MD Anderson, Dexamethasone, and the Wild, Wild West

First of all, I wish to apologize to the many, many friends and family for whom I have yet to return calls and/or e-mails-I promise that, once things begin to settle down around here and cease being so hectic, I will. It's been great to hear from all of you and your thoughts, prayers, and well-wishes are very much appreciated. That includes everyone from Hawaii, Wisconsin, Texas, New Mexico, Colorado, Panama, Florida, California, New Jersey and everyone else within that big, massive loop.

This past weekend and up through today has been another somewhat predictable convulsion (no pun intended)-albeit with some potentially good news mixed in. First though, we had another great weekend with family back home in New Jersey. It's up in North Jersey which is a bit of a drive, but my dad seems to enjoy setting speed records so while the way up was a bit stymied by traffic, on the way down we set a record of just under 1.5 hours-assisted by the

complete absence of traffic. Well done, dad. While up in Jersey we were blessed and able to see my sister Caitie, who teaches at an American School in Cali, Colombia. While she loves the job (and travel opportunities) generally, I think that both she and her boyfriend, Scott, are ready to move on already. Anyway, it was very very nice to see her again and I am so happy that she came up to see us. Additionally, Amanda's brother, Tim, and his wife, Tara, from Brooklyn came in to see us with their baby boy, Conlin, (who gets cuter every time we see him!) on Saturday. Also, one of Amanda's childhood friends, Emily, came in from Queens to see us briefly on Sunday. In addition to these peeps are thrown my own brothers and sister, and we generally had a wonderful time just hanging out and shooting the breeze around the house as well as at a family reunion of sorts at my Aunt/Uncle Daley's place. Like I said, a whirlwind, but while hanging out with family has always been such a blessing, it really has taken on an incredible new meaning for me since my seizure and diagnosis.

After our wonderful weekend at the family pad, my dad drove us back down to Philly and we flew to Houston two days ago for a quick trip down to MD Anderson Cancer Center, reportedly one of the best in the business. (http://en.wikipedia.org/wiki/Md_anderson) For all you ranking-obsessed law students out there, MD Anderson is apparently ranked #1 by US News & World Report in cancer care in the US, something which puts it right up there with UPenn Medical in my opinion (which apparently is a top research and practitioner facility as well - see http://www.penncancer.org/ for a bit more info) and which seems to make my condition extra serendipitous. I must admit how blessed and fortunate I am to have the resources and wherewithal to even travel down to Houston for this second opinion (all covered by only a $25 copay-sorry about your premiums, guys, but I am SUCH a loss for AETNA!), something which many many people do not, very unfortunately, have.

Our arrival at George Bush Int'l in Houston was relatively uneventful. In fact, interestingly, I no longer fear flying at all. Not a bit. Turbulence (we had a bit)? No problem. Pitches? Rolls? No worries, I just turn up my iPod. Whether this is merely a result of my general realignment of priorities I am not exactly sure. But while before the seizure and surgery I would usually give a brief sigh of relief upon landing, now I am absolutely and completely unaffected. Hopefully this is a personality improvement rather than a sign of some new kind of death wish. I suppose only time will tell. I'll let you know if I begin to tempt fate by randomly running between cars on I-95. If this doesn't happen then maybe brain surgery of my type will become elective one day, somewhat along the same lines as Botox or breast augmentation. Anyway, I digress. So when we arrived at Houston's International Airport, my Aunt Pat picked us up and brought us back to her home in Katy, TX-a spread out and easy-living suburb of greater Houston. Unfortunately, Houston's outer reaches are pretty much a mess; an unfortunate result of having zero, that's right, zero municipal zoning regulations (though there do exist individual, but not relational, housing/business zoning regulations). But as we've learned time and time again in the more conservative-leaning environs of Penn Law, zoning regulations wrench away some kind of God-given right to property, which of course then begins to unravel the "bundle of sticks" upon which rests our sovereign right to dispose of/modify our properties as we please. Whatever...but once again I digress. (this may very well be the dexamethasone again).

Once picked us up we went to Katy and enjoyed a wonderful and relaxing evening with my Aunt (my dad's sister) and her dogs (don't worry, she has kids and a husband but they were all either at school or working at Campbell's in Camden, NJ at the time). We even went to eat Mexican food, where I was very surprised and happy to meet a buddy from high school days who just happened to be staying across the street (definitely one of the more random experiences of my life!) with one of my dad's former co-workers from Exxon (very weird, I know). It was great catching up with him again. We went to bed early and slept well, waking at 7 AM for my appointment with Dr. Yung.

The next day we arrived at MD Anderson Cancer Center, located within a HUGE conglomeration of dozens of very major medical centers. We parked with the (validatable) valet and headed inside MD Anderson's massive main cancer center building (of which there are many). Once inside we were herded through the lobby up to floor 7, where I was quickly processed and herded into the appropriate waiting area. We visited with Dr. Yung's "fellow" (basically a NeuroSurgeon who plays second-fiddle to Dr. Yung's first-string), a gent from Germany named Dr. "Something German that begins with a 'W.'" Since I don't remember his name exactly, we'll just have to call him "Dr W." So Dr. W let us know that my tumor slides had, in fact, arrived from Penn medical but had yet to be completely read. That said, he had the chance to look at the MRI/CT scan slides which I brought, and noticed that the lack of Blood-Brain Barrier leaching suggests a lower-grade, grade III tumor than previously thought. That was the good news. The other news is that since my tumor's pathology had yet to be read, we don't yet know exactly what the method of treatment will be.

When Dr. Yung came in to speak with us, he was very careful to explain that if a 1p/19q chromosomal "deletion" is present (details aren't really that important here, but suffice it to say that such a "deletion" means that the 1p and 19q chromosomes basically have "shorter legs"), then the cancer patient is much more likely to respond better to just chemotherapy, making radiation less necessary. This could potentially be a good thing, as radiation more or less acts as a searing device which destroys tumor cells around from where the cancer was extracted, but which can potentially lead to irreparable neurological deficits. "Irreparable neurological deficits." Well I guess that's what we're trying to avoid here, especially since many of those potential deficits are exactly what trial lawyers might rely on, such as short-term memory, concentration, and ethical behavior (just kidding about the last one-losing it might actually push me right up to the top of my chosen profession).

And that was my trip to Texas. I actually have a lot more to write since a lot has happened since then, but here are some pictures for the more visually-aligned among us.