There’s a Lot I Haven’t Been Telling You
There’s a lot I haven’t been telling you, but I’ll tell you (most) everything now.
Reveal 1: My larger tumors started swiftly regrowing even though the smaller ones kept shrinking. We saw this first on a CT scan in February and it was dramatically confirmed in a PT/CT in April. This wasn’t a surprise to Molly and I as we saw my quality of life was backsliding. Many of the odd symptoms I had before my diagnosis had resumed and they were getting worse week by week. I was rapidly losing weight because my stomach was likely contained by the tumor growth. I could no longer walk the hills in my neighborhood without a long rest and my symptomatic night sweats came back. We privately guarded the possibility that my only life saving treatment was no longer saving me.
By mid-April my oncologist confirmed that my immunological treatment Nivolumab (Opdivo) was no longer effective on my worst tumors, but it’s original positive effect confirmed I most likely have kidney cancer (renal cell carcinoma). Surgery and radiation are not options for me now due to the size and spread of my tumors. My doctor wanted to get me on the newest generation of Cabozantinib (Cabometyx). Cabozantanib is a targeted VEG-F inhibitor that slows the creation of new blood vessel growth in renal cell carcinoma. It comes in pill form which I take daily and has far fewer side effects than traditional infusion chemo. It’s another innovation scientists and oncologists unlocked in the last 15 years and was only FDA approved for my treatment last year.
My pain and side effects from the tumor growth was so uncomfortable I was rushing to start the new treatment. But this is America and all major treatment has to be approved by one’s insurer, and they rejected the original request. While this was very stressful, as I felt worse each day, my oncologist calmly and urgently played this out like a card game. He always expected I would have to resubmit on appeal, and he would play my Stage-4 trump card. This worked and my request was finally approved. But in-between, I went 5–6 weeks with no treatment … and things got pretty dark.
For a couple weeks my tumors hurt so much I was in pain all day. If it wasn’t for a 2:1 CBD:THC cannabis edible, I would have been hard pressed not to go back on opioids. My inability to add weight became a top concern. My sleep was exhausting. I was mostly stuck at home to avoid overextending myself. My tenuous mortality kept slipping back in to my thoughts. The neck-grabbing reminder that the savage mutation in my body will continue doing all it can to unknowingly (I would hope) destroy me. Forcefully reminding me my only chance to outlast my cancer is to live long enough that a cure is discovered that clears me of my tumors. As I said, it got dark.
So it was wonderful relief when my body started responding right away to my new chemo-in-a-pill treatment. The pain and night sweats stopped immediately. Within a few days I had hunger pangs and an appetite again. I’ve been gaining weight again and people have started telling me “you look good” again after a couple months of not hearing it often. Fortunately I haven’t been hampered with most of Cabometyx common side affects, but since day one I’ve been chronically fatigued and still am. Fatigue like sandbags. Fatigue that laughs at caffeine. I’m fine otherwise, just tired. To counteract it, I get LOTS of sleep and take Ritalin or a natural treatment when I need it. I’ve been told to expect more side effects come on as I continue taking the Cabometyx, but my current experience is a cake walk compared to getting traditional chemo. In fact even during those bad dark weeks I was still putting in work hours, seeing friends and playing games with Mabel.
Hopefully I haven’t lightly shook my readers too much. For us, this experience is what it is. What’s happening now is our journey to experience on the way to our destination. I’ve already refined my life’s focus to family, home and purpose (more on purpose below) and frankly, I’m not giving away my shot (Thank you Molly Ditmore). I’m not going to let a little tiredness hold me back.
Which all leads me to reveal number two. If you’ve been following me lately you’ll know FastCompany published my business case for the fully interlocked profit-from-purpose business model and TechCrunch published my analysis of the ImpactVCs backing them. Day or night there’s always someone looking at my spreadsheet of supporting data on Impact VCs.
The trend of sustainable for-large-profit-from-purpose businesses is already here and accelerating quickly. As COO of Tala I saw how quickly a massive market can be created by serving the financially underserved. At Tala we invented smartphone-based lending for emerging market consumers and received massive demand from creditworthy consumers previously ignored by the traditional financial service providers. With it’s global focus and great Series B, it’s very conceivable Tala can benefit a billion customers worldwide and make a lot of money doing it.
Which all brings me to …
Reveal 2: I been working with Bloom Credit for 3 months now as a very active Sr. Advisor. Instead of serving the large market of unbanked and financially underserved overseas, it’s serves the large financial market of mis-served Americans that are actually creditworthy, even though it’s not represented in their credit score. Bloom uses first-of-its-kind credit history modeling to help lenders expand their loan portfolios to reach the tens of millions of credit-eligible consumers their models dis-serve. Credit providers today (mortgage, credit cards, personal loans) consider a rejection the end of relationship and offer no guidance on how applicants could be eligible. That’s where Bloom comes in. We identify the credit-eligible people, the people with prime-like repayment habits, and help them take positive actions to improve their score. The more consumers we help get the credit services that are right for them, the more the lenders will want our leads, the more successful Bloom will be. It’s a fully interlocked profit-from-purpose where Bloom’s purpose drives it’s profit and it’s profit drive it’s purpose. If Bloom concedes too much to the lenders, consumers will lose their trust in us. If Bloom concedes too much to the consumers, the lenders will reject our leads. The revenue model throws off the most money over the long term because of, not in spite of, everyone being treated fairly.
Perhaps you can understand this isn’t just a job to me, this is a purpose. I’d personally like to show that true profit-from-purpose models aren’t just a possibility, but a reliable, repeatable defensible business model. I’m confident large profitable businesses can throw off as much social or environmental benefit as well-endowed foundations. And that thousands of such businesses can exist concurrently. Here’s a closing tip: The trend of purpose is coming like a tidal wave … why not get in front of it?