The lung biopsy
We've gotten some clarity over the last few days, with hopefully more to come with a consultation with Dr. Yorio tomorrow morning. I had the lung biopsy performed on Thursday which confirmed that (1) it is Renal Cell Carcinoma and (2) it has metastasized to the lungs. Not the news we were hoping for, but what we expected.
The day itself was pretty manageable. Fast, including no water, after midnight until the procedure. Arrive at the hospital at 11 AM. CT scan performed by noon. Prep for general anesthesia, then was put under a little after 1 PM. From there, the biopsy was performed with robotic surgery through the trachea, and I woke up a little after 3 PM. Back to the recovery room, and we left after 4 PM. Amy was with me the whole day and very supportive throughout. I think she did a fair amount of online shopping while I was under.
Thursday evening through Friday were pretty rough. I viewed it as an outpatient procedure rather than through the prism of them having a robot go through my throat and into my lungs. My sleep schedule was all screwed up, I had a sore neck, was coughing up small amounts of blood (to be expected, but still….). Just felt all around shitty.
It was the first day I really felt sick, but fortunately, I knew that it was the side effects of the biopsy. I let the leadership team I'm on at work know about my diagnosis late on Friday morning. It's the first time I've told a group. It was via a Teams call, and it was tough.
I kept it together through the call, but afterward I broke into a full on cry for the first time. I'd been choked up a few times before, but not sobbing. This time, I sobbed. It was cathartic. It's strange that the work call is what pushed me over the edge, rather than say…telling my wife, or my Mom. Perhaps it was how tired I was, or that I actually felt like shit for the first time, or perhaps it was the weird semi-dystopian nature of virtual meetings with everyone in their little boxes, but it got to me.
Amy and I went out to June's on South Congress for lunch, but I felt weak and broken the rest of the day. The pulmonologist called around 5 PM and said that they had some preliminary results that confirmed that it was RCC that had spread to the lungs. Amy broke down at that news. We sat by the pool and listened to Van Morrison. Afterward, we watched a lot of TV, and I went to bed a little after 8 PM.
And then I slept. I slept hard. I have these devices that tell me how I slept. My ring said I got a sleep score of 93 and that I slept nearly 9 hours.
And I felt better when I woke up on Saturday. Much better. I had a personal training session with Pedro, and went to the gym and had a good workout. I went to the grocery to get food to cook for the next few days. Our good friend Louis was having the male version of a baby shower - a party at the German sports bar, Koko's, with a reserved space for the England vs. Norway match. It was fun to be with friends. I came home and Amy and I cooked dinner together, and we settled in to hate watch the new Cape Fear show. It's oddly addicting, but will not be showing up in my recommendations section.
At some point, I'll talk about what an odd duck the pulmonologist was. But that's for another time. Up next, is a consultation with Dr. Yorio tomorrow morning. Hoping to get a diagnosis (this is exactly what it is), a prognosis (here are survival rates based on similar case types), and a treatment plan (here's how we're going to attack this thing). I expect we'll get some of that, but it's also likely that we need to wait for the full results of the lung biopsy to come in to confirm whether it is 'clear cell' RCC (most likely), or another form of RCC. There may also be additional scans that need to be done to confirm that it hasn't spread to the bones, the liver, the lymph nodes, or the brain. I'm ready to get this fight started but anticipate a little more waiting.
Whatever the final diagnosis is, the treatment will likely be some form (or forms) of targeted immunotherapy. RCC is not effectively treated with chemo or radiation, but immunotherapy treatments have improved significantly over the last 20 years. Before these therapies, metastasized RCC was, effectively, a death sentence. There will still be a significant mortality risk, but these therapies will hopefully give us a fighting chance. I'm in good shape. I’m relatively young. My body can withstand treatments. We're ready to get after it.
How I’m feeling
Another good night's sleep last night, another good workout this morning. I'm feeling reflective, but generally pretty healthy. Looking forward to some pool time today, and cooking a good dinner tonight. We're having overly complicated short rib tacos with a scallion slaw and some grilled Korean/Mexican street corn. Expect an upcoming synopsis.
What I'm thankful for
My wife. Again. The support she provided all day on Thursday, with the biopsy, was nice and helped keep things light. Several months ago she went in for a colonoscopy and I wasn't as supportive. I viewed it as a bit more routine, and figured, okay, I can drop you off and come pick you up when you're done. I wish I wasn't that way that day, but I was – work was on my brain and I was a little selfish. Obviously, different circumstances, but she was everything I could hope for on Thursday, and I’m grateful for that.
A Memory
In April I had to go to Ireland for work and Amy joined me for the trip. The middle of the week was filled with work, but we had enough time around both weekends to explore a good bit. We saw the cliffs of Moher, bet on horses at a pub in Dingle, made it the oldest pub in Ireland, the western most pub in Europe, and far too many more pubs. There was a fun dinner with colleagues at a Spanish restaurant where I tried to explain how gerrymandering and the electoral college led to Trumpism. We held baby sheep, saw the Wild Atlantic, experienced petrol protests and drove all the way across the island 4 times. Dublin to Dingle to Dublin to Galway to Dublin. It rained everyday but it also didn't rain parts of everyday. It was all very green and nice. We saw good music at different pubs and everyone was easy to talk to.
But the highlight of the trip was the Barack Obama Plaza in Moneygall. Apparently, Barry's grandfather emigrated from there and, as such, there is a small museum in his honor at a place where we randomly decided to stop and take a piss. This was after our overnight flight, on three hours of sleep, driving through the petrol strikes and the rain on the wrong side of the road. Pictures of Amy and I from this pit stop reflect the delusional state we were in. We were loopy and it wasn't necessarily safe. But there it was, a little museum to Obama.
Apparently, during his presidency, he gave a speech in Moneygall where he said that he came back to Ireland to find the apostrophe they lost somewhere along the way. He knew how to tell a joke. For some reason there was also a statue of Conan O'Brien. I don't know this to be true, but I expect it's the only statue to Conan O'Brien on the planet.
What I'm looking forward to
Amy and I have developed a list of things we need to do. Much of it local (go to the new Waterloo Records, get back to that restaurant, go to that new restaurant), and some of it further off (she's eyeing a Tanzania / Zanzibar trip). Also on this list is playing "Big Buck Hunter". Amy and I used to go to this Thai food truck called Thai Kuhn near the high-rise condo we lived in for our first year in Austin. While we waited for our food, we would play "Big Buck Hunter" and we both got pretty good at it. It’s the closest this Texan has gotten to shooting a gun. This would happen more weeks than it didn't, mostly because we really loved this food truck. It's been a while since we've played, but they have it at Bouldin Acres near our house. Unfortunately, the food trucks there are 'meh'. Anyway, looking for that to happen this week.
Something I recommend
"You wear your skin like iron, and your breath it smells like kerosene"
Townes Van Zandt. Start first with the song "Poncho and Lefty" or the album, "Live at the Old Quarter, Houston, TX". Brendan randomly sent me this album several years ago, and it's been in our steady rotation. It's sort of central Texas Americana / outlaw country. And just good. We've added several other TVZ albums since and he's always a good hang. Even better when you're dealing with the hot days of a Texas summer.
What I ate
Last night Amy and I cooked up a Mediterranean Snapper dish. Pretty easy:
Ingredients:
3/4 LB snapper, cut into 2 filets
Olive oil (~5 TBSP)
Cup of pitted kalamata olives
Cup of cherry tomatoes, sliced in half
4 garlic cloves, smashed and cut into chunks
1 lemon, halved
Salt to taste
Step 1: In a small saucepan add 4 TBSP of the olive oil. Once hot, add the olives, the tomatoes, and the garlic. Add salt and let simmer for 10 to 15 minutes. You want the flavors to meld.
Step 2: While the sauce is simmering, heat a large saute pan and add the remaining olive oil. Once the oil is shimmering, lower the heat to low and place the snapper filets skin side down. Let cook for 5 minutes, adjusting the heat up to medium about halfway through. You want the skin to crisp up and release from the pan. This is the hardest part.
Step 3: Flip the fish and pour the sauce over the fish. Let the fish cook for another 2 minutes. Transition to your plate, skin side up if you got a good crisp on it, skin side down if you f**ked that part up (it'll still be good). Spoon the sauce over the fish and serve with the half of lemon.
Random thought
The Fermi Paradox is a cop out. We need to look harder, and just because they might not be looking for us, doesn't mean we don't matter. They aren't who we're trying to please.
