Some Follow-Ups

A few things that I've written about recently need some following up.


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First of all, I am thoroughly enjoying not being department chair anymore. It's nice to be able to focus on teaching, and since I'm teaching two sections of a brand new class, I have no choice but to focus on teaching. I'm not exactly making it up as I go along -- I've had a plan for the course, which Isabel and I developed over the summer (she's teaching two sections of the course as well). But I am revising that plan pretty much every day.

Which isn't a bad thing. What I've always liked about teaching is the ongoing attempt to figure out my students and what they need, and then starting all over again the next semester. I may have a bad class one day, but I'll set to work trying to figuring out some other way to explain what I want them to know, and get excited about trying that new thing, and then more excited when it actually works. That's really the big difference for me between being chair and being a teacher: I could work all day on a chair project and not be successful, and be exhausted and depressed by the time I went to bed. But I could have a bad day as teacher, talk to some colleagues, figure out a plan, and by the end of the day feel energized. Being a teacher energizes me (usually), and it's that energy that I've really missed.

Of course, all of that figuring has taken up a whole bunch of my time lately (that, and the kids' activities being back in full swing), so I've had less to time to do the research and writing that goes into the blog. I'm trying to do my three blog entries per week, but it gets difficult some days to come up with something interesting and relevent.

So here are some sort of interesting, sort of relevent follow-ups for you.

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A little while ago, I posted a link for the "Seven Hamburgers of the Apocolypse." I rationalized that it was about encouraging good eating habits in my readers, but really, it was because I like looking at pictures of hamburgers.

Here's another one: the Hamburger Fatty Melt, a thick burger with two grilled cheese sandwiches acting as the bun. I love that the recipe calls for a grilling machine that will let you cook the sandwhiches and the burger at the same time. God love George Foreman.

I recommend clicking the link just above the picture, which gives "the backstory for the Fatty Melt." Read the comments section, where people debate whether or not to put bacon on it, and then whether it should go directly on the burger or in the cheese sandwiches.

(How come all of you don't have good debates like that in my comments section?)

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My guy Jon Lester continues to amaze. He pitched another 7 innings as the Sox clinched. The deabte now is whether or not he's the staff ace, and when to have him pitch in the next playoff series to best help the team. No mention of cancer, either.

Which brings up this issue: Yesterday, Isabel and I had lunch with a colleague who is a Sox fan, and we discussed current staff ace Josh Beckett's recent problems with injuries. My brilliant solution: Beckett needs lymphoma. Worked wonders for Lester. So if the Sox won't let me pitch for them, I can volunteer to donate blood to Beckett and see if that helps.

(I know, I know, it's a joke. I don't wish cancer on anybody....unless it would really help them somehow....or something.....)

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I was going to do one more follow-up on some lymphoma treatment news, but that will have to wait. Too much else going on, and it requires some reading on my part to understand it enough to explain it all. I could give you a raw link, but it wouldn't mean much.

I'll get to more of that good, hopeful cancer news soon. When things slow down. Like, in January...

Sick, Offensive Cancer Humor

Oh, sure -- you saw the title of the post, but you kept reading anyway. So no comments that it's offensive. You were warned.

The story I have for you isn't actually too bad. Not too dark, anyway, like a lot of cancer humor. It's about a guy named Jeffrey, who's just about my age, has six kids, and was being treated for testicular cancer. On the day of his first radiation treatment, he was exhausted, and after he and wife finally got the six kids to bed, they went to bed themselves and had a chance to talk about the day.


They kind of danced around the whole topic of the day's radiation treatment, his wife not wanting to talk about it unless he did. But she finally asked him how he was feeling. She told him he wasn't so good -- the radiation left his skin feeling very tender. He asked her if she'd take a look.


She started to peek under the covers, and jumped back when she saw a neon green glow.


Jeffrey, having kept his sense of humor, had placed a green glow-stick under the covers.....



Now, three things are important about that story:

First, it's great to have a supportive partner.

Second, it's great to have a sense of humor.

Third, if you have kids and they're going out for Halloween, buy some glow sticks so they'll be visable.


But mostly, keep your sense of humor.

Jon Lester

The Sox won last night, 4-1, over the Angels. My guy Jon Lester pitched, and did afantastic job: 7 innings, 7 strike outs, no earned runs.


Lester, of course, is our household hero, being an NHL survivor and all. There's a nice piece on SportsIllustrated.com about Lester, written by a guy named Arash Markazi, who writes a blog about baseball. The interesting part about the piece is that Markazi is himself an NHL survivor, having had an aggressive form while in his 20's, like Lester. Provides an interesting perspective on things, especially since Markazi links an earlier blog entry he wrote as a letter to Lester, giving Lester advice about dealing with his NHL. The blog entry from today is called "Lester Much More Than Pitcher With Cancer," and says that he has enough distance from it now that we think of him as a great pitcher, not as a cancer survivor. He was even booed in LA last night.


Well....not exactly. The stories about the game, and Lester's performance, typically still mention his being a cancer survivor (see the Boston Globe piece, for example). So it's still defines him. Not that I'm complaining -- anything that keeps cancer in the news, especially NHL, is fine with me.


But it's interesting to read about how Lester is handling it. He really doesn't know what to say when people say he's an inspiration to them. Which is understandable, given that he's a 24 year old kid. I barely know how to respond when people ask me about it, and I don't have the pressure of pitching in Boston.


(Though I would happily unleash my patented Clydesdale Knuckleball if the Sox would just return my calls.)

Still Stable

Met with Dr. R this afternoon. Things still look OK. I'm still stable -- no real changes.


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I'll be honest: I was prepared for him to say something like, "Maybe we should schedule a scan and see what's going on in there." Not that I had shared that expectation with anyone (except Isabel). It seemed to me that the nodes near my left hip were getting larger; when I bent down to tie my shodes, for example, I felt some different pressure than I'd felt before. Those nodes are fairly close to the surface, fairly easy to feel, and I had convinced myself they were swollen more than usual. So the typical watch-and-waiter worries started up, and I began wondering if maybe I was transforming to something more aggressive, and would need aggressive chemo right away. Or maybe that they weren't all that much more aggressive, but at the point where treatment was necessary, so I'd start on Rituxin. So it goes -- every ache and twinge is magnified.


But, alas, none of that. Dr. R felt around, and didn't detect anything out of the ordinary, in the hip nodes or anywhere else. The blood work is still very good -- all of my counts are within normal range. He was very reassuring about it all.


After the exam, we had our usual Q & A session. I told him I'd been doing some reading in oncology journals lately. He laughed and told me I should be reading about the economy instead. This was part of his being reassuring, actually -- I'm stable enough to have other things to worry about besides the NHL, which is proceding normally (that is, slowly).


But he wasn't blowing me off. We did discuss my questions, which centered around treatment options. I told him about an article I read recently (one that I haven't linked or fully discussed here) that has to do with the idea of Follicular NHL being incurable, and how that perception shapes our approach to treatment. Basically, the article author says that as long we do things like watch and wait, we are admitting that fNHL is incurable. But if we were more aggressive from the start, we'd have a better chance at understanding which treatments result in a cure. Since fNHL affects mostly elderly patients, many of them die of old age before they die of fNHL, so we don't know what actually cures them. So trying for a cure early on with aggressive treatment will allow us to see which treatments really do last long enough to be called curative.


Dr. R understands this aggressive approach, but is more conservative about treatment. Essentially, he thinks there will be time for aggressive treatments when the time comes -- no need to rush them now, especially since I'm still not showing symptoms. It's more or less the conclusion that I'd come to, but I was glad to hear he thought the same thing. I like that he's being conservative, as hard as the watch and wait thing is sometimes.


And this is all so hard sometimes. It's been the same way, to varying degrees, from the start: feeling the need to do something, but feeling happy that I don't have to.


Still, this was a good visit. As my support group friends say, "Stable is a very good word." Dr. R debated with himself about when to do another scan. It's been two months. He decided that, since things look so stable, he'll wait another two months to see me again, and then we'll decide when to schedule another scan.

So I'll keep educating myself and staying informed and ready for when the time comes to make a decision.

Another Race

Yesterday (Saturday), I ran in the Reebok Homecoming 5k in Canton, MA (home to not only Reebok, but also Dunkin' Donuts. Great town!). I did OK: 28 minutes, 37 seconds, placing 165 out of 258 runners. Better than the New Haven Road Race, anyway. Official results here.

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This was my first 5k in Massachusetts. It was nice, because it came close to Mom's birthday, and she likes to watch me run (I think it reminds her that I'm feeling well). So Isabel and the kids got to watch me, as usual, but so did Mom and Dad, plus my brother and his family. Quite the crowd for me.

The race began at Canton High School. They had predicted nasty rain for race time, but it held off, which was great. A little humid, but decent racing weather. It was a good-sized field of runners I like that 200-300 range. Not too many, so it isn't crowded, but enough so that there's always someone close by, giving you someone to try to pass. They herded us onto Washington Street for the 9:00am start, but then started about 3 minutes early. Not cool -- a bunch of folks heard the horn go off and had to run in from the parking lot where they were doing last-minute warm-ups. As we took off, I noticed that we were on a slight hill. Not good -- I figured we were starting in the middle of the hill, which meant the rest of the hill would be at the end of the race. But I didn't look behind me to check for sure.

I felt pretty good after the first mile, and my time was decent. I got into a nice groove during the second mile, and I checked my time and saw that I was pretty close to a Personal Record at that point. I resisted the adrenaline urge that came from that thought, remembering how I died at the New Haven race near the end.

This time, the last half mile was a hill. One continuous hill, that got steeper as we got closer to the finish. I think race directors who lay out courses this way are sick. Hills are unavoidable, and I don't have a problem with them, but planning a steep hill at the end is a sign of a sadist. The hill slowed me down, but it didn't wipe me out. I finished decently, a 9:14 per mile pace, but I have to believe I would have broken 9 minutes if it was flat at the end.

On the plus side: some of the best post-race food I've seen, and among the best t-shirts I've received (dark green and understated in design). Plus, I came in first in my division (old fat guys from Connecticut). Nice race. And nicer with all of my family there to see it.

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As I promised him: for my brother, who has switched seasons from long distance biking to hockey: a video of the Top 10 Penalty Box Momements. There's a reason they call it the "sin bin."

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I see Dr. R on Tuesday afternoon. Look for a report sometime Tuesday evening or Wednesday morning.

Running

I'm still running. I'm back inside now on the treadmill. It's not getting light until about 6:30am now, too dark to run early in the morning when I like to. The treadmill doesn't seem to give me as much of a workout as running outside does, but I play with speeds and inclines, and that keeps thinsg interesting. But I won't stop. It's too important, not only because running helps you live longer, and it's especially good for cancer patients.

Busy weekend coming up, so I probably won't post until late Sunday, maybe Monday. I see Dr. R on Tuesday for the first time in two months. I always get a little antsy a few days before, even though I'm feeling fine, and I'm still not showing any B symptoms.

I'll give you the update after the appointment.

Not a Genius

Once again, the MacArthur Foundation Awards were announced yesterday, and once again, I was not given a Genius Grant. The MacArthur people give out 25 Genius Grants every year to people in the arts, sciences, medicine, etc. The grants are for $500,000, with no strings attached.
Most recipients announce some noble intention for the money, but they could spend it on aa half million dollars worth of Cheez Doodlez if they so chose. My kind of grant. Recipients don't apply for them; they are nominated secretly, and most have no idea that such an honor is coming.

I waited patiently by the phone all day yesterday.

Nothing.

There isn't even, like, a lymphoma researcher in the whole bunch. There is a basket weaver, though. Oh, sure, she's single-handedly preserving an ancient art, and her works are on display in major art mjuseums around the country. But still. Where's the love for Lympho Bob?

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Speaking of lymphoma research....

(If you're getting tired of research news, too bad. It's either this or I write about the dog some more.)

Some excellent news yesterday from Cell Therapeutics, Inc., makers of Zevalin, the RadioImmunotherapy drug I've written about before. To remind you: Zevalin is basically a jazzed-up Rituxin. Rituxin finds the lymphoma cells by targeting the CD-20 protein on their surface. Zevalin goes a step further by targeting the protein but then delivering a shot of radiation to the cell. Since lymphoma cells are traveling through the blood, standard radiation treatments won't work. Zevalin (and a similar drug called Bexxar) allow radiation to be used on "liquid cancers," as they are called.

Zevalin has been used as a kind of "far down the line" option, most typically after a stem cell transplant hasn't worked. Yesterday, the FDA gave approval for CTI to apply for a label extension. That means that, if approved, doctors can use Zevalin as a first-line consolidation therapy: rather than waiting to use it far down the treatment line, it can be used as a second option, after, say, Rituxin or a chemotherapy has been tried. In the clinical trial that the application was based on, 87% of the Follicular NHL patients in the study had a complete response (they went into full remission). It didn't wipe out the lymphoma permanently, but it did greatly increase the length of the response. While there are some side effects, most are reversible, and other studies indicate that, unlike some fNHL treatments, Zevalin seems to work even better if it's used a second time.

It's not earth-shattering-there-may-be-a-cure news, but it's pretty good anyway. Zevalin provides another option, which is what fNHLers like to hear.