Clinical Trials ~ Lies, Damn Lies and STATISTICS ~ and data we need for melanoma decisions and treatments...

We all need real live data, proven factual information, in order to make reasonable choices about our health, needed treatments, medication, safety information on the vehicles we drive, the restaurants at which we choose to eat, and ever so many other daily decisions - large and small!  Data is important and should not be buried or fudged to attain outcomes preferred by invested parties.  When you are diagnosed with a deadly disease, you need real, tangible information in order to make the best informed decisions you can regarding your care.  I wrote this in 2012:  Educated guesses and desperate decisions..... Being a rattie in a Phase 1 clinical trail of Nivolumab (Opdivo) from December 2010 - June of 2013 was an extreme learning experience to say the least!  As a medical professional of many years, always accompanied by another, I am horrified to think of what folks without such backgrounds deal with in that circumstance.  As it was we were definitely swimming upstream during that process!  And while I am certain access and participation in that clinical trial absolutely saved my life, the management of clinical trials runs the gamut from incredible science to completely ludicrous to intensely horrifying!  Here are just a few of my rants regarding clinical trials over the years:

July 2013:  Almost 50% of Results of Cancer Drug Trials NOT published!
March 2014:  Should Melanoma Brain Met patients be allowed in clinical trials???
April 2014:  Clinical Trials and Patient Rights...An oxymoron????
December 2014:  Patient rights in a clinical trial. An oxymoron???? Redux...
January 2015:  A beautiful lady, with eloquent, though heartbreaking words re: clinical trials....
January 2016:  The Problem with Clinical Trials
August 2016:  Medical studies in children go unpublished!!! Here we go AGAIN!!!
September 2016:  New Rules to push for published trial results!
January 2017:  The trial of trials!
June 2017:  Outcomes for melanoma patients ~ clinical trials vs standard of care
April 2018:  Odds and Ends ~ Melanoma in children and cancer trial access for people of color

Sadly, many of these reports touch on points that remain unresolved!  Just last week, Medscape posted:  Most Clinical Trials Still Don't Report Results by Deadline  Despite the many lives at stake, the report notes:  "Three years after a federal deadline was clarified, mandating that clinical trial sponsors report results to ClinicalTrials.gov within 1 year of the primary completion date, most researchers still miss the deadline, ...  [To examine this issue, researchers]  ... downloaded all registered trials due to report between March 2018 and September 2019 and found that of those 4209 trials, only 40.9% made the 1-year deadline; only 63.8% reported results at any time."

Horrifying, no??  And even when researchers report trial findings, what do those results really mean?  Does 1 + 1 really = 2 mathematically???  Sometimes not!!!  Back in March of last year, 800 scientists signed a group letter calling for an end to ridiculous statistical massaging of data.  Here's a report on their thoughts from Nature:  Scientists rise up against statistical significance  The authors note:   "For several generations, researchers have been warned that a statistically non-significant result does not ‘prove’ the null hypothesis (the hypothesis that there is no difference between groups or no effect of a treatment on some measured outcome). Nor do statistically significant results ‘prove’ some other hypothesis. Such misconceptions have famously warped the literature with overstated claims and, less famously, led to claims of conflicts between studies where none exists."  Noting that in the end it was their hope, that - "Decisions to interpret or to publish results will not be based on statistical thresholds. [rather] People will spend less time with statistical software, and more time thinking."

And if the math and conclusions involved are reported AND meet "statistical" and "common sense" significance, does the issue or the drug examined even matter?  I could write reams on the first.  Studies that look at obvious issues and derive obvious conclusions, like:  "Folks who consume more calories weigh more than those who don't!!!"  or  "Children whose parents spend more time with them do better in school and life!!"  or  "Peeps who eat their fiber POOP!"  Real studies people.  Wouldn't even kid you!!!  Apart from that - are the treatment or drug options developed and studied even needed?  Unfortunately, there are many instances when you could argue - NOT!!!  This opinion piece from September 2019 in STAT, touches on that very point:   Enough with the me-too drugs. New treatments should be worthy of the people who invest their lives in clinical trials

  "...I believe are too many companies pushing mediocre and me-too drugs, also known as copycat drugs, into clinical development where they will likely fail.  Clinical trials are more than a way to test new therapies. They offer very sick people hope and a chance for more time with their loved ones. Lately, the drug development process has turned into an exercise in me-tooism — at patients’ expense. It’s time to shift the focus back to those who matter most."  With the author noting that in a panel discussion, the head of the FDA  - "called for companies to reevaluate their current clinical trial processes. He rightfully criticized the industry’s repeated attempts at testing an approach in a disease indication after it has failed multiple times.  [As an example, he pointed out] ... "checkpoint inhibitors (drugs that target PD-1 or PD-L1) for multiple myeloma. Three recent studies were conducted close together, and although they were well-controlled and well-managed with data safety review boards, multiple studies showing negative results were not needed...  There is no question that replicating studies has value, but in this situation the industry was duplicating harm to patients, as all three studies showed decrements in overall survival.  ... When people enroll in cancer clinical trials, they are placing their lives in our hands. Many have advanced disease and turn to a clinical trial for hope and possible healing. Yet as an industry, we are competing for these patients to test me-too drugs with significant toxicity, sometimes based on marginal preclinical data.  ...patients are not a company’s resource. ... They are people who are hoping for a chance at recovery, or at least more time with their families with reasonable quality of life. We should treat patients who volunteer for clinical trials the way we would treat our mothers or husbands or best friends.  [He] asked companies to be more efficient by collaborating, sharing data, and conducting platform trials. Some biopharmaceutical companies are trying to do this, but the industry has a long way to go. We should be moving drugs into clinical development only when there’s a strong understanding of disease biology and substantial evidence that a drug has the potential to truly improve lives."

Even when trials meet all of the desired criteria - how does the information attained address the individual?  After all, it is pretty clear that the disease process and treatment response (in terms of disease control and adverse events) varies greatly person to person despite group outcomes.  In the summer of last year, The Scientist published this:  N-of-1 Trials Take on Challenges in Health Care, where the author notes "... an N-of-1 trial [is] focused on the collection of treatment-response data in a single patient, this relatively little-used trial design represents the ultimate form of patient-centered medicine."  Pretty interesting stuff and probably most valuable in tweaking care for a particular patient though they could also elucidate trends when similar results are found among multiple individuals.

So, if you're still with me - and still need to find a clinical trial option that is right for you, there remains the difficulty of learning about available trials and dealing with all the "exclusions" once you've found a trial that seems as though it could be helpful.  If you've already had this medication or that one...you may be excluded.  If you can't do the prescribed number of jumping jacks...then nope.  This trial is not for you.   For the longest, folks with brain mets and CNS disease were kept out of melanoma trials.  Why????  If you are seeking care for a hang nail, then perhaps participation in an experiment with a medication that may cause awful and at times lethal side effects would be over-the-top and ill advised.  However, if you are going to DIE (no doubt about it) without effective treatment, shouldn't those peeps be allowed access to experimental treatments if that is what they want to do???  (Yes, several states now have "Right to Try" laws, but even when patients attain care under their cover, insurance companies, often say, "No thanks, you're on your own!" which shuts down access right then and there!)  Or, do we simply exclude those likely to have untoward outcomes because of their advanced disease, limited physical strength, or prior treatment failures so as to prevent poor statistical results that will reflect badly on the institution, researcher, or BIG pharma who happens to be running the trial?  In prior rants included above, I've noted that researchers can easily group such patients in an arm of their own so as to clarify outcomes.  In the category of  ~  for what it's worth ~ I saw this in Forbes:  Developers Use Artificial Intelligence To Match Patients To Clinical Trials

Despite all that is difficult, negotiating and participating in a clinical trial IS doable!!  Even if you have to do it on your own.  Here are some thoughts I put on MPIP for a forum member not too long ago:

Whether or not one wants to pursue a clinical trial option depends on many things.

1. First and foremost would be whether or not there is a viable treatment option for your condition. Back in the dark ages of melanoma (before 2011) when there were NO FDA approved treatment options other than interferon (which did absolutely nothing to improve OS and made you sick as a dog) or IL2 which, as administered back then, required a stay in the intensive care unit and a potential 10% response rate and given its toxicity wasn't an option unless you were Stage IV, we all wanted a chance at a treatment via a clinical trial as ipi and nivo were cooking along there and outcomes to them were looking better than the drugs otherwise available.  Now that immunotherapy and targeted therapy drugs are FDA approved for melanoma, the landscape has changed. So, as a starting point, if you have viable treatment options with odds that are as good or better than current trial drugs - regular standard therapy is generally preferred.

2. Personality and money. Clinical trials are not for the faint of heart. They are their own crazy in addition to the treatment. Plus, they can be expensive. Most are not "free" as many may think. Pricing is variable, but for my nivo trial in 2010 the only thing that was "given" to me was the trial drug and the labs THEY wanted to draw for the study. All other expenses (from nursing in the unit, to IV tubing, to doctor visits, to REQUIRED for participation scans and labs - not to mention travel to the location) were my problem. If my insurance company covered them great. But if they didn't and/or costs like deductibles and patient percentages were required - they were mine to pay. Further, most trial paper work comes with a disclaimer that states if you grow three heads, have side effects, or any other untoward event - the coverage for diagnosing and treating that event is NOT the responsibility of the doc or institution running the trial nor the drug manufacturer. So, that's fun. You really have to pay attention to the fine print.

3. Understanding what you are offered. Phase 1 trials are basically dosing trials. They are not technically done to see who they cure, rather they are done to determine the amount of medication needed to get a response versus the amount of drug that makes people freak. Using my phase 1 nivo trial as an example - We were divided into 3 arms of Stage IV patients with active disease and 3 arms of Stage IV patients who had their disease removed via surgery or radiation. The first arm of both cohorts got only 1mg/kg of the drug. When we did not spontaneously combust, the next got 3mg/kg. The third got 10mg/kg. The results of this and other studies at that time led to the use of the 3mg/kg dosing schedule which has now been rounded to the 240 mg dose every 2 weeks or the 480 mg dose every 4. Additionally, the drugs used in Phase 1 trials are relatively new with little data in humans to back up their use. So, there is a risk that they will not benefit the rattie as much as desired. HOWEVER, the good thing about Phase 1 trials is that everyone gets the drug. In Phase 2/3 trials - the trial drug is often randomized. With some arms getting nothing or a lesser drug. The recent/ongoing trials for ipi/nivo as adjuvant for melanoma are a pretty good deal because the participants get either the desired combo or nivo alone. So even if you get "only" the nivo arm, you are still getting a good treatment. Unfortunately, not all trial options are that good. I've ranted for years about everybody and his brother putting valid trial drugs for melanoma up against dacarbazine (a drug known to have little effect). Something that I feel at this point in time is simply unconscionable!!! I digress, but you get the idea.

4. Your doc's role. Your doctor, if they deserve the license under which they practice ABSOLUTELY SHOULD discuss trial options with their patients when appropriate and help find the one that will best suit their patient's needs!!!!!!!!!!!! However, the odds of attaining this service with a local oncologist is small. If things get beyond the treatment options they have available, they will usually just send the patient to a bigger facility that does more research - which I guess is okay. The patient can then meet with docs who are more specialized and who have access to clinical trials. NOW - THOSE docs should still be frank about how good a fit the trials at their institution may or MAY NOT be for the particular patient. Some docs are. Some aren't. I've experienced both. Sadly, many will simply try to enroll you in what they are running, rather than telling you about trial options elsewhere that may actually be better for you. I can say with complete authority that Jeff Weber, currently of NYU, is a straight shooter whom I have known to tell patients when appropriate, that what he has open currently is not really their best bet, BUT the trial being run by so-and-so would be a better option and hook them up with the other physician.

5. Trial navigators can be used to help patients find trials they need. I have mixed opinions on this one, because - like the docs - some do a really good job and some do not. Many institutions and foundations have this service. In fact, I believe MRF has some.

6. There is no advocate for the patient better than the patient - if you or a family member is able physically and mentally to do the task. Searching for trials can be absolutely daunting. But, it is doable for many. This site: https://clinicaltrials.gov/ - is fairly navigable. You can put in your disease and stage. You can put in a particular drug if you like. You can put in "recruiting" as a filter. For instance - here is what it looks like for Stage IV melanoma, actively recruiting trials: https://clinicaltrials.gov/ct2/results?recrs=ab&cond=Stage+IV+Melanoma&t... 198 trials are listed. You can click on each one. When you do that you will see the drugs used and the arms offered. You can google the drugs as needed to see what sort they are. Below that, inclusion and exclusion criteria are listed. Below that, all locations at which the trial is being offered is noted - across the globe - not just the US. A trial coordinator is often listed as well. I always tell folks - if you are at all interested in a trial - CALL!!!! Even if you are not certain you WANT to do it or if you actually qualify. It never hurts to ask questions and learn more. My husband found all the trial options I ever looked at in this manner.  In fact, he found the Phase 1 nivo trial I participated in when calling the coordinator about an entirely different trial!!

I was lucky.  But, you can be too!!!  Ratties rule!!  Blessings to each of you. - celeste

Travel Chaotically! ~ The ramblings close in NYC!!!!

Per yesterday's tale, we made our way from RI, through CT, and into NJ while avoiding driving through NYC this go round, to the NJ Enterprise car drop off at the Newark airport.  Despite the strange labyrinth of streets surrounding it, we arrived at 4 pm that afternoon.  An odd hefty fellow, bearing a strong resemblance to a bull dog, checked us in.  He behaved oddly and inattentively throughout - often directing his gaze over the expanse of cars, then distractedly peering back at us and his handheld electronic device.  Once asking, "So this is your second car?"  "No," we said, "this is the same and only car we rented in D.C."  He replied that didn't make sense while re-scanning the car with his do-dad.  He dealt with some other people.  Didn't say much else, except that we could go.  Feeling rather confused about such a process, we were directed to the 'air train' that would take us to the airport and a shuttle to the Newark Holiday Inn.  The room was pretty basic but it was funk free with none of the B and B creepiness!!!

Next morning, after a good workout, we were off. The trip into NYC was a bit more complicated and time consuming than anticipated ~  Shuttle to the air train.  Off at P4.  Take escalator to NJ Transit station were you buy a ticket for a variable fee of $11.25 or $15.25 one way.  Reasons for pricing vagaries were never entirely clear.  THEN - after a strange and dirty train ride, where there is no absolute clarity provided that you are on the right train, you pass on by the Seacaucus and Newark Penn Station stops, but get off at NY Penn Station.  Cause, you know?  Confusingly similar names is GOOD!  At Penn Station we went to the subway station for a pass to head "uptown" toward the Met.  We arrived at Lexington Station at 1 PM.  NO, I had NOT had breakfast!  But B and Le Pain Quotidien to the rescue with yummy croissants and coffee!  Nectar of the GODS, I tell you!

In keeping with the need to get in our exercise and maintain our rep for an authentic Morris Vacation, we walked over 20 BLOCKS out of our way and had to turn back the same 20 BLOCKS to get to the Met, though SOMEBODY had been told by ME that we were going past our desired street!!!  Oh, well.  T'was a Morris Vaca after all.  Still, we were a bit tired when we arrived at the museum after a 2 hour walk!  We had fun exploring the Greek and Egyptian exhibits, lovely Cassatts, and an exhibit from an artist unknown to us - Felix Vallotton - that B liked because of his use of composition and darkness as well as an amazing display of Dutch Masters that I LOVE because of their use of light and life!!!

We had a great dinner at a little Turkish restaurant I had read about - Beyoglu.

So yummy.  Spinach, shrimp and B's beloved octopus.  There was an amazing boule unlike any Greek bread we ever had.  So good!  Plus, as it was Halloween, we got to watch lots of cute kiddos dressed up for the occasion out trick-or-treating with their families, as shops and neighbors gave out treats, while we ate.  Very sweet.  Not the crazy that I had thought the occasion might be in NYC!

As we made our way back to the hotel, we encountered a bit of confusion as the path to the NJ Transit line is in common with the LIRR line, but then diverges with zero signage!  Once we did get to the NJ line, finding the proper train remained a puzzle. Asking for assistance got us a selection of differing answers including none at all!!  B finally determined that little airplane icons on the boards was an essential designation for our purposes, as we wanted to get back to the Newark Airport and they showed up along the desired track, BUT all trains were posted on the board only 2-5 minutes before boarding at which point absolute chaos ensued!!!  Despite that and other little glitches - like the fact that the phone to call our hotel for a shuttle at the terminal didn't work!!! - we made it back and crashed!  FYI! To get OUT of the NJ Transit you must still be in possession of your ticket in order to get the gate to open!!  Just say'n!
Given the efforts we expended AFTER exercising the day prior, we decided to take a pass on that effort the next day and headed out.  We managed our commute with minimal difficulty, heading straight for Best Bagel!!!

Even snagged a chair and counter space as B ordered.  Still delicious!!!

Then it was off to B's Mother Ship - B and H Camera!  THAT was an experience!!  More peyots than you could shake a tripod at.  Lots of fun.  Glad B got to visit in person!  Then off to MY Mother Ship - MOOD!!!

On this trip, Mood had a new elevator situation and was strangely organised while B and J Fabrics was oddly chaotic.  Both still great and I got some fab fabric with B's patience and assistance!  We wandered in and out of many shops in the fabric district - Botani, Gray Lines Linen, and so many others.  B was entertained by a couple of characters working at Pacific Trimming while I picked out buttons.  We shipped the fabric purchases back home at the Fed Ex next door to B and J with the help of a very nice and interesting fellow, Delford, whose paintings I hope to see on exhibit somewhere someday!!!

We took the subway downtown, window shopping, stopping at the Strand.  Wandered in Little Italy and China Town a bit.  Drooled before restaurant windows hung with roasted ducks and chickens.  Pondered unknown fruits and veg as well as all sorts of mysterious herbs in the apothecary shops.  We picked up a couple of little aluminum bowls at an EVERYTHING shop.  B asked the proprietress if it was going to snow.  She looked at him (appropriately) as if he was crazy and then said, "NO!! We got to cook turkey first!!" cackling at her own joke.  We wound our way to Tomino's and sat a few minutes at the bar as we waited for friends to join us.  It was fun to reminisce and feel as though we were back at a tapas bar in Barcelona!  We had such a lovely visit and dinner with our peeps!  With good directions we made it back to the subway, trains, air trains, and shuttle without too much difficulty.

Back on the shuttle once more next morning to catch the flight home - at the butt crack of dawn, of course!!!  Our flight took off late, spitting us out at Concourse B in Atlanta for our connecting flight at Concourse D to Chattanooga.  We took the train to D and began running.  Just rounding a corner while trying not to trample folks I heard the last call for boarding, as well as a woman's voice yelling, "CHATTANOOGA!  CHATTANOOGA!!!"  I breathlessly arrived at her stand, to see it was all buttoned up!  I gave her my name, telling her I was there to board. With great annoyance, she asked, "Where's the other one?"  I point toward B, still struggling toward us.  Shaking her head with great disapproval, she said, "Where's your boarding pass?"  "With him," I replied.  "Where y'all been?" the irritation queen queried.  "We just landed!" I told her with equal irritation.  A fact she was surely aware of as she knew to expect the two of us!  B finally arrived, turned over our passes, and we walked on to the very back two seats.  On arrival to Chatt Town that afternoon, I was surprised to see our bags actually made it!

Meanwhile in New York, and for days after, we (and Roo - as we had given her number for the required emergency contact) were relentlessly harangued by Enterprise for not having turned in the horrible nasty Corolla!!!  To the point that we stood accused of having to answer for having stolen it!  Yes, that's what car thieves do ~ provide their address, phone numbers, driver's license, and credit card info to the people you steal the car from!!!!  Seriously??!!  Finally, after being very plain spoken about Mr. Bull Dog Man at the Newark check-in and that they had best get off our case - the calls finally ceased!  I believe I've mentioned my loathing of all car rental companies in this space previously!  They have yet to change my mind!!!

All the strangeness not withstanding - thanks for another wonderful adventure, B!!!  Where are we heading next????  Travel chaotically!!! ~ les

Travel Chaotically! ~ New Haven, CT and Narragansett, RI

More exercise and "eatmeal" (Fred-o's name for oatmeal in childhood - makes sense right?) for an excellent start to our day!  Sad how little used the exercise rooms of hotels seem to be!  Then we were off on what B deemed to be the most scenic route from Fishkill, NY to New Haven, CT for a meet up with another dear J at Frank Pepe's Pizzeria!  Golden trees decorated our path despite the clouds.

Great eats with great peeps!  White Clam Pizza along with Frank Pepe's original tomato pie!  But as ever, the real treat was being witness to the incredible resilience of the human spirit, the traumas and triumphs that all too often remain unheard - but on special occasions are burdens shared - like a gift - between those who once were strangers, but are now friends.  You are incredible, J.  Thanks so much for sharing YOU, with me!

After our nice lunch and visit, we were on the road again, heading for a "lovely B and B" B had reserved in Narragansett, RI!  There was distinct foreshadowing of what was to come, when during lunch B received a strange call from someone who initially failed to identify themselves, asking if we were still planning to arrive and when.  Ummm - yes.  And, as there was no stipulation for a specific check-in time - when we get there!

I hardly have the strength or words to explain the creepy that was Sheppard's Place B and B!!  Suffice it to say that the guy "running it" appeared to be stoned out of his mind on our arrival.  When we could not find it around dusk, we called him for assistance, giving him our precise street and exact location - which turned out to be directly behind the house!!!!  He could not give us ANY helpful pointers at all!!!  We found the house ourselves, the front being hidden by a large hedge and the sign beside the drive that entered the hedge as a crescent, being very small.  Turns out we were the only guests that night.  It was pretty clear that he was hoping we would not be showing up!  His assistance and information was equally lacking in any direction toward a place to eat supper.  He gave some reference to "lots of places down that street".  The place was clean, but between him and the decor - strangely creepy.  It was already over decorated with wreaths and fake flowers and copies of paintings by the old masters and books and lamps and doilies on EVERY possible wall and surface.  Fake vines twirled up most pieces of furniture!  THEN, as if that was not enough, there were skeletons, pumpkins, witches, spiders, webs, and all manner of Halloween decor thickly spread on top of that!!!  Later we determined that stoned dude was "running the place for my mom".  Throughout the night there was a great deal of coming and going by the dude and his bud.  So, we got little sleep and when we did, we both had nightmares!!  B going so far as to awaken me when he shouted out in terror!!  It is truly the only place where we have arranged to stay that I almost made B leave - whether we could get our money back or not!!!  Anyhow - we survived!!!  HA!  The next day we were up and outta there.  We drove along the RI coast and had a walk along a trail by the ocean.  Very pretty even with the clouds in this off season.

Bittersweet, I think!

We saw huge mansions along the waterfront as well as homes for normal folk.  Gradually we wound our way back to CT and continued to enjoy the pretty fall foliage on the hillsides. Back on the free way there were many toll booths and some chaos as we made our way to and through New Jersey on our way to Newark. 

More on TURNING THE CAR IN to Enterprise, NJ, and NY coming your way tomorrow!!! Travel chaotically! - les

Travel Chaotically! ~ From NJ to the Hudson River Valley with amazing vistas and dear ones!

B and Google saved the morning.  After our stinky night, breakfast at Hightstown DINER, set our day off right.  It was incredibly busy, but the staff was amazing and energetic.  Our young waitress certainly deserved more than her pay!  Delicious pancakes for me, egg white omelet and turkey bacon for B.  He's so good!!  Then again.......

To back up a step!  Back in our foul hole the night prior, we meticulously planned our route to Fishkill, NY - assiduously avoiding NYC or the George Washington Bridge!  Why then, you might ask, do I have this?????

Because my navigator loses his mind periodically!!!  And that's not good!!!!  I traveled over a bridge I expressly asked to avoid during a POURING, FLOODING, DELUGE!!!!!!!!!  Oh, my!  Imagine driving through crazy weather, on a multilevel bridge, during NYC rush hour, in a nasty ass Corolla with a wonky left front wheel that did not behave as expected and made strange rubbing sounds, while listening to some gibberish about, "In my defense Google maps changed the route while enroute!!!" Along with sycophantic comments like, "Fortunately, excellent driving saved the day!"  What a crazy boy!  While difficult and unpleasant, (AND NOT WHAT I REQUESTED!!!) it was still not as bad as driving in Atlanta!

The drive through the Hudson River Valley was very pretty.  Little towns with old fashioned squares and historic districts were bright with red and yellow maples.  My vision of stopping and walking through them as fancy struck was stymied by the pouring rain, which was unfortunate.  However, Sleepy Hollow, Ossining, and Tarrytown were most lovely and I would have loved exploring them more as we made our way to the Springhill Suites in Fishkill which was very nice and funk free!!!

Supper was a bit sad in a strip mall at Charlie Brown's Grill.  Usual fare, served as imagined.  But, exciting times as an old grey headed codger holding forth on a bar stool suddenly fell to the floor, seemed to have a seizure - but just as B and I were about to see if we could assist - he got up, finished his drink, ambled out, and I presume - DROVE (!!!) off!!!

Up early for exercise and oatmeal - both very refreshing and on to Beacon Falls to meet our dear friends F and J!!!

Keeping it me-made, in prior jean jacket, nikko turtle, layered under a Sasha Basic instinct tee, all paired with yet-to-be-blogged Romero Trousers from the same pattern I used for Roo's shorts!

After a lengthy, but interesting history of the town provided by a local out waxing both his SAAB's on the curb (???) in front of his real estate office, we had a spot of tea and a lovely catch-up with our dear ones.  Then we were off to Storm King.  An incredible place that combined the beauty of a nature preserve with art installations!

Two of the smartest, most convivial, adventure loving, amazing peeps you will ever be blessed to meet!!!

The photog!

Such a lovely place.  Here's a cool video J shared via the NYT about the care involved in managing such a place:  Who Mows the Lawn at Storm King, New York’s Largest Sculpture Park?

So great to share time with dear ones.  So many lovely sights to be seen. Travel and live chaotically! ~ les

Travel Chaotically! ~ On to Delaware and East Windsor, NJ????

Across Maryland to the coast of Delaware!!!  The theme of minimal humans and lots of farm fields continued.  Gradually, the flats gave way to more picturesque rolling hills and we ended up here:

We climbed an overlook tower, took some walks and had a drive around the lake and marshes, seeing lots of ducks, geese, herons, and sandpipers though they were all a bit distant.  On leaving around dusk we saw a fox walking along the dirt road and this guy....

...who had joined a couple of vultures for some fine dining on what appeared to be a deer carcass.  Fancy friends in low places?  

Speaking of dinner! We ended our day at the Holiday Inn in East Windsor, NJ.  Unfortunately, it was nasty, smelling of feet, with a large wet spot on the carpet - discovered just before bed.  Did NOT even want to contemplate the WHAT or WHY????!!!!  But, before all that, we had an incredible Greek dinner at Legends Grille.  An unlikely looking hole in the wall, located at the back of the nearby Days Inn.  (Perhaps we should have stayed there!!!)  It was amazing!  B had roasted egg plant and Tzoutzoukia. The latter being delicious meatballs flavored with cumin. We discovered that the current chef/owner had been trained by the original Greek proprietor and while he knew nothing of Greece or their cuisine, he continued making things as he had been taught.  Having been in Greece a couple of times we were curious about the Tzoutzoukia, never having seen it on a menu there.  Well.  Come to find out, it is actually soutzoukakia - possibly more Turkish than Greek .  Both are a bit of a mish mash one from the other, though you can never refer to that when dealing with either party!!!  We used THIS RECIPE combined with one for Etli Kofte from a Turkish cookbook, Istanbul, by Rebecca Seal, from home, to make our own!  Great thanks to the current and former chefs at Legend's Grille (extra 'e' for flair = theirs, not mine!)!  Who knew???

Heading to New York tomorrow!!! Travel and eat chaotically! ~ les

Travel Chaotically! ~ Ramble continues, Maryland. Oh, my!

Only got a smidge lost on our walk to the Enterprise car rental.  Was dealt with by a hale and hearty dude who was nice enough.  Attained a beat up Toyota Corolla that could have been dirtier, though that would have taken a great deal of effort! (SO much more Enterprise drama later!!!) Anyhow - as they say - it is what it is!!  And we were off.  Not having traveled a block from the parkade we were almost crushed by a crazy old white man driving a large pickup.  While we (and a long line of traffic before and aft) were parked at a light, he decided he was turning across traffic and INTO me!!!  There was nowhere for me to go!  There was nowhere for him to go!  But, that DIDN'T STOP HIM!!!  Good grief! Luckily (????) I managed to give him just enough space and he was able to squeeze between and jump over a curb!  Old White Male Jerk-a-tude in action!!!

Meanwhile, this awesome old white dude - advocate for the world - and I, carried on.  Down and through Maryland.  Did you know there are very few people visible in or on most of the highways and by-ways in much of Maryland once you leave the coast??  Who knew?  But, before that, we:

Saw pretty harbors.

Walked on a board walk. (Wearing me made:  Lander pants, previously noted Linden, and Nikko, mock turtle neck)

Had a second breakfast of delicious doughnuts from the Fractured Prune, whose proprietor had a crazy tale of how it was named after this feisty old lady and how Duck Doughnuts had a spy infiltrate their staff, then made off with their entire premise of allowing customers to choose toppings and glazes for fresh warm doughnuts!!  If true, that's a pretty dick move, Duck!!!  Gotta say, for me the Fractured Prune was better!  Not that I'll be turning a Duck Doughnut down if you want to give me one!!  But, the Fractured doughnut was more like Krispy Creme glazed doughnuts as a base, while the Duck Doughnut is more cake-like!  The more you know!

Saw pretty sights despite the cool overcast day.

Driving down the length of Maryland to Salisbury we saw LOTS of corn and milo (their word for sorghum - we looked it up!) fields.  We searched for what was to be the day's "highlight" - The Blackwater Nature Reserve - which turned out to be a preserve (a swamp - it seemed to me!) that you were not allowed to enter - in the middle of NOWHERE!!!  I definitely heard banjos!!!!

Dinner!  A rather sad affair at Buster's Seafood Grill in a strip mall that had come with glowing recommendations from the lady at the hotel reception desk.  B, ever up for local fair indulged in broiled "rockfish" (local fish - white and rather dried out in this iteration) and "WET cornbread"!!!  OMG!  Don't.  Just DON'T!!!  Yes, I took a bite.  Yes, against my better judgement and impetuous, spoiled nature, I swallowed it.  It was indeed wet.  It was incredibly sweet.  It was - dreadful!!!  You don't have to take my word for it.  Check out this recipe:  Wright's "Eastern Shore" Cornbread Recipe

B's discussion of his dinner with the front desk lady was pretty comical.  It was clear that she didn't much care for "wet cornbread" either (though B was careful about how he alluded to his feelings about it - he ate it all, btw!!!) and much preferred hers cooked up in a skillet!  Like a normal person!!!

On to Delaware tomorrow!! Travel chaotically! ~ les

Travel Chaotically! ~ A strange and rambling trip that started in D.C.

October was busy!!!  After celebrating their marriage with Jamie and Roo, we took off - on a rather strange trip!  Yes, one that I concocted!!!  Though some things didn't turn out as planned (or imagined) it was still lovely to share it all together and with dear ones along the way!

Arriving at the airport to find that our flight was delayed for over an hour and changed to a smaller than advertised plane can't get you down when your outfit is comfy AND matches your luggage!!!  For you sewists, I'm wearing the Tate Top I made for fun at Roo's wedding along with these luscious linen Flint Pants!

In DC with no other mishaps.  Negotiated the subway with no problems, especially with directions from a kind and funny attendant, that B made laugh by initially asking, "Is this the DC zoo?"  However, once above ground walking to our hotel, the skies let loose with a POURING rain!  We got SOAKED!!!  As in water all the way through our shoes and some of our luggage!  UGH!!!!  Made it to our hotel pretty easily despite that.  Checked in via kiosk??!!! No peeps needed - apparently.  Then, the rain having subsided, took a little explore of M Street (in our wet shoes) to find dinner.

This was our reward!!!!  A lovely double rainbow and fun conversations about rainbows and ROYGBIV with other damp admirers!

Yummy dinner at El Canal.  Yes, the Margarita pizza was mine and I ate every bite!!!

We were rewarded with beautiful weather the next couple days and had a great walk along the canal, over to and through the Mall, and on to the Smithsonian!

An all me-made kind of day!  Vintage S6544 Pants, whose outer pocket was perfect for slipping your phone in and out of!,  Jean Jacket B5616  and  Grainline Studio Archer button-up!

We were greeted with pretty fall leaves...

...and mums that were celebrating with Roo and Jamie's wedding colors!

Remember when we thought Watergate was bad????

Remembering the fun of seeing these "creatures" with the kids years ago and wondering about a world filled with them ever so many years before that!!!!

A happy boy!  Yummy gambas, tortilla and pulpo at Bodega Spanish Tapas and getting to speak Spanish with the Texas/Mexican proprietor!

Off to the zoo!

Same pants, but you can see their amazing pocket a bit better.  Paired with Grainline Studio's Linden sweatshirt and rtw sweater today.  Feet a bit blistered and bunged up from walking so far in wet shoes.  But nothing a few band aids couldn't fix.

B loves zoos.  I have mixed feelings about them.  However, the DC Zoo is very well laid out and park like.  AND entrance is FREE as it is part of the Smithsonian.

My favorite menke!!!

This guy!  So beautiful.  Reminded me of the poem by Valerie Worth included in Eric Carle's book Animals Animals that I read to the kiddos:

Tiger ~ The tiger has swallowed a black sun.  In his cold cage he carries it still.  Black flames flicker through his fur.  Black rays roar from the centers of his eyes.

Our return walk home via a bike/running path along Rock Creek gave us a great view of these guys!

Wood ducks never look quite real!!!

Delicious falafels and humus!  So much that we had enough for breakfast!  A little weird, but not bad with tea!!!

Grateful for my Bentie and the beauty of rainbows!  Off to Maryland tomorrow!!! - Travel chaotically!!! ~les