Monthly Archives: March 2011

Results of an Italian trial testing bisphosphonates (pamidronate) on asymptomatic myeloma patients…

This morning a blog reader/friend sent me a newly-published Italian study containing the FINAL results of a trial testing intravenous pamidronate (Aredia) on 177 asymptomatic (SMM) patients. The results are very interesting…you can check them out here: http://goo.gl/2HWNV

According to the abstract, after a follow-up period of 5 years, 55 out of 88 patients in the no-pamidronate, or no-PAM, group had progressed to active myeloma…compared to 56 out of 89 patients in the PAM group. The median time to progression (note: as you read this post, please keep in mind that not ALL of these patients progressed to active myeloma…) was about the same for both groups, with, it seems to me, a very slim advantage, not statistically significant, for the control group.

Let’s see…the only really noticeable difference is that the control group had more skeletal involvement at the time of progression: 72.7% compared to 39.2%. That isn’t good, of course. In spite of that positive finding, however, the authors conclude that the administration of pamidronate in asymptomatic myeloma, while reducing bone involvement at progression, did not decrease the risk of transformation and the time to progression into overt myeloma. Indeed…

Random thought: what if the control group had taken curcumin instead of taking…nothing? There is a growing pile of scientific evidence that curcumin hinders the process of bone destruction (= it inhibits osteoclastogenesis, in more scientific terms). I have actually written a few posts on this topic (scroll down my Pages and look for “curcumin and bone loss”), but I see now that I need to update that information. A quick glance at PubMed this morning, in fact, confirmed that, since I wrote those posts, many other studies have proved curcumin’s activity against those little bone-gobbling buggers called osteoclasts…

Let’s get back to today’s topic. I have read the full study but, as I have recently stated, my new blog policy is not to quote directly from any copyrighted material…However, if I find something helpful or important for us patients in a full study…well, you can finish that sentence. 😉

The idea behind this study: bisphosphonate therapy has been shown to reduce skeletal-related events and pain in patients with active myeloma. The authors therefore wanted to see if it could also be beneficial to asymptomatic myeloma patients, in spite of the fact that, as they themselves point out, three previous clinical trials testing bisphosphonate use on SMM patients had failed. However, since the follow-up of the previous studies was too short, they decided to monitor a group of asymptomatic myeloma patients for at least five years…

Well, it turns out that their longer-term study does nothing but confirm the results of the three shorter-term studies…that is, there is NO BENEFIT in administering bisphosphonates to asymptomatic patients. Sure, there were fewer adverse skeletal issues in the PAM group at the time of progression, but there was no impact on progression to active myeloma or overall survival…Hence, the authors do not recommend the administration of PAM to asymptomatic patients…at least, on the basis of current findings…

Now, a couple of things popped into my head as I was reading this study. One is that it would have been amazingly interesting and perhaps useful to compare a group of SMM patients receiving PAM to another group receiving curcumin. What would the results have been? 

Another thing: I would also have been very curious to know the vitamin D levels of the patients in both groups…but I am sure that they were not tested. Sigh.

On that note, I would like to end with a plea…that some day soon the International Myeloma Working Group, or IMWG, will make vitamin D testing mandatory for all MM, MGUS and SMM patients, mainly based on the findings of a 2009 Mayo Clinic study: the vitamin-D-deficient myeloma patients in this study had worse outcomes than patients with normal vitamin D levels (see: http://goo.gl/sa28p), which reminds me, arrrrggggh!, that I forgot to take my vitamin D this morning!

Explosive curcumin…

A couple of days ago, a blog reader (thanks!) sent me a link that started me on a serious case of the chuckles . I mean, is there ANYTHING curcumin can’t do??? See: http://goo.gl/D96Ca

Come to think of it, this recent finding could come in handy in certain situations…Uhm, let’s say you get distracted by a cat fight in the kitchen and, instead of your daily supplements, you swallow something like…uhm…like a bit of black gunpowder or even some nitroglycerine…or how about a stick of dynamite?

Well, no worries! Now we know what to do! :-)

(P.S. Er, obviously, I do NOT recommend swallowing explosives…It’s a joke!)

To use or not to use aspirin in myeloma (conventional) treatments?

A blog reader (thanks!!!) sent me a couple of links that started me off on a unexpectedly startling and, in the end, rather confusing search mission. Who’d have thought that aspirin, = acetylsalicylic acid, might possibly be a bad thing for myeloma patients to take? (Please note my use of the conditional tense.) I concluded that it would probably be a good idea to write a post on this topic for two main reasons: 1. aspirin is currently being tested in more than a couple of myeloma clinical trials (check www.clinicaltrials.gov) and 2. there are more than 50 aspirin-myeloma studies in PubMed…

What does aspirin have to do with myeloma? The answer may be obvious to some, but it wasn’t to me…not immediately, anyway. It is because of aspirin’s blood-thinning properties. It’s because aspirin interferes with our blood’s clotting action, which is good, of course, if we are taking a drug that could cause potentially fatal blood clots, such as thalidomide. And, in fact, if you look at the clinical trials, aspirin is being given to patients on thalidomide or its derivatives. Okay, now we can keep going…

The first link led me to this letter, written by Dr. Kast and published in “Blood” in 2006: http://goo.gl/e1ZVn Here we learn that aspirin and other COX inhibitors have a long documented history of increasing the circulating levels of tumour necrosis factor-alpha…What what whaaaaaat? I didn’t know that. What I did and do know is that TNF-alpha is a major GROWTH FACTOR for myeloma cells…not quite as bad as IL-6, but most definitely one of the really really bad guys… 

Dr. Kast suggests that TNF levels simply be monitored in myeloma patients who take aspirin as part of their therapy. Should their TNF levels increase, he writes, then steps to reverse that elevation or alternative thrombosis prevention measures should be taken. That sounds reasonable…but let’s keep reading…

The second link took me to a 1996 study, published in “Immunology”: http://goo.gl/mrgsV This study examined the effects of aspirin and ibuprofen not just on TNF-alpha but also on other myeloma growth and survival factors such as IL-6 and IL-1 beta. By now I think all myeloma patients must be familiar with IL-6. As for IL-1 beta, well, among other things, it is implicated in the progression from SMM to MM, so those of us with asymptomatic myeloma (SMM) should pay particular attention: http://margaret.healthblogs.org/life-with-myeloma/what-is-multiple-myeloma/myeloma-supplements-and-il-1-beta/).

The “Immunology” study is available for free online and is quite easy to read (just click on “complete article” and wait until it downloads). The gist: a few weeks after a group of healthy volunteers had stopped taking their daily aspirin and ibuprofen doses, their IL-1 beta and TNF levels had increased compared to the pre-experiment period.

Another bad thing that happened is that IL-2, = another pro-inflammatory cytokine, also increased quite a lot. Two observations, though: 1. some sort of different stimuli were used in this study, and I am not entirely sure what that means (I would need more time, more time than I have right now, to check out all this stuff…); 2. the study was published 15 years ago, so it is a bit dated…Still, since I found the data a bit alarming, I decided to do a bit more digging…

I found two other 2006 studies on this topic. I couldn’t find any more recent (than 2006) studies, I mean on the possibly dangerous consequences of using aspirin in conventional myeloma treatments, which I found very odd, but I might have missed a study or two. Anyway, let’s begin with the first, which is, again, available for free online and starts off from Dr. Kast’s above-mentioned letter: http://goo.gl/FgkV8

Let’s look at a couple of key sentences: aspirin, according to these authors, may, in fact, have positive effects on survival in patients with MM. […] Malignant plasma cells often overexpress cyclooxygenase 2 (COX-2) and this overexpression has been found to be a predictor of poor outcomes in MM patients. A few paragraphs later, we read that aspirin inhibits both COX-1 and COX-2 and this may serve as a rationale for possible antineoplastic properties in MM.

The authors then refer to a study they carried out in 2005 (this full study is also available for free (yaaay!): http://goo.gl/ryG3S) on myeloma patients following the DVd-T regimen and divided into three groups. The group that took aspirin apparently had a better response than the group that did not. And so the authors conclude: While these preclinical and clinical observations suggest that low-dose aspirin may have antineoplastic properties in patients with MM, they are not definitive and render the alternate hypothesis (that aspirin has a deleterious effect on the survival of patients with MM) much less likely.

Dr. Kast, author of the above-mentioned “Blood” letter, wrote a response, titled “Aspirin, TNF-alpha, NFkB, and survival in multiple myeloma: the importance of measuring TNF-alpha”: http://goo.gl/RXfoU The abstract tells us that there are conflicting reports on aspirin. On the one hand it has been shown to slightly increase survival duration in multiple myeloma, which obviously is a good thing…on the other, caution is raised about use of aspirin and COX inhibitors generally in inflammatory states and specifically in myeloma. Should they increase tumor necrosis factor-alpha they could exacerbate disease. Exacerbate disease, eh? Well, we certainly do not want that!

At this point, I should announce that, even though I have read the full study, my NEW BLOG POLICY is NOT to quote directly from any copyrighted material. That doesn’t mean that I will stop reading full studies, of course, and reporting on any important bits…I just won’t use direct quotes, that’s all. So I can tell you that Dr. Kast concludes that the use of aspirin in myeloma conventional treatments is okay, provided that TNF levels are monitored, particularly should TNF levels increase together with myeloma progression…

I would also like to mention that, according to Dr. Kast’s review of the scientific literature on this topic, the data is conflicting. Aspirin, and similar COX inhibitors, he writes, can either delay or accelerate myeloma progression…Confused?

Okay, let’s see if we can figure this out.

  • First point: TNF-alpha is overexpressed in myeloma, which basically means that it is being produced in larger quantities than needed, and that is a bad thing, since TNF-alpha helps myeloma cells survive, as we have seen.
  • Second point: aspirin increases the levels of TNF-alpha. Dr. Kast reminds us that TNF levels go up as myeloma progresses…hence, lowering TNF may delay progression. That makes sense, right?

Well, it’s not that simple. Since 1996, different studies have shown that aspirin decreases, increases or does nothing to TNF levels. No kidding. Frustrating, eh?

So where does all this leave us? Well, just to be on the safe side, I will never take any aspirin again. More importantly, if I were doing chemotherapy AND taking aspirin to counter any possible clotting problems, I would have my docs monitor my TNF levels frequently and carefully. Or I might ask for a different something-or-other to prevent the clotting…

You never know…

City views…

Sometimes Stefano and I dream of moving far away from Florence…

We simply get sick and tired of all the traffic…of the pollution…of how expensive it is to live here…of the horrendous heat during the summer months (never ever visit Florence in July or August…mark my words)…

But then (as we did yesterday evening, on our way back home from walking through a Tuscan nature reserve) we stop at the Piazzale Michelangelo, which has the best panoramic views of the city, and we realize that it would be difficult for us to move away…

Florence still takes our breath away…

Recently, I have seen lots of Italian flags hanging from apartment windows in celebration of the 150th anniversary of Italy’s unification. But yesterday evening, while enjoying the view from the Piazzale, my glance fell on the, er, rather unusual flag here on the left. How original, eh! 

A quick mention, off topic: I am working on about a million different posts (well, okay, slight exaggeration, there!), but mostly I have been celebrating my good test results by taking some time off…spending it with Stefano or in my garden, planting bright, cheery-looking flowers…having fun with my girlfriends (well, and of course my day job takes up a good chunk of my time…).

Research can wait…yes…until tomorrow…

How do you spell RELIEF?

Nope, not R O L A I D S. 😆

No. You spell it as follows: S T I L L  S T A B L E.

That’s right. This morning I finally received my February test results (one of Ingrid Michaelson’s songs, “Keep breathing,” has been my theme song in the past week or so, as you can imagine…ooooof!: http://goo.gl/o8Qby). About time, eh! But last Thursday was a national holiday in Italy–the celebration of the 150th anniversary of Italy’s unification–which affected mail deliveries here…

Anyway, let’s have a look at these results. I have to admit that I expected them to be terrrrible, since I still had a bit of a cough/chest infection (=aftermath of the flu) when I went to the lab last month…but I am happy, for once! (hehe), to say I was wrong!

Let’s start with the not-so-good results: my white cell count has dropped slightly below the normal range: 4.1 (should be at least 4.4). My WBC is the only slightly bad number in my hemochrome, though. Everything else is just peachy…My haemoglobin is even up a wee bit. Oh wait, this is supposed to be an overview of the NOT-SO-GOOD results, Margaret… 😉

I knew that my total IgG would be highish, and so it was. It went from 3360 mg/dL to 3790. I actually expected it to be higher, since, I repeat, I was still a bit convalescent. But, as we will see in a sec, this is no big deal in the end…

Another not-so-good result, okay, a rather bad one: my vitamin D dropped to 27.1 from last year’s 78.9. Oh, snore! Here I should mention that I stopped taking vitamin D in May 2010 when my levels went above the normal range. I didn’t take my vitamin D supplement all summer, in fact, figuring I was getting enough sun…hah. Evidently, I wasn’t! In the fall, I began taking my vit D supplement again, but not on a regular basis…So this nose dive was my own silly fault...

Of course, there is a remedy: from now on I will take vitamin D religiously every morning. This vitamin D drop,  which, incidentally!, might explain why I got such a bad case of the flu early last month, also means that my parathyroid hormone has shot back up to 94…UFFISSIMA! 👿  At the most, my PTH should be 72 pg/mL. However, I am not concerned about this result, either, since my vitamin D intake should bring it down again…

Uric acid: 6.1. That’s a bit high. Now, this number has never gone above the normal range before, so this is a bit of an odd result. I checked my creatinine levels, which are fine, even though they went up ever so slightly (but still way within the normal range)…Hmmm, oh well…next time, it will be lower, for sure.

Okay. Enough. Now for the GOOD stuff! And yes, as you can imagine, there is quite a bit of that. I plan to go down the list, item by item, in order not to miss anything, so what follows is not in order of importance:

My ESR levels dropped from 93 to 36 mm/hour. Why, that is ALMOST normal!!! I checked previous blood tests, and my ESR hasn’t been that low since I progressed to SMM (= in 2005). Celebrate!

Total protein: down slightly, from 9.8 to 9.5.

Beta-2 microglobulin: from 2.6 to 2.4.

C-reactive protein: from 0.23 to 0.09. The lowest it has been in a looooong time.

UPDATE (oops, forgot to put this in yesterday). Calcium: down to 8.9 from 9.4. :-)

Bence Jones: negative.

IgA and IgM, still holding at 14 and 10 (mg/dL), respectively. My little heroes…

Albumin, now in the normal range: 4.65.

Gammaglobulin is down ever so slightly: 3.09 from 3.12 g/dL. 

M-spike: down from 2.98 to 2.92. Yes, again, this minuscule drop is nothing to get overly excited about, but hey, I am thrilled that it has gone down, not up! True, all the above numbers have barely changed at all, but all those itsy bitsy fluctuations are going in the right direction, which is just FINE and DANDY with me! Indeed, I think it’s time now for a little dance of joy (to Sara Bareilles’ “King of Anything”: http://goo.gl/ZaEga)

Back to us: everything else shows no change, hence my conclusion that I am stable…

Still stable, after all these years…trallallerotralalà!

Clinical trial tests omega 3 supplementation for the prevention of disease progression in MGUS, SMM and early-stage CLL…

For the past couple of days, whenever possible, I have been working on what I consider to be an important post, but today I simply couldn’t deal with it (one of the studies is driving me bonkie bonka bonkers), so I decided to take some time off and have a quick look at the Clinical Trials website…and wowwowwow!, I made some interesting discoveries, one of which I will share with you immmmmmediately…

This link http://goo.gl/zO7b8 will take you to a clinical trial testing the theory that omega 3 supplementation might prevent MGUS and SMM folks from progressing to active myeloma…How about THAT? But wait a sec…how did I NOT know about this trial?!!! Hmmm. Well, better late than never…right?

Let’s see, I already take two grams of fish oil/day…and if it weren’t so late in the day, and if I didn’t have to hurry so that I can catch the 8 PM news about Libya and Japan, I would (try to) calculate my EPA/DHA ratio compared to the trial’s ratio…Oh well…tomorrow…

This, by the way, is a Phase II trial, which is performed on a larger group of people once the safety of the substance/drug being tested has been ascertained in a Phase I trial…And it is still recruiting…

Now, I don’t suppose any of you would happen to be in this trial and wouldn’t mind posting a quick report or whatnot, eh? :-)

Why I love elephants…

After returning home from work today, I settled down to finish reading a rather startling study that I had begun yesterday…but one of my girlfriends phoned to see if I wanted to play cards with the usual group later on. Gee, twist my arm…! Besides, Dr. David maintains that friends are more important than spouses ;-), so how could I say no?

Since I have a bit of time before leaving, though, I would like to post a link that a blog reader/friend sent to me…This video kept me on the edge of my seat for almost two minutes: http://goo.gl/6iFhY Amazing, eh? Okay, off I go…

Hope…

My Mom told me about a program she had seen last week on the compelling brain cancer story of David Servan Schreiber, a French physician and neuroscientist. Among other things, she described, in detail, a very interesting (…really horrible, too!!!) electric shock experiment carried out on rats injected with malignant tumors (=a story recounted by Dr. Servan Schreiber). While she was talking, so many bells went off in my head that I decided to do a bit more research on this doctor…

Well, my search confirmed a few things that I already strongly believe in…and taught me quite a few things I didn’t know…

Before giving you the links, though, I want to describe a relevant episode from my own personal experience…and I have no doubt that many of you, if not all!, have a similar story to tell…no doubt at all…

Let’s see. Where to begin? Well, more or less in the fall of 2005, when I realized that my MGUS was progressing, I became quite concerned. Stefano and I went to see my Italian haematologist who, looking over my most recent (at the time) tests, advised me to begin chemotherapy immediately—three cycles of Velcade, then an autologous stem cell transplant in the summer of 2006. Mostly giving in to a gut feeling, I refused (by the way, this happened months before I found out about curcumin, and I would like to note that at that time I was in a conventional state of mind…I wasn’t even looking at anything remotely “alternative”). I immediately contacted three internationally-renowned myeloma specialists, two in the U.S. (both at the Mayo Clinic) and one here in Italy.

All three confirmed that, yes, I was definitely progressing towards active myeloma. But the important thing, as far as this post is concerned, is that I asked each expert what I could do at least to SLOW DOWN this progression. There had to be SOMETHING…

But they all answered: “No. Nothing. There is nothing you can do.”

Nothing??? I still remember my feelings of shock and frustration…

The only one who gave me a very slightly different take was one of the U.S. specialists, who suggested that I should simply continue with my daily life, have fun, do some exercise and follow a healthy diet. Nothing more. As for what that healthy diet entailed, or what kind of exercises I should do, well, I simply have no idea. I was in such a state of shock at the time that I didn’t press him any further…

Anyway, after those consultations, I began thinking that it was really horrible for doctors to say something like that to a patient…that it was simply unacceptable and, in fact, cruel of them to have taken away my HOPE…and that this had undoubtedly happened to who knows how many patients before me…and would happen to countless others after me…

Naturally, I don’t mean to imply that these specialists should have given me false hopes. I don’t want to be told, “everything is going to be fine,” if everything is NOT going to be fine. That would be extremely silly…But taking HOPE away from a patient is another matter…

The point of this entire section is that what I have discovered in the past five years (plus) has made me realize that, okay, while I may progress to active myeloma some day, those specialists were simply wrong (this is JUST MY OPINION, of course!)…

I have come to believe, very strongly, that we can indeed do something, indeed perhaps many things, to improve our situation, even if “only” on a psychological level. Had I known back in 1999 what I know now, if I had taken curcumin back then, I believe that my MM markers would be much lower today; I might even have remained in the MGUS category. Of course there is no way of proving that…that is, unless I can fix the technical problems I am having with my time machine… 😉

Okay, let’s put aside what happened in 2005…and my not-so-interesting ramblings…and instead go on to the central part of my post, which is Dr. David (his surname, Servan Schreiber, is soooo long that I will simply call him Dr. David from now on).

This physician definitely shares my above-stated opinion that there are things we can do to improve our situation and also that it is terrible to take HOPE away from cancer patients. And he is a medical doctor, not just someone with a non-scientific Ph.D… (er, that would be yours truly…). So let’s pay careful attention to what he says…

Let’s start with the lecture that he gave at the MD Anderson Cancer Center in July 2009 (the full transcript can be found here: http://goo.gl/cvCST; incidentally, you will find the shocking rat story about 2/3 of the way down the page…). Even though I haven’t read the whole shebang, I really liked what he had to say about “false hopelessness”:

As a physician, I am very concerned about the idea of giving people false hopes, because I know this betrayed the only thing that is truly fundamental which is the authenticity of my relationship to a patient. And I don’t wanna have false hopes for myself. I need authenticity in the relationship to myself as well. However, when we do not tell our patients or we did not tell ourselves about all of the scientific information that shows that there are powerful ways in which we can regain control of our faith in our fight against cancer, then what we are doing is inducing false hopelessness. And all of what I am trying to do today, for this book really has talked about all of my actions, is to fight against false hopelessness.

There are powerful ways to fight against cancer…oh yes, indeed…I believe that, too…strongly.

And now we get to the most important link of this post. It will take you to a lecture that Dr. David gave last year at UCSF: http://goo.gl/Bz5pT It lasts an hour, which may seem like a long time, but let me tell you, this guy is the complete opposite of boring…his talk is very interesting and even funny here and there…So make yourselves a cup of tea or coffee and settle down in a comfy chair…

Now, if you don’t want or have time to watch the whole thing, then I suggest that you at least watch the last 30 minutes. After 34 minutes, for example, he explains why oncologists scoff at the very idea of diet intervention…why they think it won’t help one bit (he strongly disagrees, by the way…). Interesting…

And, after 48 minutes, he describes the shocking rat story, which, as I mentioned, you can also find in the MD Anderson transcript. This experiment is, I repeat, the reason why I got interested in writing this post in the first place. I mean, why did the third group of rats fare better than the first two, even though theoretically they should have been much worse off? The answer is that they had HOPE. They had some sort of control. And this goes to prove that if you take away hope (e.g., by telling your cancer patient, “oh no, there is nothing you can do…” OR “sorry, but there is nothing more we can do for you”)…well…you get the idea…

Here is the link to the 68% reduction in breast cancer mortality study that Dr. David mentions in the second half of the video…the study that didn’t make it into the New York Times, even though, as Dr. David points out, there is not one single conventional treatment that can compare with that result: http://goo.gl/Gjvqu Eh.

At one point, as I recall, he says that stress doesn’t cause cancer, and I don’t believe that, either, otherwise practically the entire world population would have cancer. But let’s not forget the 2008 study that linked the stress hormone norepinephrine to myeloma cell proliferation, see: http://margaret.healthblogs.org/life-with-myeloma/what-is-multiple-myeloma/multiple-myeloma-and-stress/ So this is an area that needs a bit more exploring, in my opinion.

Let me add a brief anecdote to what I just stated about stress and myeloma. I have a friend whose myeloma had been asymptomatic for a couple of decades…Then, five or six years ago, during a period of incredibly high stress at work–pressing deadlines and so on–her myeloma markers suddenly went sky high. She panicked and decided to quit working so hard. And she began going to the gym. Within a few months, her markers had returned to pre-stress levels. So there is something to be said about getting rid of stress, enjoying life and laughing as much as possible…

But, most importantly, don’t let anyone take away your hope…

Ever.

P.S. Here is a February 2010 “Huffington Post” article listing Dr. David’s suggestions for an anticancer lifestyle: http://goo.gl/6Cqww

Recanati…

On Sunday, after visiting Raphael’s family home and walking all the way around the Ducal Palace, we left Urbino and drove on to Recanati, where the famous 19th century Italian poet Giacomo Leopardi (http://goo.gl/ElZRN) was born.

Now, as you may already know, I was born in the U.S. and am a U.S. citizen…But when I was six years old, my family moved to Florence, Italy, where I went through the Italian public school system. Anyway, when I was in the scuole medie, the equivalent, I guess, of U.S. middle school, I had to memorize heaps of poems for tests and so on…Point is, Leopardi was definitely one of my favorite poets…though, to be 100% honest!, my classmates and I tended to favor authors of very SHORT poems… :-)

Fast forward to last weekend. Stefano and I really enjoyed our overnight stay in Recanati, a very pretty hilltop town with cobblestone streets and fine views over the marchigiano countryside. Among the things we did that day was take a guided tour of the Leopardi family library, which doesn’t sound that exciting but was really worth it in the end. The family library holds more than 20,000 volumes, family portraits and miscellaneous objects…AND some of Leopardi’s own drawings and writings…his early ones, in particular.

Our guide told us some juicy tales about the family…for example, things I didn’t know about Leopardi’s very strict father, who, interestingly, demanded the same education for his eldest sons AND his daughter Paolina, which, given the period, was extremely “modern” of him…

Leopardi’s father also opened his library to the citizens of Recanati…a generous but pointless gesture, since, the guide explained, nobody in town could read at that time. Eh. Oh, another interesting titbit for Leopardi fans: his descendants (not his direct descendants, since he died childless…at the age of 39…) still live in the house (photo 2), and the only part open to the public is the library…

As you walk around the town of Recanati, make sure to look up and read the writings you will see engraved on slabs (photo 4) located mostly around the poet’s family home. They are excerpts from Leopardi’s poems…

The verses you can read in this photo are from Leopardi’s 1819 melancholy poem titled “Alla luna,” which means “To the moon.” Here is a translation of that excerpt:

Oh gracious moon, now as the year turns,
I remember how, heavy with sorrow,
I climbed this hill to gaze on you,
And then as now you hung above those trees
Illuminating all.

 

Urbino under the snow…

 

We returned to Florence late last night…went to work today…I returned home this afternoon totally exhausted…heaps of e-mails to go through, as usual…oh dear, just got a call from Stefano who told me he and his brother had to rush their father to the ER (apparently, he is okay, but I am awaiting more news)…

 So right now, to take my mind off things, I am looking through the photos I took this weekend in the region of Le Marche…the city of Urbino, specifically…including this lovely panoramic view (photo 1) taken from the Albornoz Fortress, which is the highest point in the city (485 meters above sea level).

Getting up to the fortress was no joke…Some of the incredibly steep (narrow, too!) side streets had not been cleared of snow, as you can tell from the second photo, so the going was quite slippery.

Luckily, there were handrails that we could hold onto during our climb (in fact, if you look closely on the lower left-hand side of photo 2, you will be able to see one).

The view from above (photo 1) was well worth the arduous climb, though…wow…

The manager of the hotel where we spent Saturday night informed us that Urbino had essentially shut down after the snow storm…Even the university had closed, even though this is a period of graduations…a good period for tourism…Usually. But not last weekend…

Our hotel had been forced to close for a few days, too, buried under the snow, and had reopened the day before we arrived…Even so, we (and one other couple) were the only guests there, which, I repeat, is very unusual for this time of year.

Between sighs, the manager explained that last week he had received only cancellations from clients who had been scared off by the dire weather forecasts. Of course, Stefano and I knew that Urbino had been hit by snow, but that had not deterred us from our original plans. And, in fact, our Skomer Island gear kept us nice and dry and warm (oof, icy icy ICY winds in Urbino…!)…

 Anyway, as a sort of reward for our steadfastness, I guess, we were assigned the hotel’s best room…

…a room with a view (photo 4; taken very early on Sunday morning)…