Don't Think Twice, Turan

Sunday, July 16th, 2017
Lexington, Virginia

What's been happening?

This past week, we tiptoed into the world of radiation oncology. On Monday, we met with Dr. Stephanie Terezakis, our radiation oncologist at Johns Hopkins. She explained to us some of the complexity of radiating my spleen. Specifically, my spleen is large enough that it has far outgrown its standard spot tucked under my left rib cage such that it now wraps around my kidney down below. We want to zap all of the little buggers hiding in my spleen but we want to absolutely minimize any radiation to my kidney (and elsewhere). The solution to this problem is something called intensity-modulated radiation therapy. To quote radiologyinfo.org:

Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy that uses computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. 

On Wednesday, we returned for a radiation planning session. In this session, they place you on a ridiculously hard, flat surface (the back of the human body is far from flat) and slide you up and back through a CT scanner like a toasted baguette. This lasts for about 20 minutes. At this same time, a mold is hardening against your back, releasing heat as it hardens. The mold will be used to help guarantee accurate positioning of my body each time I get a dose of radiation. They even used a special belt to monitor my breathing pattern, since my spleen moves up and down with my belly as I lie on my back and breathe. I didn't bother to ask how they account for that movement. They are the experts and I trust that they know what they're doing.

Looking ahead

Once the planning session was complete, we began a one-week hiatus from all things medical. We returned to Richmond, expecting to stay there for the week, but I've been feeling good enough lately (the calm before the storm) that we decided to sneak away to Lexington for the weekend. We haven't been here for two months and won't be back for two or three more, so it was the perfect time to squeeze in a visit.

We will return to Richmond on Monday evening and then Baltimore on Thursday evening. On Friday, the radiation oncology team will perform a dry run of my "beams," as they call them, with me and my mold in place. Assuming it goes smoothly, the radiation therapy will begin the following Monday, July 24th. The therapy is twice a day, Monday through Friday, for two weeks. Once that is complete, all of the pre-transplant steps will begin, still targeting a transplant date of Friday, August 18th.

Don't think twice

I've been trying to work as much as I can, but there are many hours during which I'm too tired to work but not tired enough to sleep. I continue to read a lot, but I've also added some YouTube exploration to the mix. I realize that much of the internet community uses YouTube simply to find the latest viral cat videos, but I use it to explore music: recordings of live performances of my favorite artists, which inevitably lead me to new artists of interest using YouTube's recommendation mechanism.

With that in mind, here are two of my recent finds. Both are covers (audio only) of Bob Dylan's Don't Think Twice, I'm Alright. The first cover is by Chris Thile and Brad Mehldau. Chris is a virtuoso mandolin player and the new host of A Prairie Home Companion; Brad is an equally virtuosic jazz pianist. The second cover is by Susan Tedeschi, a Grammy-nominated singer and guitarist.

Not To Be Missed

Kenneth Turan is a film critic for the L.A. Times and NPR. In the past, I had mentioned to my friend Don my fondness for Turan's reviews, so when Turan's most recent book -- ​Not to be Missed: Fifty-four Favorites from a Lifetime of Film -- was published, Don sent me a copy and I've just finished reading it.

I must admit that among Turan's 54 favorites, I had never even heard of the vast majority of them, and had probably watched only one or two in their entirety. Before I started the book, I thought to myself that it would be a good goal to first read the book and then watch all 54 movies in order. Having read the book and learned about the movies, I can now say that many of them hold no interest for me (with all due respect given to Mr. Turan). But, a half dozen or so have piqued my interest. If I do watch them, I'll let you know.

Until then, here are all 54 in chronological order. Click on any of them to navigate over to the Internet Movie Database for more information.

Pictures

Here are some photos that we've either taken or collected in the last week. Keep an eye out for the world's first gluten-free stem cell cake!