Feb 22, 2006

The Diagnosis

Hi all-

Sorry again for the mass email. There are very important things happening in our lives right now that we want you to know about. As you may know, back in November I started experiencing seizures in my right arm. When I bought it up to my doctor, we were treating a back injury and she opted to fix the back problem first, them look at the arm. Well, the back is better, but the seizures kept on happening so I went back. She referred me to a Neurologist at Andrews AFB who I saw about three weeks ago. They wanted me to do an EEG and MRI of my brain and also placed me on anti-seizure medication. I had the EEG two weeks ago and it was normal. I had the MRI last Thursday morning and the Neurologist called me later that afternoon and wanted me to come in Friday morning! I thought that was a quick turnaround and suspected something was up – unfortunately, Holly and I were leaving to spend the weekend in NYC Friday morning, so they agreed to see me Tuesday morning. By the way, Holly and I had a great time in NYC – what a crazy place!

Anyway, that brings us to yesterday morning. I drove all the way out to Andrews for an 8:30am appointment and the doctor told me that the MRI shows a tumor in the left side of my brain that deals with motor functions, which explains the seizures in my right arm. He was adamant that I meet with a Neurosurgeon immediately and called the on-call surgeon at Bethesda National Naval Medical Center. The surgeon agreed to meet with me at 1:00pm. I guess I expected the news, but when it came, it was still unbelievable. As I was walking out of his office, I was in a bit of a daze – I walked out the wrong way and realized that the chapel was right in front of me – I walked right into it without hesitation. I contemplated the situation for a few minutes and then the tears came. But as quickly as they came, I realized that I needed to get to the love of my life as soon as possible – I had to tell her in person although she was at work. I got into my truck and started driving to her work. On the way I called my Pastor who was in Mississippi on a rebuilding mission trip. He said a prayer for me and then I called my parents. They were very shocked but took it well. I made my way to Holly's work and thought about how I would tell her. But I couldn't think of the right words and just went up to see her. The news was upsetting for her and me, and we shared more tears together. She told her boss about the situation and we left for the appointment.

After picking up a nutritious lunch at McDonald's, we made the long drive to Bethesda. We met with a very knowledgeable doctor who showed us the film from the MRI and talked about treatment options for this kind of tumor. On to the pictures! I have attached some clear pics of the tumor.

The first picture, brain1, is a shot as if you were looking up at my brain from my feet. The right side is the left side of my brain. You can see the circular shape of the tumor. The white area around it is edema, or fluid caused by the tumor disturbing my brain. It's the brain's way of protecting itself.
Brain1


Brain2 shows exactly how deep in my brain the tumor rests. Yes, that's me – cool, eh?
Brain2


Okay, lastly, brain3 is a shot looking straight down as I'm lying on my back. The tumor is approximately 2.44 x 2.28 cm in size, or roughly just smaller than a quarter.
Brain3


So, what does all this mean? First of all, they don't think it is cancerous. It is possible that it is, but they will only know after they can get a sample. It is possibly a meningioma or astrocytoma. They are not able to do a biopsy of it because of where it is located and because there are important blood vessels there going through it or near it that could be damaged during a biopsy. The surgeon recommends that we simply remove the tumor. In fact, they think it is urgent enough that they have scheduled me for surgery next Friday, March 3. He explained the procedure to me in detail… they would perform a procedure called a craniotomy. They'll basically cut a square in my skull, drop the brain out of the way and try to get as much of the tumor out as possible. The surgeon is pretty sure that they can get most of it out as long as a blood vessel does not run through the tumor as it looks like it might on the MRI. I am going in on Tuesday for a CT-Angiogram so that they can map the flow of blood through vessels in my brain. If the blood vessel in question goes right into the tumor and stops there, they can clamp it off and take out a lot of the tumor. If the vessel goes through the tumor or just along side it going to other parts of my brain, they will not be able to get too close to the vessel or they might cut it and cause a stroke. So, they might have to leave a little bit there. Any tumor that is left there can likely be treated with radiation therapy (not to be confused with chemotherapy.) Only after they get the tumor out will they know if it is cancerous or not. Again, radiation can be used to treat cancerous cells – but we'll cross that bridge when we get to it.

It was when the doctor went into the possible complications of the procedure that I almost passed out (no kidding). During the procedure if the brain is bruised or swollen, I could temporarily lose function in my right arm, hip, torso, and upper leg. Therapy would help me regain use of these in time. Worst case scenario is that if the tissue is damaged, I could lose the use of some or all of these parts permanently (this is where I almost passed out- but I was glad I didn't as I didn't want to lose my precious lunch.)

At first we were not sure if we wanted to do the surgery here or in TX. But being that it is Bethesda Hospital, a leader in the US, we think we are leaning toward doing it here. The procedure will take 3-5 hours and then I'll be wheeled right into the ICU. Depending on my recovery, I could be moved to the ward within a few days. I should be out of the hospital within a week. Then the recovery period will begin – I cannot work for 30 days following the surgery. Again, there is still some uncertainly as to where I'll be spending this time – either in our apartment in DC or in the hospital, or part here and part in Texas. We just don't know and are trying to get answers as I type. We still have a lot of unanswered questions regarding treatment, military rules and regulation with this scenario, where we'll live, when we can go back to Texas, etc. From this point forward, I'll be posting updates on our situation, including my past two emails, to my blog website right here at http://www.mommaerts.org/weblog/blogger.html. Check back every day for updates to the run-up to the surgery and my condition afterward, as well as Holly's and my thoughts on everything and ohhhh... pictures! And please leave a comment!

We are so thankful for such supportive family, friends, church and co-workers. They have already stepped up to the plate during this time of uncertainty and covered us with understanding, love and prayer. We are also forever grateful for an absolutely awesome God that will be there, by our side, as we make important decisions and He will get us through these next few weeks. Right now, I think Holly and I are experiencing some fear, but what is getting to us most is the uncertainty of the military and its lodging policies. I hope to have more questions answered today and tomorrow. We ask that you please pray for comfort, strength and most of all, that the tumor is not cancerous and that I make a full recovery. We love you all and we will be in touch via the website.

With all His love,
-Roger and Holly
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