Wednesday, April 15, 2009

Writing now from a sun-drenched sidewalk cafe in the Hamburg harbor district's "Little Portugal" -- the place we spelled h-o-m-e from '99 to '03. Sipping coffee, watching people go by, memories sink in. Driving around the city-state with my ol' buddy and bass-guitar legend Franky for the past few days, I've been overrun by memories. For nearly every street in every district, there are bars, clubs, cafes, and apartment or office buildings that tell a headful of pages, paragraphs or parenthetic asides from an 11-year story of life in the Hansestadt.

I remember my dad's reply when, back in '92, I told him I was moving here: "Hamburg?! Isn't that German for 'Pittsburgh'?" But Hamburg truly is a fantastic town: most trees per km2 in Europe; more bridges than Venice; and one of only a handful of European cities in which bars are open all night. If you ever have the opportunity, do pay the town a visit. Come for the sunshine, stay for the drizzle. Incidentally, I've heard that Pittsburgh is actually one of the most livable cities in the U.S. At least, it was in the top ten a couple years ago. Now NFL champs, so that may put 'em in the top five.

Came up north for the week to spend Easter with Sammy and Anke and her parents, to see some old friends, and pay a visit to the clinic where resides the doctor who's leading the study and setting the protocol for the particular therapy I'm undergoing -- rituximab+zevalin as pre-conditioning for own stem-cell transplant. It's a relatively new regimen, and particularly novel in combo with "only" an own-cell transplant (as opposed to a full-blown donor transplant).

Sammy is staying a week at her grandparents' place. She's proud as a peacock to be on her own for a week. It's good for her self confidence and feeling of independence. Speaking of Sammy, I should note that in the euphoria of my last posting over treatment finally starting up again, I mistakenly wrote that Sammy turns 10 on April 1st. Just for the record, as many a savvy reader quickly pointed out, she of course turned nine. Mea culpa. She went with mom and friends to a swimming pool / water park. And had a blast. Still wary of germs, I didn't join in the aquatic festivities. But as treatment got pushed back a day, I did get to celebrate with her after all: breakfast, lunch and the award ceremony.

The aftermath of treatment was less uppity than my euphoric anticipation thereof -- kinda like how, in college, knocking back a bottle of tequila seemed like a really good idea at the time (Hey, what the hell, these pesos are burnin' a hole in my pantalones and, after all, when's the next time we're all gonna be in Tijuana?!) But the aftershocks have faded by now. I came home about two weeks ago, freshly radioactive from a dose of Led Zevalin. Good thing I'm insured. Saw the bill for the stuff: 14 whopping Ks. They kept me in hospital overnight as they said it wasn't a good idea to go right home radioactively charged. Which is probably sound advice. Apparently, the Geiger counter showed my half-life had worn off enough for them to release me. Aside from being really tired, I didn't really notice my radioactivity. But on the taxi ride home, the traffic lights all turned green for us from half a mile away. And I can still keep a cup of coffee warm for up to an hour with my bare hands.

A week prior, the first round of chemo (rituximab) went down surprisingly easily, thanks to a hefty dose of cortisone. Rituximab is the stuff to which I had had an allergic reaction the first time, so they always had to run it slowly, over the course of 16 hours, for the ensuing (meanwhile 11) treatments, all of which I did as an inpatient. Not wanting to prolong the bed wait, I said I'd give it a go as an outpatient in same-day service, which meant they'd have to run it about 7x faster. Which they did and, knock on wood, no allergic reaction.

Blood tests since the Zev show all systems green. HB count still riding high, just under 14. My doc told me that the latest study results of my treatment course indicate that it's better to wait a while between Zev treatment and transplant, which for me is now planned end of April. This gives the nukes more ample time to radiate the boat. Kaboom. On the one hand, it's a drag to have the treatment path dragged out longer; on the other, it's comforting to know they're feeding real-time data from this relatively new therapy into my treatment plan. And so I also look forward to the opportunity to talk with the Hamburg doc who's writing the protocol, to hear first hand of the results patients are having thus far. And here's to me soon being one of the success stories.

A hearty "Tschüß" from Hamburg.