Wednesday, January 7, 2009

" I would be happy just to hold the hands I love Upon this winter night with you" Gordon Lightfoot

It has taken me too long to get around to Gordie's gold, as I have plowed through many more contemporary Canadian singer songwriters.

I doubt old Gordie had a walk at sunset at the water's edge in sunny Newport Beach in mind when he penned:

The fire is dying now, my lamp is growing dim
The shades of night are liftin'
The morning light steals across my windowpane
Where webs of snow are driftin' 

Still I love the still more empty winter. The summer is more visceral, more stimulating, and more participatory. The winter is more visual, more distant, more contemplative. Like Gordie's tune.

I have decided to get a third opinion. I will be asking another transplant expert to help me make the next call. The details and the dollars involved are yet to be worked out, but I would like to have my back up person in place, like the hockey goalie on the bench, dressed in all his equipment, ready to jump in and play for keeps on a moment's notice should the starter pulls a muscle or flubs an easy wrist shot. I am hoping this will be like packing extra medication when you travel. If you have it all ready, you are guaranteed not to need it, but if you aren't prepared, you can bet the unplanned occasion will arise. Would that reality was so easy to control with such simple and sweet paradoxical intentions! But it does give me that oh so necessary illusion of control.

I have decided to write JAMA (Journal of the American Medical Association) a letter about the mixed messages from the CDC and the heme-onc world on the zoster vaccines (see prior posts). My attack will not focus on the underlying studies, because there are none, but on the damage caused by the choir singing two songs at once. Makes me feel harmonious.

I have decided and already started doing some volunteer work to help my medical group with some policies and procedures to make our doctors better care givers. Makes me feel useful.

I have decided to push ahead with my book instead of looping around and around on word smithing the first few chapters. Makes me feel productive.

I have decided I have made enough decisions for awhile.  Makes me feel sleepy.

I need my nap.



Blogger Barry B. said...

How do recent developments in your situation make you question the decision to do a transplant early in the process?

I have acquired the 11q del, unmutated, ZAP-70 positive, high B2M, and have been living with CLL for over 10 years. I view a SCT as a last-ditch effort to save my life.

I would try almost anything prior to taking such a drastic step.

However, it is recommended, so I've read, to do a SCT when you aren't backed into a corner. OTOH, delaying the decision often doesn't seem like a bad decision.


January 7, 2009 at 7:09 PM  
Blogger Brian Koffman said...

You asked if I had any second thoughts about my very early transplant decision in view of my ongoing rejection of the graft.
I could just rely on my motto to never to look back, but truth be told, I think it was the right decision, but in hindsight I was not adequately immunosuppressed. In other words, I would do it again, but with a bigger hammer. That BTW, is probably my next step.
Be well

January 7, 2009 at 10:49 PM  
Blogger TomD said...

If I were you, I would plan for a back-up to the back-up. That is, your back-up may suggest something different than the two approaches you now have.

January 8, 2009 at 10:07 AM  

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