No leaves, no coats

Sometimes you see a sign in a restaurant or store that reads:

Yesterday was an amazing day for February in New York. By mid-afternoon, the sky was clear, the sun was bright, and the temperatures had risen into the high 70’s ºF. We could not let such a magnificent opportunity pass us by, and headed over to the New York Botanical Gardens. I kept thinking that we would see a sign reading

No leaves No coats No winter?

 

To the best of my memory, the only time(s) we have ever visited the NYBG during the winter is for the train show. Those visits have consisted entirely of parking the car, moving as quickly as possible to the Enid Haupt Conservatory, spending an hour or so at the indoor exhibit, and quickly returning to the car. Walking around the grounds in the dead of winter is simply not enjoyable. Yesterday was different, but while the temperatures were more like late spring, the grounds still appear rather barren. Still, it was a wonderful feeling to be there, and we look forward to returning when spring actually arrives in earnest.

(here is how it looks during the summer)

The visit brought to mind an old folk song originally written by Pete Seeger in 1955, “Where Have All the Flowers Gone?” Additional verses by Joe Hickerson were added in 1960, and the song has been recorded by countless artists over the past 63 years. I learned today in preparing this post that it was performed in French by Marlene Dietrich at a UNICEF concert in 1962, and recorded the song in English and German as well.

The joy of spring was quite short-lived. Today it is chilly and raining. But yesterday was a welcome break, and a hopeful sign of warmer days to come.

Love,

Rebecca

A plan in place

We had a wonderful weekend up in Sharon. We had dinner Friday evening with Simmie, Ronen, Eliana, and Maya. Joshua joined Barry and me for lunch on Shabbat day, and the boys spent much of the afternoon sorting through the 2018 Topps baseball cards which have become an annual Chanukah gift for Joshua. After Shabbat, Simmie, Dina, and I had a “ladies’ night out” at J.P. Licks. On Sunday we took the three older girls to see “Early Man” (I’ll need to write a review). Yesterday we spent the afternoon with Julia, who is an amazingly entertaining little girl.

While we were playing with Julia yesterday, Dr. Iyer apparently tried to call. He is off at a meeting for the next couple of days but wanted to touch base with us before he left, so he sent the following via e-mail:

I wanted to let you know that the biopsy confirmed my suspicion that there is cancer within the lymph node that was sampled and that it is bladder cancer. I suspect that some of the lymph nodes may have already been involved at the time that you were receiving radiation therapy but that there was too little disease at the time to be detected by imaging. The nodes that are involved are mostly outside the radiation field as well.

I think we should move forward with immunotherapy with pembrolizumab as we had initially discussed. While there is a small risk (<10%) for serious side effects such as pneumonitis or other autoimmune conditions, I think that the potential benefits outweigh the risks. There is no absolute right answer in this situation so I think that as long as you are comfortable with the decision, we should commit to starting the pembrolizumab.

We have you scheduled to come in for a follow-up visit this Friday but I would like to go ahead and schedule the first treatment with pembrolizumab for then as well. 

Pembrolizumab is given every three weeks as an infusion. You may have seen commercials for this compound, which is marketed as Keytruda^®. It was first approved for treatment of melanoma, and later approved for a number of other cancers including bladder cancer that had progressed after standard first-line treatment. Recently reported results of the phase III KEYNOTE-045 trial versus conventional therapy for bladder cancer showed an improvement in survival when pembrolizumab was used as “first-line therapy” (the first course of treatment following diagnosis), which led the Food and Drug Administration to approve this use.

So here we are, just hoping for the best.

Love,

Rebecca

About to reach another milestone

I just need four of you to click on the link to get up to 55,000 pageviews!

Pageviews today

50

Pageviews yesterday

77

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880

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54,996

Waiting for next steps

My deepest gratitude goes to all of you who have reached out to me over the past few days. I apologize for the delayed post but I was simply exhausted when we returned home yesterday and Barry would not let me even near the computer!

The procedure went well, as far as I know. The major challenge was that in order for them to get to the lymph node, I had to lie on my stomach, which makes it very hard for me to breathe. But they were monitoring my O₂ level and said it looked good, and after that I really do not remember much until they had me move from the table back onto a bed. You’ve got to love those drugs they use! A couple of hours later, we returned home and I slept through most of the afternoon, had some dinner, and then went back to bed.

Now we just wait to learn what the next steps will be.

On a somewhat related note, I heard a report on the radio this morning about the current water shortage in South Africa. By way of background, in Sharon, Massachusetts, rather than a city-wide sewage system, homes and buildings rely on back yard septic systems. During the summer you often see trucks digging big holes in the yards and you know what that means: the septic system has failed and must be replaced.

One of the water conservation efforts currently underway in South Africa is to limit the number of toilet flushes, and the local official being interviewed said that the advice to residents is

“if it’s yellow, let it mellow, if it’s brown, flush it down.”

The first time I heard that quip was in the late 1980’s from our friend Marvin, a gastroenterologist who lives in Sharon. I always appreciate finding humor in adversity, and that line has stuck with me all these years. Their system had failed during the winter, and they had to deal with the issue for a number of months until the spring thaw allowed the system to be replaced.

It is time to move past all this talk of bodily functions, so I will end this post by sharing an amusing and informative report I heard on NPR the other day. Who knew that this font I use for the blog was the source of so much controversy?

Comic Sans

Have a great day.

Love,

Rebecca

Phantom Thread

On Sunday afternoon we met our dear friends Ava and Jason downtown at Cinépolis in the Manhattan neighborhood of Chelsea. We had never been to this theater; I don’t know just how long it has been there but it is new enough to have those large, comfortable seats.

We had chosen to see “Phantom Thread,” a film starring Daniel Day-Lewis as Reynolds Woodcock, a London fashion designer to a variety of wealthy clients whose business is managed by his sister, Cyril (played by Leslie Manville). Woodcock meets and is taken by a young waitress, Alma (played by Vicky Krieps), who becomes his model and eventually his lover. But Woodcock is quite a difficult man with whom to work, let alone share a life, which eventually leads Alma to a rather dramatic act in order to gain his attention. I do not want to give away too much here in case you decide to see the movie, but I will tell you (as does the New York Times review) that it involves a mushroom omelet.

I especially appreciate the names that writer/director Paul Thomas Anderson has chosen for the two main characters. “Alma” is a name that means kind or nurturing, and “Woodcock” (putting aside that it is a type of bird) is an appropriate, if somewhat off-color, name for an emotionally challenged male character.

Here is a bit of what A.O. Scott had to say about this film:

Is Alma a feminist heroine? Some version of that question is likely to fuel more than a few post-screening arguments. Your answer may depend on what you think of the mushroom omelet that is the movie’s spoiler-proof surprise. There are other things to talk about. On first viewing, the captivating strangeness of the mood and the elegant threading of the plot are likely to hold your attention, but later you can go back to savor the lustrous colors, the fine-grained performances and the romantic mystery that holds the whole thing together.

I must say that I love Mr. Scott’s clever use of the phrases “threading of the plot,” “lustrous colors,” “fine-grained performances,” and “holds the whole thing together” in the review of a film about dressmaking. With a couple of day’s distance, I am better able to appreciate his fondness for this film.

After the film, we stopped for a snack at Murray’s Bagels, giving us a chance to share our thoughts, and then dropped off Ava and Jason at their next outing before heading home ourselves.

I spent Monday morning in a routine check-up with my pulmonologist at Mount Sinai, and then we headed over to MSKCC in preparation for tomorrow morning, when I am scheduled to have a CT-guided needle biopsy of the lesion in my bladder. Keep the good thoughts coming.

Love,

Rebecca

Who knew grammar was this valuable?

This New York Times piece caught our eye.

Oxford Comma Dispute Is Settled as Maine Drivers Get $5 Million

By DANIEL VICTOR FEB. 9, 2018 (Susan Beachy contributed research)

Ending a case that electrified punctuation pedants, grammar goons and comma connoisseurs, Oakhurst Dairy settled an overtime dispute with its drivers that hinged entirely on the lack of an Oxford comma in state law.

The dairy company in Portland, Me., agreed to pay $5 million to the drivers, according to court documents filed on Thursday.

The relatively small-scale dispute gained international notoriety last year when the United States Court of Appeals for the First Circuit ruled that the missing comma created enough uncertainty to side with the drivers, granting those who love the Oxford comma a chance to run a victory lap across the internet.

But the resolution means there will be no ruling from the land’s highest courts on whether the Oxford comma — the often-skipped second comma in a series like “A, B, and C” — is an unnecessary nuisance or a sacred defender of clarity, as its fans and detractors endlessly debate. (In most cases, The Times stylebook discourages the serial comma, often called the Oxford comma because it was traditionally used by the Oxford University Press.)

It appears the Maine Legislature has learned its lesson, at least. It revised the disputed state law last year to end ambiguity by adding new punctuation — but not in the way you might be thinking.

The case began in 2014, when three truck drivers sued the dairy for what they said was four years’ worth of overtime pay they had been denied. Maine law requires time-and-a-half pay for each hour worked after 40 hours, but it carved out exemptions for:

The canning, processing, preserving, freezing, drying, marketing, storing, packing for shipment or distribution of:

(1) Agricultural produce;

(2) Meat and fish products; and

(3) Perishable foods.

What followed the last comma in the first sentence was the crux of the matter: “packing for shipment or distribution of.” The court ruled that it was not clear whether the law exempted the distribution of the three categories that followed, or if it exempted packing for the shipment or distribution of them.

Had there been a comma after “shipment,” the meaning would have been clear. David G. Webbert, a lawyer who represented the drivers, stated it plainly in an interview in March: “That comma would have sunk our ship.”

Since then, the Maine Legislature addressed the punctuation problem. Here’s how it reads now:

The canning; processing; preserving; freezing; drying; marketing; storing; packing for shipment; or distributing of:

(1) Agricultural produce;

(2) Meat and fish products; and

(3) Perishable foods.

So now we get to replace Oxford comma pedantry with semicolon pedantry. The change, sponsored by Senator Andre Cushing, was among dozens of legislative tweaks signed by the governor in June. “It clarifies the intent of the legislature, to conform with federal law, that the distribution of certain products is exempt from the provisions governing overtime pay,” according to a summary of the changes.

“It amends the 1995 law by reordering the series of exempt tasks for the purpose of eliminating any perceived ambiguity.”

As far as the actual overtime dispute goes, Mr. Webbert said the case ended well.

“We are pleased the matter was resolved to the satisfaction of all parties,” he said in an email.

In a statement on Friday night, John Bennett, president of Oakhurst Dairy, said the company “is pleased the dispute regarding overtime pay for delivery drivers has been resolved to the satisfaction of all parties.”

Without giving details, he said he expected that the resolution would soon be approved by the court overseeing the dispute.

I do not for the life of me understand why they changed all the commas to semicolons. Why not just add another comma between “shipment” and “or”? Would that not have provided the needed clarity?

I just hope no one is going to sue me for $5 million over any of the myriad of grammatical errors I have undoubtedly posted on this blog.

Love,

Rebecca

Reminded of a line from an old Joni Mitchell song

In my complicated effort to post that little video of Julia, I was forced to go back to my old way of notifying readers of a new post and including a link to the blog in an e-mail message. That has resulted in 67 pageviews in the last couple of hours, far more than I have seen after any post in the last few weeks.

I do know that many people read the posts about my recent medical news, because so many of you have reached out with loving and encouraging words. While I do not consider myself nearly as needy as some far better-known individuals in the news over this past year, positive feedback is always a plus.

So, at the risk of sounding a bit vain, this uptick brought a smile. And that’s when I started to hear the refrain from that old Joni Mitchell song in my head:

Don’t it always seem to go,

You don’t know what you’ve got ‘til it’s gone?

Pave paradise, put up a parking lot.

I hope you don’t mind if I go back to the old way of doing things. It never hurts to keep up those numbers!

Love,

Rebecca