Tuesday, October 4, 2011

The Tumor

My first MRI appointment was on May 25th, but by some stroke of bad luck I became very ill on May 24th, more ill than I'd ever been in my life.  I'd felt fine at work, and no one else got sick before or after.  About two hours after I got home I passed out, and figured that'd probably be a good time to get to bed.  I slept for 40 hours, waking up only long enough to call in to work.  I have no idea if my sickness was related to the cancer, or exacerbated by it, or if it was simply a very bad cold.  I still wanted to get the MRI, but given my tenuous hold on consciousness and potential for contagion, it really was not an option.  The next available appointment was on June 16th. 

By then, I had noticed some more symptoms.  I kept seeing a reddish tinge in the corner of my left eye, only to eventually notice there was a sort of burn there, something that persists to this day.  Turning my head to the left or right made me extremely dizzy, and my neck felt sore.  I was getting one or two minor optical migraines per day.  In the waiting room, the TV was showing live proceedings from the Casey Anthony trial.  The judge had denied her motion for a mistrial, and the receptionist seemed very pleased about that.  She and I chatted for a while, then I went in for my MRI.

MRIs are generally unpleasant.  They're very tight, and very loud, and take about 45 minutes.  Sometimes (as in my case) they involve a large-gauge needle, to apply contrast.  As a bit of foreshadowing, I now think that MRIs are quite roomy and comfortable.  More on that later.

After the MRI I returned to Dr. Eyeballs' office, and he informed me that they had not found a blood vessel pressing against my optic nerve.  But further back they found, in his words, "a big problem."

You know when a doctor describes something as "very large," it's not a good sign.  I asked him to confirm, for the sake of complete clarity, that we were talking about a brain tumor.  Yes, we were.

When I saw the MRI for the first time, all I could say was, "that is very big."  It occupied most of my left frontal lobe, and completely filled the front left ventricle, a sphere of tissue with uneven streaks of white within, indicating areas of increased uptake.  Dr. Eyeballs told me that the edge of the tumor was well defined, and they'd likely be able to remove the whole thing.  Dr. Eyeballs is not an oncologist.  He did not note the light, whispy trail leading across my corpus callosum, branching into my right hemisphere.  That part accounted for only about 2% of the tumor's total mass, but all it takes is a single neglected cell. 

He immediately referred me to a neurosurgeon with an office across the parking lot.  I saw him immediately, and he was not as optimistic as Dr. Eyeballs.  He noted the intrusion into the right hemisphere.  He noted that the higher uptake in the core of the tumor, along with the sudden onset of symptoms, indicated that it might have transformed into a grade 3, or high-grade, cancer.  He said that he could remove most of the mass, but that in all likelihood I'd only recover mentally about 75%.  That eventually most people probably wouldn't even notice a difference, but that I would.  He said that it would likely take me weeks or months of occupational therapy before I could return to some semblance of a normal life.  He also said that he'd performed about 16 similar resections during his entire career.  My family and I scheduled a date for the surgery (July 1st), but decided to seek a second opinion.  My mother pretty much hated him.

I didn't.  She hated him because he gave us bad news.  I appreciated that.  I tend to deal with problems by learning as much about them as possible, both the good and the bad.  I would much rather someone give me an honest survey of my situation than sugar-coat or keep things from me, and to be honest, given that doctor's level of experience I have a feeling his prognosis would have been correct had we gone with him.

The day after my initial diagnosis, I returned to work.  People always seem a little shocked when I tell them that, but I really had no choice.  I needed a distraction, anything to take my mind off the previous day.  Things got off to a rocky start as my mother e-mailed me 4 times in the first 30 minutes, each time with some ridiculous miracle cure promising to completely cure me if only I ate enough vitamin E.  She's fond of the "nutraceutical" movement.  It had to stop.  I couldn't have her constantly reminding me of my illness when the only reason I'd gone to work was so I could ignore it for a while.  More than that, I couldn't let her believe that everything was going to be just fine.  Things were going to change; how could they not, when I was to lose a piece of brain the size of a lemon?  There is a fine line between pessimism and realism, and while I stay optimistic about my situation, I am first and foremost a realist.

Plan A is to beat my cancer.
Plan B is to understand that Plan A is unlikely to happen.

I called my father to play mediator and he decided to limit her to one e-mail per day.  She sulked about it, but it was a tremendous help to me in those early days.

For the second opinion, we went to New York City and one of the leading cancer centers in the world, where we met with one of the leading neurosurgeons in the world, let's call him Dr. Brain.  Dr. Brain met with me for all of ten minutes before accepting my case, and seemed genuinely interested in it and in me as a patient.  He gave us a slightly better prognosis but did confirm that there would likely be some effects and that I might need some occupational therapy to get back up to speed.  However, Dr. Brain was recognized as one of the stars in his field and had so many resections under his belt I was surprised he still had a waist.  We decided to go with him, and he scheduled the operation for June 30th.

Things moved very quickly from there.


  1. How old were you and how good was your insurance policy?

  2. This was 2011, so 29.

    I don't really like to talk about the financial side of it (though I may touch upon it in a more general sense at some point), but my insurance has covered everything I've needed so far. I will say that I am very glad I am insured right now.