SBRT and Houston Calorie Quest
The finish line for both by SBRT treatment and the time in Houston is now in sight. Overall, things have gone very well and I’m enjoying the exploration of the Houston food scene and attractions. Aiday and Charles came to visit and support me for a few days. Even though there is still lots to explore around Houston, it’ll be good to return to Chicago when this radiation phase of treatment is complete.
SBRT Treatment
The treatment has gone according to plan without any complications or unexpected side effects. I’m tolerating it well and hopefully it’ll be as effective as we hope. It’s gone well enough that it hasn’t slowed down or caused disruption to the Houston exploration time. At this point through 3 treatments (only 1 left), I’ve had 27 Gr of radiation, which is the equivalent of nearly 3 weeks of standard daily radiation. I’m definitely feeling a lot better now than I did in 2018.
To prepare for each treatment session, I have a routine to make myself as comfortable as I can. For whatever reason, I wake up each morning in Texas with congestion and coughing. This concerned me at first, as that would make laying still quite difficult, but the congestion clears with an anti-histamine (Zyrtec) and being out of the condo throughout the day. Perhaps it’s an allergy? Second, I have to address my dry mouth, which seems worse the last few weeks. I drink plenty of fluids and take xylitol lozenges. Since my tongue is held down by the radiation stent, I can’t run it across the roof of my mouth during treatment, so I try to make sure I have enough moisture there before getting under the mask. Finally, my neck and upper back muscles have been tight for a while. I brought a heating pad and a massage ball, which I use to try to loosen up the muscles. All of these have helped, as I’ve been able to get comfortable under the mask.
So far, as predicted by Dr. Phan, I’ve tolerated the radiation well and haven’t had major side effects. One issue is that a few hours after treatment, I get some more ear fullness and tinnitus on my right side only, similar to the feeling I get after receiving a pembro infusion. The care team said this is expected inflammation, and they have prescribed dexamethasone, a drug I’ve taken before without issue. The fullness usually resolves within a day (before the next treatment). Besides that, my mouth and taste have remained intact, and I’ve been able to eat normally. I don’t think I’ve had increased fatigue. I did take a nap one day, but that was more likely due to the combination of Texas heat and overindulgence of smoked meats, i.e. “meat coma.”
The radiation treatment on Friday (session #2, day 3) went as well as could be expected. I went straight to the radiation treatment center and valet parked the car. They brought me back to the radiation machine (Varian TrueBeam) right after I checked in for my 10am session, so I didn’t even sit down in the waiting area. Since the first treatment went well, I didn’t want to change anything, so I kept the Radiohead music selection. There was a little delay getting in starting the scans, which they explained as waiting for the doctor so that they could do the CT scan and then start the radiation right after. When everything was all done, it was 10:25am, so I spent about 20 minutes under the mask, as expected. It couldn’t have gone any smoother.
The third session on Monday went similarly well. I didn’t go back to the treatment room until about 10:30am, so I sat in the (cool) waiting room for ~40 minutes watching videos of Charles to help me relax. The nurse said I did well during the treatment, so that was good to hear.
I asked the nurses to take pictures of me under the mask, so these will provide a sense of what I look like during treatment. When I first put in the stent and they clamp down the mask, it’s not that comfortable. I also have to remember to tilt my head back, as that would keep the alignment more inline with the planning sessions. It takes a few minutes to get used to being under the mask, but after that initial period, I feel could be under the mask for longer. To get a sense of how tight the mask is, when I tried to open my eyes during session #3, my right eyelid remained closed. The mask is in contact with all parts of my face, though perhaps there is a little more pressure on my left forehead. There are also holes for the radiation stent around my mouth, so that may be held in place by both my mouth and the mask. The fit around the shoulders is a little looser, and the nurses said that is fine, since only my head is getting treatment.
Houston Calorie Quest
The exploration of Houston’s diverse food has been a fun one. We returned to a few places and have the opportunity to try out some new ones, particularly when Aiday and Charles were in town. It hasn’t been hard to meet the 3000+ calories a day goal. Here is a quick rundown of places so far (days 2-6 (Thu-Mon):
Barbecue: Killen’s Barbecue
Asian fusion: Da Gama (Portuguese-Indian), Jun (Chinese-Mexican), Kau Ba (Vietnamese-Cajun)
Seafood (in Galveston): Black Pearl Oyster Bar, Gaido’s
Tex-Mex: Pappasito’s Cantina
Returning favorites: Hugo’s, Lucille’s
Ice cream: Amy’s Ice Cream, Cosmic Ice Cream, Craft Creamery, Honeychild’s Sweet Creams
Perhaps my favorite of the places so far has been Killen’s Barbecue. With Thursday (day 2) being a non-treatment day, we decided to drive to the original location in Pearland, about 25 minutes away. This had been on my list and when both Dr. Phan and the server at Pappas Bros Steakhouse mentioned it as a favorite, we definitely had to go. We got there a little after 11am, and to our relief, there was no line. My initial order was my usual sampling of brisket, pork rib, sausage and a side, plus brisket tacos. However, I had forgotten to order some of the signatures, so I added a beef rib and pork belly burnt ends. All of it was excellent. The “moist” / fatty brisket was one of the best I’ve had and I currently prefer that the leaner brisket due to my dry mouth. The pork belly burnt ends had a really nice combination of smoke and sweet, and it’s not something I’ve had much before. The brisket tacos were really good too - the pico de gallo and the tomatillo sauce go well with the brisket. The beef rib was huge - 1.5 lbs! - so we only took a few bites to enjoy the flavor before taking it home. The sides were really good too - I had creamed corn and mac & cheese. We had over ordered, so the remainder became a leftover lunch on the weekend.
The other restaurants were all quite good with a few standout dishes at each. Houston is one of, if not the most, diverse cities, and the food reflects the different cultures in a natural way. We were excited for Jun, run by Evelyn Garcia (Top Chef finalist) and her husband, who is a Chinese chef. The fried chicken and the gulf shrimp in aguachile were our favorites. At Da Gama, we liked the piri-piri chicken and the spiced scallion naan the best. The piri-piri chicken had great seasoning and the meat was very moist, especially for being grilled. Kau Ba is a Vietnamese restaurant whose chef has been featured on multiple food shows. I wish we were hungrier that day, as we didn’t sample as much as we could have. I did enjoy the king crab banh mi quite a bit. Going back to favorite places, the fried green tomatoes, biscuits and fried chicken at Lucille’s are still outstanding. I’d been to Hugo’s before for dinner, but we went for the Sunday buffet brunch. It’s a legendary spread with lots of choices. Charles ate quite well here and he especially liked the cookies. They also had an excellent Mexican hot chocolate.
Texas Attractions
This was also Charles’s first time in Houston, so explored a few places with him. The condo is near the Children’s Museum Houston, so we went a few times. It had a number of interactive STEM-based exhibits, so that was a nice way to spend some time.
The highlight of the weekend was a trip to the Space Center Houston, the visitor center to the Johnson Space Center. On display are a number of historical spacecraft from Gemini, Mercery and Apollo programs as well as the Skylab. Charles also got to touch a lunar sample. We also got to go inside the Space Shuttle on top of the 747 transport craft. When we were in the gift shop, Charles found a Saturn V cozy that he quite enjoys. We think he enjoyed the visit, as he is quite content to watch videos of rocket launches and about the space program.
Space Center was quite crowded (and extremely hot) on the weekend, and we didn't get to do a tram tour. Steve and I ended up going back on Monday to do the Mission Control Tour. We took a tram to the Johnson Space Center (the control room for the ISS is a floor below the restored Apollo control room) and watched the recreation of the lunar landing, with the screens displaying what the engineers saw that day and time. NASA has faithfully restored the mission control room used in the Apollo missions, down to the cigarette butts and ashtrays on the desks. It was a good experience. We also took a separate tour to see the Saturn V rocket (on its side). The size and power of that rocket is still quite impressive.
As we were so close to the Gulf of Mexico and we hadn’t been there before, Steve and I took a drive to Galveston (we were already halfway there at the Space Center). There is historical downtown architecture and a railroad museum, so it was worth the drive. We drove by the East Beach, where a development of luxury houses is being built. They had a pretty interesting architecture, with the homes featuring large verandas and almost built on stilts. They are made to withstand big storms. Too bad I forgot to take a picture.
We figured that the seafood would be freshest where it is caught. We actually weren’t so hungry that day (Monday, day 6), but we did manage to eat two dozen gulf oysters at Black Pearl Oyster Bar and then had more seafood at Gaido’s, an old school restaurant open since 1911. The gulf oysters are a bit larger than other oysters. They worked well as a baked dish, but in its raw form, I don't think they are as flavorful (not as briny or mineralogy) as oysters from the coasts. We weren’t that hungry when we got to Gaido’s, so just an order of crab stuffed shrimp for me.
To make sure I’m meeting or exceeding my calorie goals, I’ve been eating a lot of ice cream. On Monday, we went to Cosmic Ice Cream, located in a strip mall in Webster. The texture of this ice cream was exceptional and the lemon poppyseed muffin flavor may be the favorite flavor so far.
Cosmic Ice Cream - triple chocolate (left); lemon poppyseed muffin and key lime pie (right)
Texas Heat
Believe it or not, it’s actually been hotter in Texas than expected. Like the rest of the country, summer 2023 has been warmer than previous years. When I landed last week, it was 103F at 6pm. The highs each day have been 100-106F, and it remains hot throughout the day, especially when the sun is out (nearly every day). Normally, we would talk a few blocks to dinner. But when the car temperature registers 111F, we figure the drive was worth it so we didn’t have to spend the first 20 minutes cooling down from a 10 minutes walk. Coming out of that dinner at 9pm, it was still in the 90s but breezy. It’s probably the coolest a 93F temp has felt to me. Good thing air conditioning works. It’s too hot to do any activities outside, so no walk in Hermann Park, even though we are across the street from it. I still have to bring a jacket when I go to MDACC, it feels like the radiation treatment waiting room and the treatment room itself are in the high 60s.
There is only 1 more SBRT treatment left and hopefully it goes well. I’ll provide another update after I finish treatment, including information on what the treatment plan going forward will look like. I have a few appointments with multiple doctors and specialists at MDACC on Wednesday (23 August) before I leave Houston.
Thanks again for reading and for your support.