January 2007

MRI images are like photos: it’s really difficult to take a photo of a living object from exactly the same position months apart. Nevertheless, the 2 images above show the same tumor in my head, left, as of this morning, and right, on December 7, 2006. The angle of the MRI is different, as is the exact depth of the image, which is one reason why they look different in my crude screen grabs. The relative smaller size and density of current tumor view, left, appears to be real, however.

The PACS medical imaging system at UCSF, in the hands of a skilled neuro-oncologist, pulled images similar to these two into a comparison screen, and put same-sized grids around them. The resulting measurement showing that the the tumor may have stopped growing: indeed, it may be smaller, and it’s Magentic Resonance Spectroscopy signature – based on my understanding – suggests it is not growing as aggressively as it appeared to be in December.

I guess some 90 minutes (in what turned out to be a particularly tight, 4-year-old, then-state-of-the-art 3.0 Tesla GE Signa machine) was well worth the slow breathing exercises and patience. I may have overdone the Lorazepam a bit (1mg too much?), but claustrophobe I nevertheless got through an hour-and-a-half in a space tighter than the 1.5 Tesla GE (’it’s how we get the field strength’) without so much as a single hyperventilation, so, all’s well that ends well, I guess.

Anyway, I don’t want to get too far ahead of myself, but this is the first good news we’ve had since the brain tumor was discovered: I feel better, am functioning better and the tumor seems to be responding to a chemo regime that can be home administered (and which will now start up again quickly). My current life plan – return to normalcy – can proceed. We’re about as happy as we can be…..

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So, we’re headed up to UCSF this AM for a full day of procedures and a consult with my oncologist, Dr. Susan Chang. UCSF is a remarkable institution, and its fine, bright, knowledgeable and relentless doctors and other staff have brough great hope to me as I confront a strange and bewildering disease.

So, I don’t really mind going, even though my morning starts off with 90 minutes in a GE Signa 1.5 Tesla Magnetic Resonance Imaging machine. You may recall that my claustrophobia is such that it took some weeks of cognitive therapy to even begin using an ‘open’ MRI. True, I have now done several 45-minute and a even a 90-minute back-to-back MRI and MRS (Magnetic Resonance Spectroscopy) in the closed Signas since then (this morning’s procedure is a MRI-MRS), and the information really helps my oncology team make the most informed decisions for treatment, but it’s still not my most enjoyable way to spend a morning.

So, Cassie and I decided to try out the new tripod we bought last night, after our hematology lab firedrill left us in downtown Menlo Park with time to kill before spouse Linda could arrive to shop and find dinner (we ate at Carpaccio, eventually). The Ritz Camera store was advertising various sales, and I came away with a nylon bag for the Lumix, and a very lightweight tripod – a Quantaray 7001 that cost $39.

In this digital era, tripods and time exposures are a whole new game compared to my days in press photography. Both cameras and tripods are so light that they are easy to carry and quick to set up, unlike the heavy, hulking Bogen I recently donated to my old school that used to hold a, say 600mm lens and a brass-and-steel motorized Nikon or even a 4×5 camera. The cable release is now a button on an electrical connection, not a mechanical gizmo: there seemed to be very little shake when I hit the switch.

So Cassie and I made our way on a 2.5 mile walk, the better for me to be calm and a little tired in the MRI, and snapped some time exposures along the way, including Oak Knoll School, on our block, above. The Quantaray tripod has a hand grip that makes it easy to carry with the Lumix attached, and it only took seconds to set up and shoot a dozen pix or so. Cassie is a great helper, and wrapped her lead around the tripod any number of times….

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The good news about the ‘dead’ 8 AM meeting is that I worked nearly to the bottom of my to-do list today (remember, we are fast becoming ‘Mr. Time Management’ as we near completion of our GTD course) before catching the 4:25 to Menlo from SJ Diridon (and observing the pretty long shadows cast by the low winter sun as I made my way to the station in the PM). This included stuff like getting my Mac to print to the new Lanier copier/fax/scanner/sub-orbital vehicle injector that replaced the old Lanier multi-function device on my floor at work during medical leave.

The old multi-function device just showed up in my Mac’s printer browser and worked – kinda like a good old laserwriter of old. The new one required a call to tech support, an IP address, a driver download and install and a 10-page PDF to get it configured and going. After numerous false starts (user-error on my part all the way – I was way too impatient), I finally can print (not that I do much printing), but you gotta be ready for those incoming boss/colleague requests to ‘give me those ten pages of your PowerPoint, quick! I gotta meeting!’

This day was long, and just past half-way into my second week, I can say that I am being treated with exactly the same contempt and respect of peers, getting a few bumps and knocks as if the health issue hadn’t happened, which is just right. You go back to work, you’re back to work: colleagues have to be able to count on you, they don’t need to remember the kid gloves. We have a business to run, shareholders to take care of, and customers to please… and I’m ready…!

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