Sunday, December 25, 2011

My favorite presents from Christmas 2011:

~~ amazing “Star Wars” characters and “woodland animals” produced during the annual cookie decorating party;

~~ late-night “Downton Abbey” marathons (and where, by the way, was Maggie Smith with her explanation of how an estate is entailed when I was trying to master future interests in my 1L real property course?);

~~ shouts of all the Bradford and Ngo kids with Akemi playing “Boogle” and “Pit”;

~~ Barbara’s specialty fudge;

~~ Akemi’s rendition of “What Child is This?” in today’s Sacrament meeting program;

~~ teaching niece Carly how to make cream puffs;

~~ hearing Akemi practice the Tchaikovsky violin concerto, the b-minor Bach partita, and the Mozart “Haffner” symphony;

~~ hot baths and the gym steam room which ease away the achiness.

And to all, a good night!

Wednesday, December 21, 2011

“A steaming cup of hot chocolate with buttered toast is surely one of the most heart-warming, body-warming, and taste-satisfying combinations known to man.”

With that opening sentence in a column which ran in the 1970s, James Beard had me hooked. He went on to decry the notion of hot chocolate being something “tipped out of a little paper bag into a cup, dissolved with hot water,” which was what I knew, and reminisced of where he had enjoyed real hot chocolate: Swetland’s from his Portland, Oregon hometown; Paris sidewalk cafés; Viennese salons. Beard revealed to me the differences between the French, Spanish, and Mexican approaches to ingredients and preparation. His description of sipping chocolate between bites of crusty rolls or buttery croissants – “an enchanting marriage of flavors” – captured my imagination and elevated my thinking about food.

That clipped-out food section article started my interest in food writing and my recipe collection. I resolved that one day I would do better than packaged hot chocolate mix. I confess that most mornings at work, that’s all it is, but when circumstances permit, I strive for making my own recipe with steamed milk served outdoors accompanied by whole-grain toast, some nice French brie, and a crisp apple.

Last night while shopping for the ingredients to make Akemi’s welcome home dinner, I came upon a cocoa called “chocolate alchemy” with a dash of cayenne pepper and cinnamon. I just tried it, and for someone who doesn’t drink coffee, this version of the Mayan xocolatl delivers a nice morning kick. Maybe I should send some to Mitt Romney.

Akemi’s dinner tonight will feature some recipes I’ve saved to repeat and a couple to try out: braised short ribs, roasted carrots, latkes (we like them and it’s Hanukkah, after all) and homemade applesauce, sautéed swiss chard, garlic and rosemary cloverleaf rolls, molten chocolate mini-cakes with vanilla ice cream. In addition to celebrating Akemi’s successful fall semester, we will celebrate my falling IgM and m-spike numbers.

Come on by for short rib leftovers, or xocolatl anytime. Now off to get ready for Akemi’s homecoming.

Friday, December 9, 2011

I’ve never been to a horse race, so I don’t know what it’s like to see your horse win. But right now I’m feeling that maybe I’ll get to found out.

For months on the IWMF talk-list I’ve been reading about how Dr. Treon’s team has identified a gene mutation in 90% of 30 cases analyzed in his genomic study. Today Dana-Farber issued the press release in advance of Dr. Treon’s presentation on Monday at the 2011 annual meeting of the American Society of Hematology: http://www.dana-farber.org/Newsroom/News-Releases/Researchers-identify-genetic-mutation-responsible-for-most-cases-of-Waldenstroms-macroglobulinemia.aspx.

The mutation they identified is in gene MYD88. Dr. Treon explains in the press release: “The mutation causes the cells to produce a distorted protein, which switches on the IRAK complex pathway, leading to activation of NF-kB, a protein that is essential for the growth and survival of Waldenstrom’s tumor cells. . . .When we shut down the pathway by blocking the abnormal protein with drug molecules, the tumor cells entered apoptosis [i.e., die].”

What’s significant for drug development is that the tested molecules had no adverse effect on normal cells. One case study patient reports that target therapy research for this specific gene mutation is now the Bing Center’s highest priority, and during my recent visit, his office said they were way ahead of where they thought they would be in coming up with a definitive drug.

As Waldenstrom’s is a so-called “orphan disease” – one that is so rare that there’s little financial motive for governmental and pharmaceutical investment in its research – I want to point out that funding for this research was provided by patients: contributors to the International Waldenstrom's Macroglobulinemia Foundation and Peter Bing and his family. I decided this past year to stop donating to other cancer and broader lymphoma organizations, and contribute directly to the IWMF. I like the idea that a small group of patients worldwide have banded together to fight for our own cure.

Not long after my first visit last Thanksgiving, Dana-Farber opened its Yawkey Center for Cancer Care. I got to experience this beautiful new facility this past visit. On my way out, I passed by lovely meditation gardens and this interfaith chapel with a wall that shimmered of stained glass. I stopped in to give thanks for my many blessings and particularly for those who dedicate themselves to cancer research. And for the insistence that I bet on the Dana-Farber horse, I am especially grateful.

Wednesday, December 7, 2011

I was just waking up from my Tylenol- and Benadryl-induced nap three hours into today’s infusion when a group of young people wearing holiday hats and reindeer ears trooped into the clinic. Some USC medical students had come to carol us. Surely a sign of my age is that medical students look to me to be undergrads and the undergrads I pass in the hallways on main campus look to me to be high school students. . . .

Clearly each of them had sung in some madrigal or concert choir group before and I happily would have any and all of them in my ward choir. The other patients weren’t into clapping or showing much appreciation. Something that I try not to let bother me each time I’m in the clinic is that the other patients are mostly elderly, usually frail, and understandably cranky. I hope some of the other patients might have enjoyed the short impromptu concert even though some acted perturbed that the carolers had disturbed their sleep. In any event, I ended up being the enthusiastic listener, thanking them for singing as they passed by me, and got big smiles from each of them as they exited. I wanted to say to my clinic neighbors, “Look! These are medical students! We are training them to be compassionate, caring, and self-sacrificing! They could be sleeping themselves! Give them a little positive reinforcement for their thoughtfulness!” But oh, well; I have made Janet and others promise to kick me if and when I ever get cranky like this and they have my permission to tell me to shape up.

I guess because the other patients watch TV or a DVD when they are not sleeping that the nurses have been fascinated when I’ve brought my laptop to ambitiously tackle work or am concentrating on emails on my Blackberry. They usually ask me about what I’m reading and occasionally ask if the reading is for a class I’m teaching because they see me reading texts, papers, and masters theses. I started out lugging a big bag of work, along with my journal, the Ensign, my cooking magazines, letters to write. . .and then I got realistic that I, too, quickly get groggy and sleep most of the time. So I’ve schooled my expectations on what I can concentrate and now just bring one book. Okay, today it was two books. Book reports to follow.

Today my USC doctor agreed with the Dana-Farber recommendation to slightly change my treatment schedule. Instead of once every two months and ending next August, now it will be once every three months and ending April 2013, so eight more treatments instead of four more (sigh). The idea is to try to mitigate the toll which the Rituxan is taking on the good immunoglobulins and white cells and stretch out the number of Rituxan treatments I can have, since I’m responding to it.

Another realization is that life is less achy with Tylenol, although it makes me sleepy. So now it’s time to cave in to day 1 grogginess.