Cheers to a treatment plan

We've gotten some good news and some clarity since my last update. We met with Dr. Yorio again Thursday morning. Results for the full body bone scan were negative, and while we don't have the radiologist's report on the brain MRI, Dr. Yorio was able to look at it and said that he'd seen enough of them to declare my brain "unremarkable".

Insert jokes here.  

In short, it appears that the cancer hasn't spread to my brain or my bones. We'd grown accustomed to these scans showing the worst, and it was a great relief to get this news. We were also able to settle on a treatment plan. It'll be a dual immunotherapy, administered intravenously every 3 weeks for 12 weeks, for starters. Continued immunotherapy thereafter, with updated medications based on the progress. For the nerds, the specific drugs are Opdivo and Yervoy.  Treatments will start on July 28th.

Another piece of good news is that we were able to schedule the treatments so that it won't interfere with our trip to hike the Dolomites and Croatia. We have something to look forward to and that's important. 

We've also gotten the full results of the lung biopsy and it has confirmed that it is 'clear cell' renal cell carcinoma. This is preferred to non-clear cell as there is more data and more trials focused on clear cell RCC. 

We take our victories where we can find them.

How I’m feeling

Today I feel the best I've felt since the lung biopsy. Probably since a couple of weeks before then. Before today, I had started coughing up very minor amounts of blood. It started again on Wednesday, mostly just droplets in my spit after I'd cough, but there were a couple of times where it was more substantive (about a teaspoonful). It was presumably from the lung biopsy, but that was only supposed to go on for a couple of days. We're 9 days past, so…not great.

We contemplated going to the ER, but really didn't want to deal with all of that. A call to the after-hours line at Texas Oncology confirmed that we were good to wait it out. It was still with me yesterday, but today everything seems to be clear. I also got a good workout in this morning and some pool time. 

I feel optimistic and relaxed. 

What I'm thankful for

The team at Texas Oncology. I was originally scheduled for the bone scan to occur on July 27th. This essentially meant an extra couple of weeks of waiting. Waiting to know for sure. Waiting to finalize a treatment plan. The team at Texas Oncology found another hospital that could get everything done on Wednesday, and got me scheduled for a virtual appointment with Dr. Yorio on Thursday. He has been great – very patient and thorough and clearly an expert.

Most importantly, we are through the diagnosis part and moving on to treatment, and that's a load off my mind and I'm thankful for that, too.

A Memory

I sort of liked the early parts of the COVID pandemic. Sure, there was uncertainty about what was going on, and there was tragedy all around with vulnerable populations dying, and it was really hard on essential workers (thank you!) and people like Amy's Mom and Dad who were in retirement homes, and no one knew what it would mean for the economy.

The big things all sucked.

But for us, the world just slowed down and we liked the pace. At first, work was slow. Even when it picked up it was flexible. We were able to do an extended trip working from Colorado, hiking the Ouray rim trail, falling in love with this little mountain town called Edwards, and getting to Breckenridge in the summer. We did an extended trip back to Philly the summer of 2022, driving there with the dog and renting a house for a month, seeing family and friends. 

We did a lot of antique world map puzzles. A lot. Like 10.  Our dining room table is still covered with them, almost as a tablecloth. I love it – Amy's not so sure. We cooked a lot. Long cooks, got deep into Thai food, made bone marrow tacos, butterflied snapper, and everything in between. A dish taking all day to make was a challenge that we were allowed to mess up. Laith and Paige walked by most days, and often stayed for dinner. Things were slow and they were nice and we had the opportunity to take a moment, appreciate each other, and appreciate the little things each day.

Not that I'm rooting for another pandemic. 

What I'm looking forward to

Next weekend we're headed to upstate New York to celebrate our friend Sarah's 50th birthday party. Our NYC crew of friends will be there – Tracy, Allen, Allison, and John, and they are always a fun time. There will be golf, good food, good drink, and a few days away from the Texas heat.  

Something I recommend

"When you're lost in Juarez and it's Easter time too"

Look it's about time I recommend something by Bob Dylan. I've got 40+ Dylan LPs but don't go to them all that often, mostly because I listened to him so much, for so long, that I just go in another direction. This morning, as I was sitting by the pool, I put on "Highway 61 revisited". It's really a flawless album. If you haven't listened to it in a while, give it a go.

Side note, Amy got my a Bob Neuwirth album for me for my 50th birthday. He's the guy from the cover of Highway 61– the one with only his lower body showing. It's been a bit since we listened to it, but expect a report back here soon.  

What I ate

Last night Amy and I went to J. Carver's.  It's one of the "it" steakhouses by the restaurant group that did Red Ash here in Austin, which is one of our favorites and super hard to get into. 

The food was great – oysters, bone marrow with crusty bread, a Caesar salad, and a bone in NY Strip. But the place also gave off weird steakhouse vibes. It seemed like there were some influencers there. It was super dark, despite the fact that we showed up at 5 PM. There was a maitre d' that walked with a slanted head, and made a point of learning and remembering our first names. His name was Arnold. It's a place that was on our list of places to go and we're glad we went. 

3 stars.

We probably won't be going back.

Random thought

Most of the sports that we follow were invented in an agrarian or early industrial society, and their modern day basis is still, for the most part, the same as it was then. At least in the big ways. Golf is still 18 holes, which is absurd. It takes up most of a day, takes up too much space, is challenging to schedule, and prices a lot of people out of it. And why? Because that's the way it's always been done. Baseball is 9 innings, three outs, 9 fielders, the pitching mound is 60.5 feet away. Why? Because it's always been that way.

Tradition is important in sports. It's how you measure players from generations. It's how stats matter. It's how my Dad and I would debate the merits of McGwire and Sosa chasing the home run record and talk about the Phillies from the 1980s to the 2010s. It bonds parents and children.

But if we invented these sports today, they would be different. The basketball hoop might be larger or smaller. Soccer would have time outs. Football might be played with flags…

At any rate, what would you change, if tradition didn't matter?