Adventure #2, as of May 12

A Bouquet Above Copyright 2020 Abe Pachikara (click for larger image)

• To Mom for all things ranging from helping with the roses, the meals, and keeping things ship shape.
• Big, big thanks to my sisters Susan and Cindy, and brother-in-law Chris.
• A huge thank you to my extended family and friends for your well wishes and musings.
• A very notable thank you to a group of friends who are helping me cushion the financial stress as the transplant puts me out of work for yet another 12 months.
• Thanks to Davis Uncle for helping me understand my current treatment.
• Thanks to my cousin Niseema for the runs to CostCo and local Indian food stores.
• Thank you to the tireless and vigilant medical team at SCCA, including counseling, nutrition, social work, physical therapy and financial services; and particularly Team Coordinator Joseph Delos Reyes, RN extraordinaire Beatrice Franco, PA Hematology-Oncology Megan Shelby and Dr. Andrei Shustov. It’s akin to a carrier strike group, mobilized against my cancer. I am humbled.
• Last but by no means least, a big thank you for including me in your prayers. It’s perhaps the oldest, and certainly one of the most powerful of antigens.

• Tumors… They are coming roaring back. My underarms tingle, sometimes in an uncomfortable manner, from all the hypermetabolic work underway. Again. Sigh…
• Energy & stamina… So far, things are okay here.
• Blood chemistry… All elements are in the healthy range, albeit at the low end. One exception is my all important lymphocytes – – they continue to be just below the recommended minimums.
• Blood pressure… Rising a bit.
• Heart rate… Rising a bit.
• Body geometry… “Geometry” – – yes it’s an odd term to use. But my tummy seems to be growing, as is the left side of my chest (my left “moob”?). But my muscles are still pretty minimal. Something is afoot.
• Weight… After a high of 162.8, I am drifting down. Now at 160.8. This may be the weight scale itself as it’s no more than a consumer grade product. Or the lymphoma again consuming tissue. Time will tell.
• Financials… As of Jan 1, the treatment cost is: $362,349.33. The discount the insurance company received: $162,114.63. The amount my insurance company paid: $193,620.29. My personal bill is now maxed at $6,900.00. More frightening: if I add the Kaiser costs from Nov / Dec 2109, the tally is $483,470.72.

Out of Control Good Looks… Copyright 2020 Abe Pachikara (click for larger image)

Musings

• An HDAC inhibitor (drug: Romidepsin) helps stop tumor growth by inducing cells to stop dividing rampantly, appropriate cell death and cell differentiation.
• A DNA methyltransferase inhibitor (drug: Azacitidine or 5-azaC ) which is a DNA-modifying enzyme that helps genes regain their ability to suppress tumors. 

The “next round” began last week. Let’s see what transpires, no?

Another Beauty Copyright 2020 Abe Pachikara (click for larger image)

 

 

Other Worldly Bachelor’s Button Copyright 2020 Abe Pachikara (click for larger image)

Health Insurance For All

Two Precocious Twins Copyright 2020 Abe Pachikara (click for larger image)

Life Carries On

• My older one turned 18. Shoot! No way! When did he get past being this toddler with a tummy that was not just roundish, but so perfectly rotund it makes you think of touristy sculptures of Buddha? Now, he’s lanky, sinewy, low key and quietly mapping out a very different college future from that he had in mind just months ago. One of the unchanging aspects of Paul is a hearty, loud laugh. Some goodness stays the same, eh?

 

 

• Another age related example of “Life Carries On” – – my younger sister turns 50. 50?? To paraphrase a friend, “When did this happen? At times, she’s still 9 in my world, and I her teenage brother.” I literally had to recount my sister’s life by decade. So much has happened. Geez, there’s a lot of goodness contained in such a long duration no? Do I only focus on my cancer, or do I smile in disbelief?
• Unrelated to age, there’s just the idea of physical growth itself. One of my lads is 5′ 9 1/2″, the other just a pinch less than that. Again, I ask, “seriously?” I think there was a worry among my boys – – “will I only be as tall as the shortest relative I know of, across both sides of my family?” That is no longer the detail that they need to fret over. And compared to the two toddlers that awkwardly rough housed 15 years ago, today’s horseplay by Paul & Sidd is scary to watch, given their speed, size and strength. Again, I get to choose what I observe – – Do I watch this glorious rise, or let the cancer distract me to lesser attractions like tumors?

Three Amigos (or… Mom and the Two Behemoths) Copyright 2020 Abe Pachikara (click for larger image)

• In the land of cooking, I have always tried out new stuff. Having Mom here with myself means a steady conversion of nuanced Indian dishes, from cryptic proportions and actions, into a codified recipe. There’s deep selfish value in having each relative come and stay for an extended period of time, if you ask me. The resulting recipes become an esteemed, permanent part of one’s “intellectual property of living.”
• One more piece of cooking goodness – – 3 times in the past few weeks, I have had good luck cooking new recipes. A lamb dish. A pork dish. And a pizza crust so oddly simple to make and yet, my boys said it was the best crust they had had, anywhere. All this occurred under my roof? No way. ( I will paste the lamb and pork dish recipes below.)
• Mindful walking. Yes, “mindful anything” always struck me as a high falutin’ term. What is that? But I have a better understanding of it now. When Mom and I saunter around the neighborhood, we stop to scrutinize and marvel at what’s new in terms of buds and blooms. We’re akin to flower cops, walking our beat. She brings her deep and wide botanical knowledge, and I bring nothing more than my camera to document a new flower from different angles. By the end of each day’s walk, we feel at ease, as we know of some of the goodness being compelled out of the ground by the sunshine, water and nutrients.

Just Us Dandelions Here Copyright 2020 Abe Pachikara (click for larger image)

• One last example… Daily rosary prayers as a social habit. For me, prayers = more religion; pretty quickly, too much religion. In truth I have learned my “religion tank” is smaller than I had envisioned. Okay, so be it. But I had not expected that meeting – – via Zoom – – to say a Rosary would be the vehicle for a daily chit chat with some good folks. I have been self-quarantined since December 2019 and this habit is very, very similar to friends meeting after work for happy hour, or neighbors meeting at the backyard fence with genuine curiosity and companionship for a “hello, how are things?”

• Good News Video. If you need a smile, the latest “Some Good News” video will help.
• Good Music. Thanks to former colleague Dan Piling, I discovered Times Like These by the Foo Fighters. Here’s a new version on BBC. And an old one that gets my blood pumping. (Thank you Dan from the bottom of my heart.)
• What will “college” be in the fall? My older son wonders, what just vanished? Typical Freshman traditions seem shattered by COVID – – laboratory format classes, football / basketball games, after-parties and after-after eating, everyone seemingly smarter than you, meeting up with a new set of thought provoking people, etc., etc. Who knows if colleges will really open up, and for how long if they do before shutting down due to the second wave? No longer does Paul assume he’s physically moving into dorms for Freshman year of college.
• Time flies. In getting ready for my younger sister’s 50th bday, a question arises again and again: do I really know someone from 50 years ago? Do you ever ask, “Wait, do I actually have a memory that is more than [ 20… or 30… or 40 ] years old? How  much time has passed in my life?”
• Time vigilance. As my health improved, so my use of time deteriorated. One example – I was going to take photos of myself in my journey back to my target weight. But instead, I have no progression of shots. Such a photo series would have also captured the unexpected, like my left “moob” is larger than my right due to the returning lymphoma, and my face has gone from too skinny, to slender, to repopulated with tumors. I did not use time to capture this morphing back to the odd side of the world. But I can restart my time vigilance today.

A new and trippy phenomenon I am experiencing. My sense of taste is distorted. For starters, my tongue has a green tinge when I wake up. Water has a metallic taste. And it goes downhill from there. It lasts anywhere from a day to a week, depending on the individual.

18, at Last… Thank God Almighty, 18 at Last! Copyright 2020 Abe Pachikara (click for larger image)

Two Recipes I Promised Above

• 1 cup full-fat or 2% Greek yogurt
• 1 garlic clove, finely grated
• 1 tablespoon fresh lemon juice
• Kosher salt and freshly ground black pepper

• 6 tablespoons olive oil
• 12 ounces ground lamb
• 3 garlic cloves, finely chopped
• 1 teaspoon cumin seed
• Kosher salt and freshly ground black pepper
• 1 (15-ounce) can chickpeas, drained and rinsed
• 1 teaspoon crushed red pepper flakes

• 1 large or 2 small bunches of kale, or Swiss chard, or mustard greens

• Fresh tomatoes, quartered, or Olive Oil–Roasted Tomatoes (page 38), for serving

• Combine the yogurt, garlic, and lemon juice in a small bowl.
• Season with salt and black pepper and set aside.

• Lamb: Heat 2 tablespoons of the olive oil in a large skillet over medium-high heat. Add the lamb, garlic, and cumin, and season with salt and black pepper.
• Using a wooden spoon or spatula, break up the lamb as it cooks until it’s browned and crispy, 8 to 10 minutes (the lamb will not be rare here; that’s more than okay because it will be crispy, and in times like these, crispy is better than rare). Using a slotted spoon, transfer the lamb to a bowl, leaving the drippings behind.

• Combine the remaining 4 tablespoons olive oil, the chickpeas, and red pepper flakes in the skillet with the lamby drippings and season with salt and black pepper. Cook, shaking the skillet occasionally, until the chickpeas are very well browned and starting to crisp up, 8 to 10 minutes.
• Return the lamb to the skillet and toss with the other ingredients, letting everything mingle together. Remove from heat and transfer to a large serving bowl, leaving anything in the skillet behind (you’re not done with that skillet).

• Separate the leaves and stems from your greens, then thinly slice the stems and tear the leaves into 2-inch-ish pieces and set aside.
• Add the chopped stems to the skillet and season with salt and black pepper. Cook a minute or two, just to soften slightly; they should stay pretty crunchy and fresh. Add the leaves and toss to coat until just wilted, 30 seconds or so. Season with salt and black pepper, if needed.

• We add the greens to the serving bowl of chickpeas and lamb

• Option 1: We will prep Indian chapatis, or you can use similar alternates like tortillas. Smear yogurt sauce on a chapati, and add the mix of lamb, chickpeas and greens. Eat.
• Option 2: Per the original recipe, smear yogurt sauce onto the bottoms of four bowls and top with the chickpea and lamb mixture, sautéed greens, and tomatoes.

• 3 tablespoons neutral oil, grapeseed, vegetable or canola
• 8 garlic cloves, thinly sliced
• 1 pound ground pork
• 1 ½ teaspoons red-pepper flakes, plus more to taste
•  Kosher salt and black pepper
• 4 cups chicken broth
• 3 tablespoons soy sauce or tamari, plus more to taste
• 1 large bunch pea leaves or spinach, thick stems removed, leaves coarsely chopped
• 1 tablespoon finely grated fresh ginger (from about a 1 1/2-inch piece)
• 6 ounces rice noodles (thick- or thin-cut), cooked and drained
• ½ medium red, yellow or white onion or 3 scallions, thinly sliced
• 1 cup cilantro, leaves and tender stems, coarsely chopped

1. Heat vegetable oil in a large, heavy-bottomed pot over medium.
2. Add garlic and cook, stirring occasionally, until the slices become nicely toasted and golden brown, 2 or 3 minutes. Using a slotted spoon, remove garlic and set aside.
3. Add pork and red-pepper flakes to the pot, and season with salt and pepper. Cook, using a wooden spoon or spatula to break up large pieces, until the pork is well browned and in small bite-size pieces, 5 to 8 minutes.

4. Add chicken broth, soy sauce and 4 cups water. Bring to a simmer and cook for about 5 to 8 minutes or so, until the pork is very tender and the broth tastes impossibly good. (Give it a taste and season with salt, pepper, red-pepper flakes and soy sauce, if you want.)

5. Add pea leaves, half of the onion slices, and all of the ginger. Stir to wilt the leaves.
6. To serve, ladle soup over noodles and top with remaining onion, cilantro and toasted garlic..