Tuesday, July 24, 2012

Last week soul-blues man Curtis Salgado underwent surgery in Portland, Ore., to remove a part of  his lung containing a mass suspected to be cancerous. Doctors pronounced the surgery "successful" and Curtis is now home and on his way to what Doctors say should be a full recovery. 
Remember he's got a great new disc out on Alligator Records called Soul Shot! Go check it out! And he's already got new midwest tour dates up at curtissalgado.com including 

Zoo Bar | Lincoln, Nebraska on September 4, 2012

& Uncle Bo's | Topeka, KS on September 7, 2012

Check the official press release here

There is a chip-in set up to help with Curtis' medical expenses. Please share the link

During the last week I made the acquaintance of a few fellow friends of Curtis including BluesWax.com contributor Stacy Jeffress.

Stacy asked me to reshare this interview she did with Curtis for BluesWax.com in July 2010 about his experience with cancer and the health care issues that musicians, artists and others without insurance face.

Here is the text of her article.
If you have comments or questions you can reach Stacy Jeffress at luvmyblues@yahoo.com

Curtis Salgado Interview, from BluesWax.com

July 2010, by Stacy Jeffress

Reprinted with permission. 

 


                  Imagine that you’re a self-employed professional at the prime of your career, you don’t qualify for private health insurance thanks to pre-existing medical issues, and you left your state’s high-risk pool because you couldn’t afford the high monthly premiums. Then you get the news, which feels more like a verdict than a diagnosis, that you have an inoperable tumor on your liver, and you have 6 to 7 months to live.
            That’s the situation Blues artist Curtis Salgado found himself in 4 years ago. His only option for survival was to get a liver transplant, an operation that is available to people with:
             (1) financial resources (Salgado didn’t have any), and
            (2) a qualifying Model for End-Stage Liver Disease (MELD) Score (Salgado’s wasn’t).
            A core support team came together and, with precious little time, took on the seemingly insurmountable challenges involved in getting Salgado the medical treatment he needed to survive. Shane Tappendorf, the performer’s manager, took on the staggering responsibility of raising funds. Tappendorf says he knew that with each evaluation costing from $20-40,000, it would take at least $300,000 to get started. The plan was to get evaluations at the Universities of California (San Francisco) and Washington, the Mayo Clinic, and a transplant facility in Jacksonville, Florida. Tests to determine the suitability of Salgado’s close friend Andrea Crawford as a living donor ran $20,000. (She proved to be a perfect match, but more about that later.)
Over $200,000 was raised through a benefit concert held in Salgado’s hometown of Portland, Oregon, in June 2006. Most of the expenses, including those for production and promotion, were donated, the Rose Garden venue waived its fees, and entertainers such as Taj Mahal, Robert Cray, Steve Miller, and Little Charlie and the Nightcats contributed their time. Team members Kris and John Bockmier coordinated silent auctions held in conjunction with that benefit concert and another in Eugene which brought in significant amounts.
There were also many benefits held across the country by blues societies, cash contributions sent in from fans, and friends who cashed in their IRAs and took out second mortgages on their homes in order to loan money to Salgado.  When another $100,000 was needed at a critical time, two of Salgado’s friends handed over their life savings knowing they would not be seeing that money again anytime soon.
Strategizing where to seek a transplant became team member Andrea Crawford’s full-time mission. Although she and Salgado had been in a long-term relationship, they had parted ways prior to the diagnosis. Salgado recalls with awe that once Crawford learned of his illness, she quit her well-paying job and devoted herself to researching each and every one of the 90-some liver transplant programs in the U.S. The project demanded that she spend 10 to 12 hours every day for months in front of a computer with a medical dictionary so she could decipher the jargon. She wonders now, “What if we’d had 4 kids, and I had to work full time? He would have died.”
Based on the knowledge she gained through her intensive inquiry, Crawford is currently putting a resource notebook together for YES, a non-profit organization based in Texas, so that others in need will have the necessary information all in one place. She learned from her legwork that most oncologists don’t know all the treatments available for liver cancer. “If you rely on your doctor,” Crawford says, “You won’t survive.” Through her investigation, she discovered that every transplant facility has a list of tests it wants performed and has a reluctance to accept results from the same tests performed elsewhere. All those tests add up to more expense for the patient. Salgado recalls that starting anew at the Florida facility would have cost him $47,000.
            Crawford also learned that each transplant center had its own eligibility criteria for who it would accept into the program. The United Network for Organ Sharing (UNOS) sets the rules for who receives transplants, and it employs the patient’s MELD Score as a method of prioritizing who receives available donor livers. At the risk of oversimplifying a complex concept, the general idea is that the sicker the patient’s liver, the higher the score on a scale from 6 to 40: the higher the score, the more likely the patient will be eligible to receive a liver.
            Salgado’s score started at 11, reflecting the fact that he was healthy other than that pesky lemon-sized tumor, e.g. the threat to his survival came from the cancer and not from the liver. As a point of comparison, Salgado says that the University of California, San Francisco, Medical Center required a MELD Score over 30 and had a waiting list of 2 years. Crawford says that people with MELD Scores from 17 to 24 are the most likely to receive a liver.
            If Salgado could have been “awarded” the points available under the MELD formula for cancer, that would bump his score up. Ironically, his tumor was too big for UNOS to give him the cancer points. For the same reason, a transplant program in Seattle deemed him ineligible for a UNOS organ, which must be pristine, but said he could have a UNOS-rejected liver, meaning one that had Hepatitis C or other issues.
            Salgado’s team became very concerned that he wasn’t going to live long enough to receive a donor organ. Crawford knew that if the cancer metastasized, he would have no chance of being accepted by any program. Salgado says that 7 people die every day while waiting for an organ transplant. As he describes it, “This egg was about to crack and explode and let loose cancer.” Since qualifying for a cadaveric organ seemed unlikely, it became evident that accepting a partial liver from a living donor was the best option. And it was Crawford who provided the perfect match.
            Since their romantic relationship had ended, Salgado was reluctant to accept this gift from her knowing how grueling the procedure is for the donor. From her point of view, making the donation was the only course to take because it would save her friend’s life.
As a man with nearly 2 decades of sobriety to his credit, Salgado very much wanted to survive. He had started drinking at age 13 and says that for years, his focus was on making music and getting high. “I partied hard and wasn’t thinking about health insurance or retirement,” he remembers and, like many young men, he considered himself to be bullet proof. When he made money, he invested in inflatable dinosaurs instead of paying taxes.  (When Tappendorf later became his manager and worked to straighten out Salgado’s finances, the artist owed $16,000 to the IRS.)
By age 34, Salgado had developed hepatitis C and a cirrhotic liver due to substance abuse. He refused to take interferon, the medication recommended for treatment, due to the debilitating side effects which would interfere with his ability to travel and perform as a Blues artist.
Years later, he decided to begin interferon treatment and applied for insurance to help with the cost. He had dropped out of the Oregon Medical Insurance Pool, the state’s high-risk health insurance program, in 2004 due to the cost of the premiums. Salgado met with an insurance agent and, at the salesman’s direction, answered “no” to the question on the health profile of whether he had hepatitis C although the point of getting the insurance was to acquire interferon to treat that very disease. Naturally the insurance company quickly figured out that Salgado had misrepresented his health status and the coverage was rescinded. By then, the salesman, having received his commission, had retired, and Salgado was back to square one.
He eventually managed to qualify for an interferon program through a pharmaceutical company which cost $5-600 per month. Three months later, on March 13, 2006, to be precise, Salgado suffered a gallstone attack which landed him in the hospital. The resulting CAT Scan revealed his 5.5 centimeter liver tumor, and the race to save his life - sans health insurance - began.
Based on a number of factors, including transplant success rate, the number of organs received, and the number of people on the waiting list, Crawford determined that the Transplant Center at the Nebraska Medical Center in Omaha was where they needed to be. Salgado concurred and found the helpful attitude of the staff there a welcome change from some of the programs he had encountered. Surgery was scheduled for Tuesday, October 3, 2006, with Crawford fully prepared to give 60% of her liver to Salgado. She insisted on making the trip east a few days early in order to garner some positive energy.
The week before the surgery, Omaha added cancer points to Salgado’s MELD Score which raised him from 11 to 24 and put him within range of receiving a UNOS program liver. “What are the chances of getting a cadaveric liver?” Salgado asks. “They put me on the list four days before I was about to take Andrea’s liver.”
When Salgado answered the phone very early on Saturday, September 30, a transplant nurse told him he was getting a donor liver. He had an hour to report to the operating room. “I just happened to have the right number, the right blood type, the right size, the right situation, and the hoses have to be in the right places, your little connections. You’ve got a couple of tubes coming out of your liver, and not everybody’s is located in the same spot,” Salgado says. “The odds are astrofuckingnomical.”
When his diseased liver was biopsied, the doctors found that the cancer has metastasized; there was a microscopic invasion of a blood vessel. Had that been know before the operation, he would not have received the new liver.
At his four-month check after the transplant, there was no evidence of further cancer. Four months later, doctors found a spot on his lung. It became a waiting game to see if the spot grew… and it did. On October 24, 2007, Salgado had surgery in Omaha again, but this time the marble-sized tumor of liver cancer was removed from his lung.  “The egg had cracked, and some cancer got out into the bloodstream and took off to parts unknown,” he says.
Yet he still received good news from the doctor after she had told him the tumor had been removed. “I’m sitting there looking at her, and she goes, ‘Where are the others?’ I kinda wait a little bit, ‘What do you mean, where are the others?’ She goes, ‘There are no others and there should be. You are immune suppressed which gives cancer even more of a reason to spread. And normally when we see a metastasized tumor, you should have more than one tumor, and it should be the same size as that tumor. We’ve checked your whole body, and we don’t see anything anywhere else, and there should be more tumors, and they should be the size of a marble which is the size of that one. Miracles are cheerfully accepted here at the Omaha Medical Center, and this is one.’”
It will be 4 years in September since the transplant and 3 years in October since the lung surgery, and - knock wood – Salgado remains free of cancer. However, the financial impact of the dual health crises will be with him for many years. His sister Wendy Salgado is the team member responsible for paying the bills. She estimates she has paid out nearly $1 million all told. She explains that they had to have $300,000 in the bank to get in the hospital door, and attributes a half million to the transplant procedure and related expenses.
By the time of the lung surgery, Salgado was re-enrolled in the Oregon Medical Insurance Pool thanks to Crawford’s efforts, so that covered 60% of the second operation. (Although he was in the OMIP prior to the transplant, he had not been in the plan the requisite 6 months to cover the cancer, a pre-existing condition.) As generous as the donations were that poured in through the various fundraisers, Salgado still had to accept loans to raise the necessary funds. Tappendorf calculates that there is approximately $200,000 to be repaid and emphasizes that Salgado missed nearly 2 years of touring, and the resulting revenue, due to illness and recovery.
The debt weighs on Salgado. “They didn’t give it to me; they loaned me their life savings, but they have not bitched about it one bit. That’s what’s remarkable. I’m the one who’s doing all the sweating. One person gave me $60,000, and another person gave me like $35,000 and saved my life. Everybody saved my life.”

-by Stacy Jeffress, for BluesWax.com,
July 2010, reprinted with permission.
You can contact Stacy Jeffress at  
luvmyblues@yahoo.com

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