3 day vacation. Really impressive since my childhood memories of Disney are littered with standing for hours on end in blazing heat for a 2-3 minute roller coaster ride. Already planned are trips to Detroit to see my brother, Indianapolis for the Boilermaker Ball, Winter Park for skiing, Las Vegas for just Kristen and I to get away, San Francisco with the kids, and finally Maui next summer with my cousin. I've even considered renting an RV for a pseudo-camping trip with the family (I have no interest in the type of camping that requires me sleeping on the ground in a tent covered in mosquitos). Needless to say, we're making the most of the time we have.
As you would expect, life has been quite different for me since the surgery and diagnosis. Without work, my days consist of doctor/chemo appointments, medical/disability administrivia, chores, naps (fatigue), and time with friends/family. Almost everyone is aware of my situation now, but every few weeks I have someone who is not on social media reach out with "OMG, I just found out!" When people actually see me for the first time they generally get a bit uncomfortable and there's a lot of awkward pauses as they search for words. I've gotten used to the awkwardness and try to show them that I'm the same guy they remember, only thinner and a bit less mobile. My closest friends/family have now gotten comfortable with the "gallows humor" that I often use these days. One of the positive benefits of my situation is that lots of things that used to really bother me, just don't matter much anymore. Whoever said "Don't sweat the small stuff. It's almost all small stuff" was exactly right.
I've thought a lot about death since my diagnosis. It's such a taboo subject that people are really uncomfortable talking about (especially with someone who is terminally ill because it's not just a hypothetical topic). Whenever I'm talking about estate planning, or my bucket list, or other aspects of planning for the inevitable I get a lot of well-intentioned "you never know, miracles happen everyday, god works in mysterious ways, you can't give up" comments. While I'm definitely not happy about my prognosis, I have accepted the reality that the 5-year survival rate for someone in my position is less than 6% with the average being about 2 years (my oncologist thinks that I can make it 3 years based on my response to chemo). That doesn't mean that I've "given up", it just means that I'm a pragmatist at heart and I consider every day since August 24th, 2014 to be "bonus time". That being said, some days are harder than others. It's a surreal feeling to know that you are approaching the finish line. I won't say that it doesn't make me sad, it does. Usually in the form of a few minutes of tears each day when I'm alone. But then I hear the giggle of one of my kids or the voice of my wife in the background and I smile and quickly realize that I don't have time to sulk or feel sorry for myself. Now is the time to live; Death will just have to wait it's damn turn ;)
Friday, October 3, 2014
It's so easy to get wrapped up in our day-to-day lives that you fail to recognize the impact that your life has had on those around you and thereby on your world. It's a shame that most people will never get the gift that I have received. Most of us will pass through life without realizing our own impact on the world. I'm lucky. It's a gift I will cherish for the rest of my days.
Monday, September 22, 2014
"Terminal". It's such a devastating word. One I hope you never hear.
I awoke momentarily in the ICU (intensive care unit) out of the narcotic induced haze and overheard a doctor in my room use the word "cancer". I was too loopy to see anything and in too much pain to respond in any way... but I heard it distinctly before I fell back into my narcotic induced sleep. It would be two days before anyone used that word in my presence again. It was a nurse who asked me the simple question "Have any of the doctors actually shared your diagnosis with you yet?" I responded that I had overheard the word cancer and she confirmed it for me. I asked "Terminal?" and she nodded.
While this is the 3rd time in my life I have been diagnosed with an incurable disease (Crohns & PSC previously), nothing could prepare me for the phrase "terminal Stage 4 metastatic colon cancer". We are certain that it has metastasized to the lymph nodes and we believe it has also metastasized to the liver as well. We cannot be 100% sure of this today because the surgeons were not able to get a liver sample before closing up my abdomen during my initial surgery (apparently they were worried I wouldn't make it beyond the 6 hours I was already in surgery). Our hope is that we can stop/slow it from metastasizing to the lungs (the 2nd favorite destination of colon cancer beyond the liver). We have found no evidence of lung involvement to date but, of course, cancer cells are too small to be seen so all we can do is hope.
An additional downside to the cancer diagnosis is that it makes me ineligible for a liver transplant if my PSC were to worsen. Many thanks to those who stepped up and volunteered to be a living donor for me, I cannot tell you how your generous offers touched me and my family (I am crying at the thought as I type this line). But it is not to be.
One of the few nice things about being ill the the outpouring of love and support that you receive (or at least that I've received) from my friends and family. Emails, cards, text messages, phone calls, unexpected visits, comments on Facebook/blogs/twitter. I read / listen-to every single one of them and while I cannot always reply, every one of them lifts my spirits and makes me realize how my life has touched others. I got one of the most heartwarming voicemails from someone I haven't worked with in several years just yesterday. I cried when I listened to it. It's been wonderful to have my parents so close (about 30 mins away) and I've gotten to see a lot of them both in the hospital and since. I talk to my brother in Michigan every week which certainly brightens my day. But most of the heavy lifting has rested on the shoulders of my amazing wife, Kristen. She is my wife, my home healthcare provider, and my savior at the moment. She is the strongest person I have ever met. I may not be lucky health-wise, but when it comes to choosing a spouse, I am truly the luckiest man alive.
With two young children at home (ages 6 & 9) Kristen and I had to decide what to share, with whom, and when. We definitely didn't want them to find out about my diagnosis and prognosis by overhearing a conversation or piecing things together. So we decided to be honest with them and sat them down last weekend and just told them everything as clearly yet concisely as possible. They were upset of course, but I've been amazed at how adaptable children are. We can now talk about it as a family without any hushed tones or raised eyebrows. It's difficult to know for sure, but I think it was the right choice for us.
As for work, I am fortunate to work for an employer (Pivotal) that provides life insurance, short-term and long-term disability insurance, and is generous on top of all that. I am not sure if I will return to work or not (or even whether I will be strong enough to have that option). I certainly gain a lot of my self worth and gain a lot of satisfaction from my work, so it could actually be theraputic for me. I'm currently on short-term disability insurance and will migrate to long-term disability when that runs out. I guess I will just have to wait and see whether returning to work is a real option for me.
Tuesday, August 26, 2014
A few of you may have heard that I have had a recent health scare. If you read my prior post in January you learned about my PSC diagnosis and the challenges of liver transplantation.
This months edition will dip back over 2 decades ago when I was diagnosed with Crohn's disease. In 1991 it was bit generally well known and there was no world wide web yet to learn about it. It's an inflammatory bowel disease that can range from mild to terrifying. Over the part few weeks I took that accelerated journey.
It started with a colangitis attack (liver infection) about 3 weeks back. I took a well of antibiotics (yes, finishing entire bottle). One of the dangers of antibiotics is a new infection that springs up right after the antibiotics stop...it s call "c diff" and it is incredibly dangerous. I developed a c diff infection but didn't realize it for over a week (was traveling in California). On Friday I got home to Atlanta and went to the doctor who confirmed her cdiff diagnosis over the weekend and got me started on new antibiotics. Unfortunately, they didn't work in time and on Sunday night my colon perforated spilling the contents off my bowls into my abdomen. On a pain scale of 1-10 this is a twelve. I couldn't breath and thought I might suffocate. It was 3 am and Kristen quickly got me to the e.r. where we waited in line (not patiently, but we waited). I finally saw a doctor about 60 -90 minutes later and was told I needed surgery immediately. Monday morning the removed my colon and have me a illeostomy bag that hangs from my abdomen. Today I managed to get internet access and get my breathing tube removed. It's still painful to talk much, but comments and email is welcome....but the single best thing you can do for me is fill this out.
Thank you and I will add health updates here so that you don't have to learn by word of mouth.
For those of you who dig scars here you go. The loop goes around my belly button.
Monday, January 27, 2014
About three years ago, I received a diagnosis called Primary Sclerosing Cholangitis (PSC) which is a rare liver disease (affecting 3 out of every 100,000 people in the U.S.) without a known cause or cure. The disease prevents the bile that’s produced in the liver from properly draining into the small intestine. Without proper drainage, the bile buildup causes stones and cirrhosis of the liver, which will ultimately require a liver transplant to survive. Given the serious nature of the condition, I decided to share this information only with my immediate family (obviously, that has now changed).
As you might imagine, this news came as quite a shock to me and my family. But, I was asymptomatic at the time, so it was easy to live in denial for a while. About 6-9 months later I was on a business retreat in the mountains of Colorado when I suddenly felt very ill. Instead of participating in the meeting I slept for about 18-20 hours straight. I had no idea at the time that I was having a cholangitis attack (liver infection) and that my life was in danger without medical attention. Luckily, my body was able to fight off the infection and I returned home none-the-wiser. About a year later I was on vacation with my family at the beach and I had another cholangitis attack, this time I found my way to the emergency room and spent a week in the hospital recovering with the help of antibiotics.
Proactive Monitoring & Therapy
I get pictures (MRCP) taken of my liver every so often by my heptologist to track the progression of my disease. A few months ago the pictures showed what appeared to be a lot of gall stones that had formed behind the strictures in my liver and my doctor was very surprised that I had not experienced more symptoms yet. He proposed that we insert a drainage tube through my ribs and into my liver that would help to drain out the bile and hopefully a lot of the gall stones. The tube would be taped to my side and i would come back to the hospital periodically over a period of 6 weeks where they would insert instruments into the tube and try to balloon strictures in my liver and remove gallstones.
On January 9th I checked into Emory Radiology for my procedure. When I came out of anesthesia I knew something was wrong. The amount of pain I was experiencing far exceeded what the doctors expected. After a couple of days in the hospital on narcotics I went home. Only to return 3 days later with uncontrollable pain. They did an MRI but could not determine the reason for the excessive pain. I was put on a narcotics cocktail of 3 drugs in an effort to control the pain. We then installed a 2nd liver drain in my abdomen with the hope that it might be less painful and we might be able to remove the 1st one. No such luck. Finally, we switched to plan B and used the drains to help guide an endoscope (tube that goes down your throat) into my primary bile duct and install a stent to improve the flow of bile from the liver into the small intestine. Once they installed the stent the doctors were able to remove the drains altogether (yippee). Finally pain free, I was able to go home after a 5 day stay in the hospital.
Unfortunately, a few days later I developed a fever that progressed over the next 3-4 days until I was told to return to the hospital for treatment of a probable liver infection (a clear risk of the procedure, but not one that you expect to happen). So I’ve been hospitalized for the 3rd time in three weeks, this time with a cocktail of IV antibiotics to fight the liver infection. After 5 more days in the hospital it looks like I might be able to finally go home (fever free) with a PICC line installed so that I can administer my own IV antibiotics for the next 4-6 weeks. I’m writing this from my hospital room right now as I await the doctor’s decision.
The Road Ahead
This will not be the last time I am hospitalized for PSC. I know this. But my hope is that we were able to clear away enough gallstones and sludge from my liver and balloon enough strictures during the procedures and the painful time that the drains were in that we have extended the life of my liver. Also, since I now have a stent inside my primary bile duct we should be able to conduct future therapies endoscopically (down my throat) rather than having to punch a new hole in me.
PSC is a strange disease. Some people need a liver transplant within 12 months of diagnosis and others spend 20 years or more with their original liver. There’s just so much variance that statistics aren’t much help. So, I will go on about my daily life until the next time that PSC decides that it’s time to remind me of it’s presence and we will deal with the challenges as they come.
As word of my hospitalization spread I was asked continuously “what can I do to help?”. And I never knew what to tell them until now. You can be a hero and become an organ donor online right now, before you close your web browser. It takes 5 minutes. There are over 35,000 people waiting for a kidney and over 10,000 people waiting on a liver this very moment. On average, 18 people die every day waiting for an organ transplant. Take the 5 minutes now. Click a mouse, save a life, be a hero. Your organs aren’t much good to you once you’ve passed, but they are a source of hope for thousands who sit waiting for that miracle phone call “we have your new liver/heart/lung/kidney/etc" : http://organdonor.gov/becomingdonor/stateregistries.html
The life you save could be mine.