Keeping in Practice

Nothing new medically to report, other than I did get a leg cramp in my sleep the other day--first one of those in a long time--and I'm still digging around for the gumption to keep exercising.

Robbie story:  Friday night we all were at the home of our friends Bill and Ellen, celebrating the impending departure for college of their amazing daughter (and Robbie's favorite babysitter) Elizabeth.  Wonderful get together with a lot of neat people.  We were in Liz's rental car, due back to Avis the next morning.  As the evening grew late, Robbie came to me and asked for the keys to the car.  My assumption:  he was on a mission from Mommy.  I gave him the keys and thought nothing.  Ten minutes later, Robbie came up to me frantic and in tears.  I finally got him calmed down enough to get a story out and found that somehow, against all odds, he had gotten into the rental car, started the engine, then gotten out of the rental car, and locked the door.  The locked car was now idling in Bill and Ellen's driveway.  Robbie was disconsolate.  Liz and several other engineers commandeered a coat hanger to attempt the rescue, while (at our friend Robin's suggestion) I called Avis.  Apparently we were not the first folks ever to lock keys in a car; Avis launched the duty locksmith, who arrived thirty minutes later with all the right tools for the job.  The whole time we were waiting, Robbie kept running from me to Liz to the house, crying to break your heart, all the while telling anyone who would listen that it was his fault.  It was so precious.  Anyway, locksmith arrived, Robbie shook his hand, and the car was open in about two  minutes.

My thanks to Bill and Ellen, who were phenomenally gracious, even offering us the use of a car until the situation was resolved.  Elizabeth is now firmly ensconced in her new home for the next four years and her younger sister Katie has volunteered to take over babysitting duties.  It was a win all the way around.

That's all for now.

Still Here

Sorry it's been a while since I've posted, but not much has been going on.  Medical update--the thingee in my left ear was in fact a basal carcinoma (lowest rung of the skin cancer ladder) and I am scheduled in September to go to get it re-looked at (read: cut on and burned some more), but it could be a lot worse.  It doesn't appear to have spread and once they do the procedure, it's gone.  Would that CLL was so easy.   I'll continue my yearly pilgrimage to the dermatologist and recommend you do the same.

One of the reasons I haven't posted is that I've been kicking around a topic that, quite frankly, I don't like.  For a couple of reasons.  I don't like it, but I have to write it before I can move on to anything else. Now that I've started this post, I'll finish, but let me say up front this is not a cry in the darkness or an attempt to change any behavior on anyone's part.  It's just a slightly melancholy recognition of a situation in which I find myself.

Way back when I was a teenager--just after the moon was invented--we used to float the Tangipahoa River on inner tubes, well before anyone made it a commercial activity.  It wasn't known as 'tubing'.  It was known as 'floating the river'.  You'd always start with a core of people, but on nice days you'd often meet up with other groups.  Many times they were great people and you would float for an hour or so in their company.  Floating with a group is easy--it takes only minimal effort to stay close.  You just have to reach out, grab an inner tube, and you're back in contact with their beer cooler.  But say you get distracted and you float a little ways from the group.  It can take some real effort to catch back up.  Lots of flailing and splashing.  Every now and then you'd find yourself so far from a group that you knew no amount of effort was going to bring you back to them.  You didn't like those people any less--you just knew the river had taken you different ways and the distance between had grown too great to bridge.

So it is with social groups.  It's dawned on me lately that while I still have wonderful friends, I no longer belong to any particular social group.  The phone just doesn't ring anymore.  No one appears to be saying, "Well, it ain't a party if Tim isn't here!"  As an admittedly social creature, this is extremely disconcerting to me.  The group with whom I used to hang has gone in a different direction.  They zigged while I was zagging.   We weren't wrenched apart; we lost contact in the fog of everyday life.   Until recently I've allowed complacency, inattention, and (finally) trepidation to mask this disconnection.  I've been in Southern Maryland for almost 14 years now and there are people here about whom I care very deeply.  We just don't move in the same circles any more.   The hardest part is knowing that I am to a large degree responsible.  I am lousy at keeping up friendships (just ask my friends in Louisiana, or the Navy, or New Jersey).  It's actually a pattern with me, though I usually wait until I move away from people before I lose touch.  It's weird losing touch with people to whom I'm still geographically close.

I was hoping that through writing this I'd reach some epiphany, find some final satori to wrap this all neatly, but I got nothin'.  When it comes to friends, I have been and am one of the luckiest guys on earth.  I look through my ledger and read the names of some incredible people.   To my comrades in good times and bad reading this, to those with whom I've sweated and bled and laughed and danced, to those on whose shoulders I've cried and whose tears have dampened my shoulder, I hope you know how special you are and how very much you mean to me.   My hope is that some confluence of currents, eddies, and tides will bring us back together again (mainly because you ended up with the cooler).

OK, that's out of my system.  On to better things.

Adventures in Dermatology plus the Death of a Cell Phone

Hello all!

It's been a couple of weeks since I've had anything to post, then this week:  BOOM! goes the dynamite.

Following the advice of just about every medical professional whose seen my left ear over the last several months, I went to my dermatologist this past Thursday.  I've had a 1/4" circular 'thing' (I call it a thing to spare you the less savory details that a fuller description would entail) on the pinna (Google it) of my left ear for about four months now.  At first I thought/hoped it was a bug bite,  healing slowly due to poor circulation in the area. In my heart I knew better--I've been expecting this for the past 15 years.  I was pretty sure it was some form of skin cancer (I have to learn to just say 'no').

The following are the risk factors for skin cancer (provided here for your edification):

• Fair skin. Having less pigment (melanin) in your skin provides less protection from damaging UV radiation. If you have blond or red hair and light-colored eyes, and you freckle or sunburn easily, you're much more likely to develop skin cancer than is a person with darker features.
• A history of sunburns. Every time you get sunburned, you damage your skin cells and increase your risk of developing skin cancer. After a sunburn, your body works to repair the damage. Having multiple blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult. Sunburns in adulthood also are a risk factor.
• Excessive sun exposure. Anyone who spends considerable time in the sun may develop skin cancer, especially if the skin isn't protected by sunscreen or clothing. Tanning, including exposure to tanning lamps and beds, also puts you at risk. A tan is your skin's injury response to excessive UV radiation.
• Sunny or high-altitude climates. People who live in sunny, warm climates are exposed to more sunlight than are people who live in colder climates. Living at higher elevations, where the sunlight is strongest, also exposes you to more radiation.
• Moles. People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer. These abnormal moles — which look irregular and are generally larger than normal moles — are more likely than others to become cancerous. If you have a history of abnormal moles, watch them regularly for changes.
• Precancerous skin lesions. Having skin lesions known as actinic keratoses can increase your risk of developing skin cancer. These precancerous skin growths typically appear as rough, scaly patches that range in color from brown to dark pink. They're most common on the face, lower arms and hands of fair-skinned people whose skin has been sun damaged.
• A family history of skin cancer. If one of your parents or a sibling has had skin cancer, you may have an increased risk of the disease.
• A personal history of skin cancer. If you developed skin cancer once, you're at risk of developing it again. Even basal cell and squamous cell carcinomas that have been successfully removed can recur.
• A weakened immune system. People with weakened immune systems have a greater risk of developing skin cancer. This includes people living with HIV/AIDS or leukemia and those taking immunosuppressant drugs after an organ transplant.
• Exposure to certain substances. Exposure to certain substances, such as arsenic, may increase your risk of skin cancer.
• Increasing age. The risk of developing skin cancer increases with age, primarily because many skin cancers develop slowly. The damage that occurs during childhood or adolescence may not become apparent until middle age. Still, skin cancer isn't limited to older people and can occur at any age.

Of the eleven, I can check the block on at least eight, if not nine.  So it was not really a surprise when the dermatologist said, upon looking at my ear, "That has to come off."  Not the ear, silly, just the thing.  Good news is it appears to be a 'basal carcinoma' rather than a 'melanoma'.   Melanoma is heap bad.   On the other hand, "Basal Carcinoma" sounds like a British game show host or something you'd order at Olive Garden.

Anyway, she numbed me up, apologizing for any discomfort.  I laughed and said that after five marrow biopsies, it really wasn't so bad.  She took a biopsy sample, scraped out the rest, then cauterized the wound.  Sounded funny, smelled bad, but didn't hurt.  Put a bandage on it and told me that we were almost certainly done with this adventure.  I figured out a carcinoma blog would likely be much shorter than a CLL blog.

Then to make the week even better--and under the heading of cosmic payback--I fell victim to an accident of a nature for which I had previously mocked others with a similar fate:  My cell phone did a Back 2 1/2 Somersaults in the Tuck Position into the toilet this week.  After hanging on valiantly for a few days, and even seeming to have staged a full recovery, it succumbed to its injuries Friday morning.  I went to the AT&T store today and discovered today that, completely to my surprise and totally against my norm, I had taken out insurance on the phone.  New one should be here in a few days.

Beyond that, DC had an earthquake, BP plugged the leaking well (maybe),  and we finally got some rain.  As I said, an eventful week.

New summer haircut

Meeting with Dr. Cheson: Latest Status

You may be asking (as my mom did), "Why is there a picture of the Iwo Jima Memorial of the flag raising on Mount Suribachi on your blog?"  Excellent question!  When I leave Georgetown, I go home over the Francis Key Bridge, through the city of Arlington, and down the George Washington Parkway to get home.  Everytime I take the onramp to get on the GWP, I pass this statue.  I've probably passed it 30 times or more over the last year and a half, and I've never stopped to see the memorial.  Wednesday was a beautiful day, I was out of my appointment before eleven, my lunch "date" with my friend Elena had been overcome by events, and I found myself with time on my hands.  So I stopped.  It is a beautiful memorial with several informative plaques around.  I learned that of the six men depicted (five Marines and one Navy corpsman), three subsequently died on Iwo Jima.  Anyway, it was a neat place I've been meaning to visit, and now I have.  It seemed like an appropriate pre-Independence Day picture

On the the biopsy read:

This is where we are.  I am not yet in remission, but we've beaten the living crap out of the CLL.  The marrow biospy yielded no visible structures associated with the CLL, and the flow cytometry--which measures things at the microscopic cellular/chromosomal level--show a less than 1% involvement of the CLL still in the marrow.  Consider that when this all started, my marrow was over 50% involved.  Consider also that for some patients, merely stopping the advancement of the disease is considered a win.  This is pretty good news, and we're not sure that the Revlimid has finished doing it's thing.  I still have enlarged lymph nodes, but these are significantly down from where we started.  I'm hoping for a comment from Nurse Louise to put this in some perspective for me.

Bottom line:  we are now in "observation" mode.  My next appointment is in three months.

Anyway, I'll soon be hitting you all up to sponsor me in Dr. Cheson's 50-mile Lymphoma Research Bike Ride this October.  Help me stay on this guy's good side.

Have a happy 4th.

Father's Day Picnic