Sunday, February 17th, 2019
I 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.
In 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 September
With 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.
I'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.
Here are some photo collections from some of the highlights of the last year. Click any of them for more pictures.
Here are some photos that we've either taken or collected recently.
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