Thursday, September 22, 2011

Wow Squared

Finally I have figured out the elusive equation that defines personal happiness (at least for this week).
It follows that happiness equals:

Weekly Happiness = Children's Happiness (N^7) x (7-[n2+n3])days/week x WOW^2

WOW^2: Wow squared represents what I uttered out-loud today as I clicked on that final result from my electronic medical record (being an MD has its percs) and seeing the number 38 staring back at me. (20 is normal.) This is the lowest that my Kappa light chains have been in recorded history, Wow................Wow!
For those interested in the treatment of amyloidsosis this resulted from the conversation I had last month with Dr. Schrier. Revlimid had stopped making a noticeable difference, therefore Velcade (or Bortezomib) was added (not replaced.) The Kaiser Cancer Clinic now gives the weekly Velcade dose subcutaneously as opposed to intravenous. This is reported to decrease the side effect of neuropathy. This may be true as my neuropathy has only slightly worsened, (above my usual baseline of tingling toes,) after 4 doses. Unfortunately, it also causes skin reactions at the injection site. The first was the worst, however since then I have asked the nurse to inject with the full needle perpendicular to the skin to bury the dose as deep as possible. The last three have had much less of a reaction. I got very sick from Velcade two years ago, but haven't had that reaction this time. I am now off my Revlimid for a month, but will continue weekly Velcade and dexamethasone. I will repeat the Kappa level in 4 weeks. If it remains low, bye bye, Revlimid. Does a lower kappa chain level indicate I will live longer and prosper? Fascinating question; no answer. Hopefully.

All of our children are happy this week. 2 daughters-in-law both got great jobs this week to support their twin husbands as they begin graduate school (deja vu all over again). Son-in-law loving school supported by my daughter as she starts her career in her dream job. (As seen on TV) Youngest daughter voraciously attacking her first semester of college with aplomb, while being wooed by a very nice and overly eligible young man. I once heard a wise man say that a parent is only as happy as their saddest child. In this case the inverse remains true while the contra positive paradoxically is not. (at least not relevant). Furthermore, the increase does not occur linearly, rather exponentially. Children's happiness N (number of children)^7.

Some days the drugs steal my joy for a little while; usually 2 days after the dexamethasone for 2 days. Hence the (7-[n2+n3]) giving 5 goods days a week.

All in all this represents a whole boatload of happiness. I am going to bottle up some of it and share it with others. This is clearly too much to keep for myself.


P.S. I just noticed that it is 12:01 A.M., Happy Birthday, Rebecca.

Saturday, September 10, 2011

Ten years later

It was Monday evening and Rebecca and I were sitting at the kitchen table. I glanced over at the calendar and then commented to her, “Hey, Rebecca, did you know that tomorrow is international emergency day?” Knowing of my propensity for puns and wry observations she glanced up with the expectation that I finish so she could get back to her homework.  “Tomorrow is 9-1-1,” I said. All I got was silence and a slight smile.
About the same time Barbie called her voice teacher to let him know that she wasn’t feeling well and needed to cancel her voice lesson for the next day. That meant she would not need to travel to 12th Avenue on the lower west side of Manhattan in the morning.

It was September 10th, 2001.

I finished my first case and a nurse came in and said a plane had hit the world trade center. At first someone said it was a small plane and it was an accident. I went into the OR lounge to see the image of the tower with smoke. Talking heads droned on the television behind the image. Suddenly, a dark image circled around and headed toward the towers. In the seconds prior I thought, is this an observation plane? Then it hit and we all witnessed the explosion. The talking heads stopped. The mumbled to themselves, as they were no longer reporters, rather numbed observers as ourselves, “Is that live feed?” In that instant we all knew. We were under attack.
We sat there in shock wondering what it all meant. I went back to do my next case in the OR and reports came in. “The pentagon has been hit!” I said to the resident there. “This changes everything; things will never be the same.”  
Soon the news came, “One of the towers has fallen.” By now we were all in the lounge unable to look away, only one tower remained. And just when I thought it couldn’t get any worse, we watched it fall. This was not a movie, this was not a historical documentary, this was happening in real time 75 miles from where we stood.
The rest of the OR schedule was canceled as we went on alert in case victims of the attack needed medical care. We waited all day; none came. It was as if the world had stopped.

The elementary school didn’t say anything to the children and left it to us parents to explain the day’s events. There was no perspective to put this in. It was just horrible. Eventually the TV became an endless stream of images and words. The words became meaningless as the power of the images, repeated over and over, overpowered us. We could no longer watch; we had to look away.
The next few days were a struggle for everyone. Who was to blame? Who was to pay? How would this new world affect our lives?

The following weekend was Stake Conference. As the stake presidency, our speaking schedule was light as we would have a visiting general authority who would take the bulk of the time. I personally didn’t have a speaking assignment.  Friday night President Fluckiger called me to inform me that the visiting authority was grounded in Canada as all flights to the United States had been suspended since Tuesday. We were on our own and I would need to prepare a talk for Saturday night and Sunday morning.
The next morning the cub scouts were taking a hike up Sleeping Giant, a large hill in our town of Hamden, Connecticut. As we walked, the primary president, Mariann Pillar asked me what I was going to speak about. “I don’t know.” I responded. I looked up at the cliffs above us thinking of the precipice upon which we were all now teetering.  Suddenly, an image from the Book of Mormon came to my mind. It was the prophet Alma standing with his disciple Amulek watching in terror as the enemies of the believers were torturing and killing hundreds of innocent people and burning them alive. Amulek pleaded with Alma to call upon the powers of heaven to stop this atrocity.

Alma responded, “But Alma said unto him: The Spirit constraineth me that I must not stretch forth mine hand; for behold the Lord receiveth them up unto himself, in aglory; and he doth suffer that they may do this thing, or that the people may do this thing unto them, according to the hardness of their hearts, that the bjudgmentswhich he shall exercise upon them in his wrath may be just; and the cblood of the dinnocent shall stand as a witness against them, yea, and cry mightily against them at the last day.

This became the essence of my talk. I then spoke of the persecutions that we as Latter Day Saints had suffered during our early history, being driven from state to state, our lives and property destroyed. And yet, we were able to rise above hatred and despair to forgive and move on. It was not for us to judge the Muslim people because of evil men among them. To succumb to hatred and fear was to grant the terrorists success.
I ended my talk and heard the collective, “Amen.” And felt drained. I said what I had to say and now it was time to heal.
It is now ten years later and I wonder if we have learned anything. I cannot say as a society that we have yet risen above this, but I do know that the individual human spirit remains undaunted. The reversal of evil is accomplished through the daily kindness of compassionate acts. That is how we heal. It is altogether fitting to remember the lives lost on that day and remain resolved that hope will subdue all fear.


Thursday, September 8, 2011


The month of August was fantastic. Aug 1st I began the hike that was truly the peak of my Summer. One more item on the "Things I thought I would never do again list" that was erased. The following week Jason and Rebecca came to visit for a week. They wanted to spend some time Caitlin before she left for college. They went with me on the 9th and 10th for my biannual heart check-up where I get the echocardiogram, doctor check-up, right and left heart cathterization, 10 tubes of blood work, EKG and heart biopsy. I also went to see Dr Schrier at Standford to figure out what to do with my chemotherapy. I was hoping he would allow me to stop for a while, or, if not, switch to Velcade since the Revlimid doesn't seem to be working as well. He prescribed plan 3; stay on the Revlimid and Dexamethasone and add Velcade on top. I could just imagine the adverse reactions with that. But, I do what my doctors tell me. He did say that if all goes well, later on I might be able to drop the Revlimid. (I see a high probability of that occurring) All of the tests came out great. The heart is a champ and there is no sign of amyloidosis in my new heart after 3 years. It looks like this pump is good for a while longer.
My heart birthday was spent in the OR and the 'rest of me' spent a quiet day driving to stores to by me some shirts on the 19th.
Saturday was stake conference and President Perez asked me to speak in the evening session on how having a change of heart is a similitude of our acceptance of the atonement of Christ. It was a very emotional talk for me as I shared very specific experience of all that I had lost until all that I had was my faith in God to keep me going. Recalling these memories is never painful. Rather it is a reminder of how blessed we have been and how much we are loved.
Barbie directed the choir on Sunday. She did a wonderful job. I love singing in her choirs. She truly has the gift of making an average choir sound wonderful.
Monday we had an impromptu party for Caitlin for her last day in California. That same day she finished her demo CD to audition for her major; five songs that she wrote and performed. Her mentor and engineer was Brian Rhodes, a man of amazing talents and boundless kindness.

Leaving Caitlin at BYU was like be dropped into the Salavador Dali painting, "The persistence of memory" It was surreal. For 25 years we have had children in our home. And then one day you give your youngest a hug and a kiss, tell them you love them and then walk away. The drive home was quick and quiet. Caitlin already loves everything about BYU. I don't think she misses us too much (which I guess is good)
Apropos, August ended on the 31st with me getting my Revlimid and Decadron at 7:30 AM and my first shot of Velcade (now subcutaneous to diminish neuropathy) at 8:30 AM and then off to see my first clinic patient at 8:45 AM. The best month in years abruptly came to an end.
I don't regret the down days because the subsequent days and weeks of lightness and elevation feel so new and amazing. The sweetness of being is fully manifest.
For our entire family: Jason and Rebecca, Alexandria and Jeremy, Michelle and Samuel, Caitlin, and Barbie and I, It was a great time of new beginning. The future is just getting started.