Author: Michael

It is election day, and Jacqui and I exercised our democratic birthright just after lunch at the Russian Orthodox Church two blocks from our home.

It was a rough night and morning, and the puke-o-meter ticked up one notch to seven at around 6:30pm last night. It was not fun. When I vomit I look like a character out of The Omen, shooting green goo and Satan’s lymphatic spawn across the room, hopefully aiming well into a toilet.

I did my best to sleep off the post-nausea sickies, so I could eat enough democracy-laden food to give me the strength to vote. A scrambled egg, wheat toast, and a banana did the trick, and at around noon Jacq and I headed down to the polling place. The person in charge of the polling site noted that I had changed my hair, as my ID showed me with a full doo. I told her, eliciting great guilt, that my chemo laden head was not by choice, but that I would be OK, and that I was glad to be able to vote, even though I was afraid I might puke on the machine at the sight of the name Santorum (I am, at this moment, watching Santorum give what is a surprisingly gracious concession speech).

The nausea returned later in the day, and I ended up back at Penn for some routine blood tests, some fluids to fill up the tank following last night’s pukage, and anti-pukage medicine that has left me relaxing at home watching election returns come in (which, it is entirely possible, may also make me puke at some point, depending on the results).

Once again, after a heavy dose of methotrexate, my super kidney has done its job and metabolized one ginourmous bag of yellow chemo. I was discharged at around 1:30pm, and now me and my tired kidney are at home resting.

The B cycle crash will probably come earlier this week as my counts already began to drop even before I left the hospital, so I suspect that by Wednesday or Thursday I’ll be mushed into the pillows of our comfy red couch.

Special thanks to all of those who came to visit me in the hospital this week–my mom and sister, Rick, Vandana, Paul, Bette, Jaime, Renee, Bill, Ivy, Maya. Special thanks to our friend Matt who drove down from NYC for a visit and brought with him the good news that he starts his first job as a nurse at Mt. Sinai on Monday, and the yummyness of Zabar’s in the form of fresh bagels, sturgeon, fresh cream cheese, and, most importantly, a pound of whitefish brought especially for my doctor who ate breakfast (and sometimes lunch) with me to chat about lymphoma, chemo, good Jewish food, and Jacqui’s giant belly.

Given that Jacq will be busy taking care of me and Lester this week, and I will be short on hemoglobin and brain power, I am welcoming contributions for guest blogs. So if you feel like blogging, send ’em over to myudell@gmail.com. See you online!

The dreaded B cycle, which should knock my socks off some time late next week with very low blood counts, has been pretty easy going down so far. Right now I am getting an IV dose of a drug called leucovorin, a “recovery drug”, which helps my body metabolize the 24-hour-straight chemo that I finished last night. I cannot leave the hospital until that chemo is well metabolized, which was not a problem last round, so I should be good to go home by about 3pm tomorrow just after my final dose.

I got a new roommate last night, who was here only briefly, was very nice, and had working ears. Last night was thus quiet night. Hopefully tonight is the same.

My nurse just told me a crazy story which proves that truth is much, much stranger than fiction. On Halloween night last week, one of the patients here on the lymphoma floor had their young son come to visit in full costume. Take a second to consider what the most offensive costume someone could choose to dress up as on an oncology floor? A zombie doctor? No. Dr. Jack Kevorkian? No. How about a four foot tall grim reaper going door to door on Rhoads 7 trick or treating? Yes! And how about the transplant patient who had to be medicated after opening her door and finding a miniature grim reaper, scythe and all, yelling trick or treat.

No grim reapers tonight. Hopefully one doesn’t show up as my roommate for the evening.

Checked into Rhoads 7 at HUP last night at around 6:30pm, only to discover that the private room they had promised me was now a shared room. This unfortunately means that Jacq can’t stay with me, although the nursing and admissions office are doing their best to try to switch me given Jacq’s size and status. There is, however, a high census of patients who need to be in isolation so it might not happen this round. I miss Jacq terribly at night, but given her size, I am glad that she is at home in comfort cuddling with Otis.

My roommate on the other side of the curtain is a ninety-five year old hip-fracture patient who I learned served in World War II and was shot in the butt. I’ve also learned that he is nearly deaf, so when any family member, nurse, or doctor enters the room, I generally stick my fingers in my ears or go for a walk. Thank God he is not a snorer. His ninety-something-year-old wife and two daughters were here with him last night, and there was nothing sweeter than watching them say good night to one another, telling each other in their very, very, very old person’s voices (a slightly raised voice combined with what must be almost seventy years of love) to kiss the other’s hand given one was immobilized in bed, and the other in a wheelchair. I look forward to the day when I am a crusty and cranky old man who, hopefully not with a cracked hip, does the same to my lovely wife. By then maybe hearing loss will be reversible and I won’t have to yell or be yelled at to communicate with Jacq and others.

The chemo so far has been uneventful, and I expect to be out of here late afternoon Sunday. Monday will be my crash day, although I do hope to make an appearance at school for a few minutes to meet our new students who are taking a class I was supposed to teach.

Below is today’s chemo hat in honor of Humphrey Bogart, who was not born on this day, but on December 25, 1899.

Checked in a few hours ago. 7022 Rhoads Pavillion at UPenn.

Waiting for my drugs and dinner.

More later…

After being told that I had a bed and would begin treatment last night, a series of hospital emergencies combined with patients who did not check out kept my bed occupied and we instead went out for Italian. Delicious bruschetta, a ceasar salad, and breaded flounder. For the Philadelphians out there, a big thumbs up to D’Angelo’s on 20th and Manning.

So, we are waiting for the call that there is a free bed. It could come today, or maybe tomorrow.

In the meantime, life goes on. Time for lunch and then a few hours in the office. Later.

Today we had an ultrasound of little, or should I say, “big Lester.” According to the sometimes inaccurate ultrasound measurement, Lester weighs almost 6 pounds. Wow. S/he’s going to be a big kid.

Jacq, who had only a snack for breakfast, got nauseas during the procedure and had to be rolled (literally at this point) on to her side so the tech could continue. So she unfortunately didn’t get to see the incredible images of Lester’s head, belly, bladder, arms, legs, teddy bear, and blankie.

What we both did get to see took our breath away. No, it wasn’t Lester’s “giant umbilical cord.” Nor was the little dude(tte) wearing a Yankee’s shirt. It turns out that Lester almost had a buddy in Jacqui’s belly. There it was. A second, small gestational sac with a tiny bud-like structure attached to Jacqui’s placenta. The doctor, who called this a vanishing twin, reassured us that though rare, this happens, and there was absolutely no risk to Lester. But we now know that probably for a few moments very early on we had twins.

Holy cow, we almost had twins! That would have been nuts. Not that we would have placed the second child in a reed basket and sent him or her downstream, but given all that we’ve been through one at a time is probably the best reproductive strategy for the Yudell-Rick household.

We both felt sad today for little Bud, knowing that it was almost our second child. But seeing big Lester’s heart beating, and hearing the doctor say the words, “you’re baby is healthy,” made today extraordinary, and we look forward to meeting the big baby soon.

In less than six weeks (and hopefully a few weeks sooner) Jacqui will give birth to our first born, who as a fetus, we have nicknamed Lester. I am not sure where the name came from. We called the fetus Junior for a while, but at some point early on I called it Lester, and the name just stuck. I apologize to all the Lesters out there, but the name has a funny ring to it, and it makes us laugh each time one of us talks into Jacqui’s belly-button microphone and says “hi Lester.” We, of course, do not know the gender of the baby, so if Lester turns out to be a girl, I suppose we should start putting money towards her therapy bills now.

Our firstborn is arriving at an obviously crazy time in our lives. While we knew that we would have to deal with me and my wacky lymphatic system some day, this is not what we envisioned for our first, or for that matter, any of our children. When I was diagnosed, and then got past the one-year-with-no-change-in-my disease hurdle, the odds were with us that we’d have significant time before I had to go through delymphomatization. Screw you Las Vegas bookmakers who put the over/under at five years!

There are moments when I look at Jacqui’s belly and wonder what lies ahead for little Lester, Jacqui, and I. At what point in Lester’s life will I tell him/her about what I went through from when she/he was little more than a clump of cells? How can I make sure that Lester doesn’t grow up afraid of losing dad, but realizes that there are no guarantees that my lymphoma will not come back some day, that I’ll need to be retreated, or that that treatment might be more brutal than what I am going through now? How will I let the little dude(tte) and future sibling(s) know that everything will be ok?

Should I need to be retreated, one option, the “home run” of lymphoma treatments, would be an allogenic bone marrow transplant, which means that a family member or total stranger donates their marrow to me (this is different from an autologous bone marrow transplant, where I donate my own marrow back to myself. The auto-transplant is a safe procedure, one that I will be going through later this year as part of the process of delymphomatization).

Donor (allogenic) bone marrow transplants, while potentially curative, are also very dangerous (a 10-25% mortality rate). So it is not, as you might understand, an attractive option, except as one of last resort. FOR THOSE OF YOU THAT MIGHT BE CONFUSED, I REPEAT, THIS IS NOT THE PROCEDURE THAT I WILL BE GOING THROUGH, SO DON’T FREAK OUT. I HOPE TO NEVER HAVE TO GO THROUGH THIS, BUT…

Hopefully the current treatment does its job forever and we never, ever have to think about IVs, neutropenic diets, and delymphomatization again. Lymphoma treatments are evolving quickly, and the need for such brutal cures will hopefully be a thing of the past soon. But should I ever need a donor transplant, there is a good chance that the marrow that saves me could come from my firstborn. At birth, we will be collecting Lester’s umbillical cord blood, and it will be stored somewhere in the Arizona desert, where I hope it will collect dust forever, or be donated to someone else in need. But should I ever need it, and Lester’s marrow is a match to mine, it’s there. And should I need it, and Lester’s immune system in the form of his/her marrow saves my life, it will be a miracle, our lives literally meshed together, father and child as one in the ways of medicine and in life. And to Lester I will forever say thanks and love.

Some time late next week, once the dreaded “B” cycle begins again, I will probably need another transfusion to prevent my platelets and hemoglobin from dropping to levels so low that I actually slip between the cushions of the couch. Two bags of blood await: one is a holy bag, the descendants of Abraham’s finest in the form of blood from my Rabbi; the other, a bag from my friend Brian, a local Philly guy who is such a rabid Philly sports fan that I fear his blood will just make me sit in the corner and cry for days about blown chances.

The bag of blood I unfortunately won’t be getting is from my sister Andrea, who has been truly amazing during this time, coming down for my treatments, and especially taking good care of Jacqui and Otis while I am in the hospital. My sister, it turns out, despite being an A+ blood donor match, is ineligible to give me blood. Exposure to the Epstein-Barr virus from a long-ago bout with mono (because EBV is may be a contributing factor to some lymphomas, the folks at the blood bank suggest I steer clear). Damn you, boy with mono who kissed my sister in the 9th grade!!!

And while the Rabbi’s blood might have me dancing The Hora and eating too much whitefish, and Brian’s blood might send me running out for a Philly cheese steak, I’ve been wondering what Andrea’s blood might have done for me? Andrea’s empathetic abilities (she is a social worker, after all) would, I am convinced, have finally qualified me for the position of ship’s counselor aboard the Starship Enterprise. There I would be, standing besides Captain Picard, using my empathetic senses to warn him that the evil Romulan was hiding something. And it would have been Andrea’s other wonderful trait, her free spirit, now coursing through my veins, that would have led me into joining Star Fleet in the first place.

Andrea is my little sister, which means that since she was born she suffered through brutal teasing, the occasional pulling of hair, and certainly the “I am too cool for you and your little friends” years of high school (save, of course, her one little friend who crawled into my bed at 2am the night before I left for college). But through it all she always showed unswerving love and dedication to her big brother, and has most importantly, forgiven me for torturing her. With her blood in my veins would that mean that I’d actually be easier on myself?

And while blood may be the literal gift of life, I say to my sister (assuming I get the holy blood): “Behold, Andrea! While thou may not giveth thy brother the corpuscles of life, thou are thy brother’s keeper, and hath giveth him so much more.”

Saw the doctor today for my routine between chemo appointment. Blood test showed that I am no longer neutropenic, and that my counts continue to recover nicely.

Immediately following the appointment, no longer on any dietary restrictions, I headed right to the neighborhood sushi bar where I downed some delicious tuna, salmon, and yellowtail. The food-fest continued at the Famous Deli, where Jacq and I ate sandwiches, pickles, and french fries. It’s now almost midnight and I just made myself a salad. And the night is yet young. What should I eat next? One more wafer thin mint? Get me a bucket!

Despite overeating tonight, I am feeling remarkably well. I said to Jacqui tonight that I have not felt as good as I do now since the first drop of chemo started flowing nearly two months ago in this wacky process of delymphomatization. My recovery from the first two rounds never felt complete. And while I am 6 pounds underweight and still sometimes try to place the square block through the triangle hole, tonight, in the crisp autumn air, walking around the city with Jacq, I felt a semblance of myself in mind and body. And boy did that feel good! I am looking forward to writing tomorrow, teaching Wednesday, solving the crisis in the Middle East Thursday, and writing some more on Friday. Bonus points to those of you out there who can identify the source of the title of today’s blog (Hint: It comes from one of the 900 movies that I’ve watched in the past 2 months).

A final word of thanks to all of those who visited this weekend–the Jacoby’s, Greg, Nicole, Paul, Jen, Ruthie, Paul, Bette, Hollie, Chris, Josh, Melissa, and Andrea–and especially Jacqui’s parents, who took good care of me in my weakened state. I may have been a little weak from the low blood counts, but it never dulls my feelings of love and gratitude for all that all of you are doing for us during this time.