No stem cells for you!

Sunday, October 1st, 2017
Richmond, Virginia

Health update

I apologize for the very long delay since my last post, but it's been an eerily quiet month with nothing substantial to report until now. If you'll recall from my last post, this is where we left off:

The official name for my current condition is non-cirrhotic portal hypertension, which decodes as: elevated blood pressure in the veins leading back to the liver that is not caused by damage to the liver itself... Until this hypertension is dealt with, any bone marrow transplant takes a back seat.

It turns out that I misunderstood what non-cirrhotic really means. Refining my definition from above, it should have read: elevated blood pressure in the veins leading back to the liver that is not caused by cirrhosis of the liver. There are plenty of other ailments that might plague the liver and cause portal hypertension.

Click to enlarge

So where do we stand now?

Here is the capsule summary of where we stand right now:

1. The disease in my bone marrow is gone
2. The disease in my spleen and elsewhere has been substantially eliminated
3. A stem cell transplant is needed to knock out the last vestiges of disease
4. A stem cell transplant will fail (i.e. death) with an unhealthy liver
5. Circumstantial evidence (i.e. portal hypertension) indicates an unhealthy liver
6. A liver biopsy is needed to confirm or deny that indication
7. I am not healthy enough for a liver biopsy (my platelet count is too low)
8. In light of (7) and (8), we must assume that the liver is unhealthy
9. A stem cell transplant is therefore not an option
10. The last vestiges of the disease remain unchecked

That last point is the real kicker, of course. The liver specialists outlined two general approaches to #10:

• Do nothing (i.e. palliative care)
• Do something (e.g. a clinical trial or experimental therapy)

Assuming that we're not prepared to proceed quite yet with the first approach, we will be meeting with my oncologist at Johns Hopkins soon to discuss what the latter options might be. We'll keep you informed about what is discussed.

On the positive side, I haven't felt better all year! Go figure.

About the title of this post

For those of you who do not orbit in the Seinfeld universe, the title of this post is a reference to a classic catchphrase from that show. Check out the accompanying video to see more.

Kids on the move

All four of our kids are currently professionally displaced for one reason or another:

• Cameron was evacuated from St. Croix in advance of Hurricane Maria
• Nathan is in San Antonio, Texas at a Petco conference for senior dog trainers
• Ian continues his adventures in San Diego, now extended through Thanksgiving
• Eli is in Jacksonville, Florida to observe an occultation of Triton, one of Neptune's moons

Alison and I continue to live vicariously through their various adventures.

Books

I've knocked off a few books in the intervening month. They were:

Notes from a Small Island

Bill Bryson is a favorite author of mine, one for which I try to read everything he's written. Notes from a Small Island chronicles his three-week "goodbye tour" of the UK before relocating to the United States around the turn of the century. I enjoyed the book, but it quickly fell into a regular pattern: for each town he visited on the tour, he was almost always surprised, pleasantly or otherwise. Plus, having never heard of almost any of the towns he visited, I found the book seemed repetitive. Native Brits might find otherwise.

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Still Foolin' 'Em

The full title of this book is actually Still Foolin' 'Em: Where I've Been, Where I'm Going, and Where the Hell Are My Keys? Written by Billy Crystal, it is an informal memoir of his unexpectedly rich and varied life. It's well worth the quick read.

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Glass Houses

Written by Québécois author Louise Penny, Glass Houses is the latest installment in her Inspector Gamache series. I recommend that you read them all, in order of course, in order to understand and appreciate the expansive story arc.

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The Social Animal

I have a bad habit of always finishing a book that I've started, even if I need to set it aside and come back to it a few years later. The Social Animal: The Hidden Sources of Love, Character, and Achievement, written by The New York Times columnist David Brooks, is one of those books. This densely written book falls squarely in the realm of social psychology and I expect that I could have finished it more easily if I had read it back in college when my mind was a bit more nimble. I do recommend this book if you have any interest in the subject matter, but make sure to take it slowly and easily. It's not a page-turner.

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Robert B. Parker's Kickback

Robert B. Parker wrote over 70 novels in his lifetime, 40 of which concerned his best-known protagonist, Spenser. After Parker died suddenly in 2010, his family selected author Ace Atkins to continue the Spenser series. He's written six Spenser novels so far; this is the fourth of them. If you are already a fan of Robert B. Parker, then by all means continue your reading with this book. If you've never read Parker but enjoy crime fiction, then definitely start at the beginning with his debut novel, The Godwulf Manuscript and continue from there.

Tidbit

This past month has also been a busy one for crossword puzzles. In the past, I've always enjoyed doing them (for example, if I saw a half-finished puzzle lying on a coffee table) but it is only recently that I've switched into daily mode. Each day I do the puzzle from either The Wall Street Journal or The New York Times. On more ambitious days, I do both!

When doing these puzzles, you can't help but pick up new words, but not necessarily words that you will ever have the opportunity to use in everyday speech or even writing. Case in point: a recent clue was simply Stage direction and the answer was...

 Exeunt is borrowed from Latin, the third-person plural present indicative (yikes) of the verb exire, which translates as "to go out" or "to leave." When I run across words and explanations like these, my response is always the same: