8.14.2006

Monday, August 14, 2006 - 10:45 pm

Below is Mike's letter to friends following the series of surgeries in late January and early February to implant the shunt. That shunt turned out to be infected and lead to serious cognitive complications throughou thte month of February. But upon his return home, he was feeling quite good. I gain a lot of perspective from reading this email. Such as... Mike hated the hospital. He always had a sense of humor about his situation. He realized how complicated his case was, even if he acted like it was fairly straightforward. And.. did I mention, he hated the hospital?

The following email was sent to friends on February 6, 2006. (See previous post for info on our March 8-12 trip to Charleston, SC):

Hello friends,

I am thankfully back at work today, having been released from the hospital last Friday. And since I’m not in the hospital, today is a good day.

I’ll recap here for those of you who may not have been on Danna’s email lists. On Thursday, Jan 26, I checked back into Jefferson Hospital for more surgery. A cyst had grown where my tumor was previously, apparently a fairly common occurrence for a craniopharyngioma (the fancy name for my brand of tumor). After consulting with the radiation therapists, my doctors concluded that it made the most sense to drain the cyst first before I started radiation therapy to kill of the remaining cells.

I had the surgery on Friday, Jan 27. Unfortunately, the surgeons were working somewhat blind. Last time, they went in endoscopically through my nose. This time, they went in from the top of my skull. Given the procedure, the top of the skull method was less invasive. They attached a frame (kind of like a halo) to my skull, and then took an MRI. This frame had to literally be screwed into my skull at four points, which wins for Unpleasant Surgical Procedure of the Day. Especially when you consider that the frame wasn’t designed for an enormous head such as mine. The frame gives the surgeons coordinates to orient themselves with, and a software program then directs them to the cyst. My surgeon wasn’t sure if he punctured the cyst during surgery, so he sent me for a CAT scan while still under sedation. The CAT scan was inconclusive: either he had punctured it, or he had just missed. Since it was possible that he had hit the target, he chose not to try again and expose me to greater risk. He ended the surgery, and scheduled me for an MRI to get more conclusive evidence. The MRI confirmed that he had missed.

Saturday morning, my surgeon suggests that we try again. He can send me home and have me come back at a later date, or he can fit me in Tuesday and just keep me in the hospital. I’m so ready for this to be done, I decide to stay. After an intensely boring weekend in the hospital, I go back to the pre-op area Tuesday morning. this time, they give me a sedative cocktail before screwing on the frame, making the experience much more pleasant. I awaken after surgery to find out that they did penetrate the cyst. Success!

Tuesday night, I sleep terribly. I run a fever as high as 103.9, similar to a problem I had last November. Wednesday morning, my surgeon stops by early. While they did penetetrate the cyst, they were a little too successful: the catheter is now very close to one of the main arteries in the brain, and my surgeon doesn’t want to scratch that artery by accident. He wants to go in one last time and retract the catheter a few millimeters. He thinks that might be the cause of the fever as well, since it may be upsetting the hypothalamus. I sigh in resignation. What else can I do? He apologizes, and says he’s never had this much difficulty with such a simple procedure. He orders me antibiotics added to my IV, and ups my hydrocortisone level.

Thursday morning, I once again am headed to pre-op. As I am wheeled down on a stretcher, five different nurses say, “Good luck, Mike.” You know you’ve been in the hospital too long when that many nurses can identify you by name. Finally, the procedure is performed and works. A CAT scan shows great placement, and that they’ve shrunk the cyst down when they withdrew fluid during surgery. Hurray!

Friday afternoon, I leave the hospital, thrilled to get out of there. Now I have to schedule followups with my original surgeon, my endocrinologist, and another radiation therapist. Originally, we were going to wait a couple of weeks before starting radiation, but my surgeon doesn’t want to wait for the cyst to reform, so he’s pushing a faster timetable. I meet with the new radiation therapist on Feb 14 to find out more.

Unlike last November, I feel just fine now. My energy level and stamina are fine, and I’m not suddenly wiped out. This allows me to be back at work and driving immediately. It’s a big relief. I do have a big shaved patch on my head. Fortunately, it’s placed in an inconspicuous place: the front of my head. Ah well. At least the scar is along my natural part, so it should eventually disappear beneath my usual shaggy mane. In the meantime, I’ve gotten my hair cut shorter than it has been since my college days. Tom Javian suggested I shave the other side and dress up as Lt. Worf from Stark Trek TNG. We could then tell people that a side effect of the surgery had me convinced I had become Lt. Worf, and I would wear a Star Trek uniform to work every day. Oh, the fun you can have with a brain tumor!

Regards,
Mike

No comments: