Sunday, February 17th, 2019 Lexington, Virginia Rachel DuncanI never met Rachel Duncan. I did see her on stage and heard her perform many times, as Principal Trumpet of the Charlottesville Symphony at the University of Virginia. At the age of 33, having already performed with prestigious orchestras around the world, Rachel was a rising star in the classical music community. Rachel left our world (suddenly, unexpectedly, sadly) in August of last year. In September, the University of Virginia held a memorial service for her at Old Cabell Hall, home of the Charlottesville Symphony. Eli and I attended the service, which was structured as a series of musical performances from Rachel's closest friends and co-workers. Rachel's husband spoke eloquently of her, after which he performed (also on the trumpet) an original jazz work with the UVA Jazz Ensemble. Lastly, the jazz department's John D'earth led the mourners out of the auditorium to a slow and haunting rendition of Patsy Cline's Just A Closer Walk With Thee. The service ended with Rachel's husband on stage, alone, playing the closing notes of the song to an empty auditorium. The entire service was incredibly moving. It was, really, beyond anything that words could express. So, I won't even try. Health updateIn my last blog post, made almost a year ago, I said: All of that explains why I need the procedure (installation of a TIPS, or transjugular intrahepatic portosystemic shunt). As for when and where, the procedure will be done this Wednesday (March 14th) by the Interventional Radiology staff at Johns Hopkins. I will be monitored for a day or two and then sent home, barring any complications from the procedure. I'm happy to report that there were no complications from the procedure that prevented me from going home after a couple of days in the hospital. I was unlucky enough, however, to exhibit one of the known complications from the TIPS procedure: hepatic encephalopathy. To quote Wikipedia: The first stage of hepatic encephalopathy is characterized by an inverted sleep-wake pattern (sleeping by day, being awake at night). The second stage is marked by lethargy and personality changes. The third stage is marked by worsened confusion. The fourth stage is marked by a progression to coma. I quickly advanced to the third stage, rendering me (in my own words) a "happy dimwit." It was a very odd feeling, listening to someone speak, hearing the individual words, but having no ability at all to string those words together into something imbued with meaning. Luckily, however, "there's a drug for that." In this case, it's a drug called Rifaximin. Although it was developed and approved for the treatment of irritable bowel syndrome, it turns out to be an excellent treatment for hepatic encephalopathy. Go figure! Fast forward to SeptemberWith the encephalopathy under control, I was able to steer clear of doctors and hospitals for a good, solid six months. In early fall, however, my hemoglobin started to drop. To combat this, my oncologist started me on a course of steroids. That did the trick to remedy my hemoglobin, but the steroids also made me susceptible to other "opportunistic" infections (since steroids work by "shutting off" one's immune system). In my case, I came down with a case of cryptococcal meningitis. That's a fungal infection in and around the brain. The diagnosis and initial treatment for it cemented my inpatient status at Johns Hopkins for a couple of weeks in November. The complete treatment for this type of meningitis takes a full year, but it is as simple as taking a daily pill. All in all, I continue my tour of modern medicine and the seemingly miraculous solutions that it can provide. What will the rest of 2019 bring? Who knows, but I bet it will be something interesting. MusicI've discovered a few new bands lately. Here is one of my favorites: Jenny and the Mexicats. Although many of their lyrics are in Spanish, a language that I do not know, I find their music and melodies to be infectious. Your mileage might vary. Photo collectionsHere are some photo collections from some of the highlights of the last year. Click any of them for more pictures. PhotosHere are some photos that we've either taken or collected recently. Tidbit
4 Comments
Jennifer Payne
2/18/2019 06:29:57 pm
For anyone reading this who might assume that Josh's mind is now muddled, I visited him in December, and his memory was so sharp that he reminded me of many people we met and sights that we saw during a trip in college. I need me some Rifaximin!
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Maria Parker
2/18/2019 07:11:11 pm
Glad your health is improved enough to allow you to send this out. Love your blogs/newsletters.
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bev Bley
2/19/2019 08:54:28 am
Oh, Josh--so good to hear from you. Sounds like an extremely harsh and frightening time for you and Alison. We think of you both so often and wish we could send you magic healing powers. I love your new word--I can think of many uses for diktat.
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Harry and Beth Davis
2/19/2019 01:34:38 pm
Seeing your email pop up today made my day. I always enjoy reading updates and learning cool stuff. The clip of Rachel and her fellow brass performers was stunning! I took the time to read her online obit...she was originally from Plymouth MN where some of my relatives live. I wonder if they have heard of her. Love you lots and glad that you are feeling well enough to share your world view with us,
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