Bad News

9 05 2010

I was shocked to see the MRI pictures.  The large empty tumor bed from the original surgery had filled up with fluid and was compressing the left side of my brain in all directions: front, back, and even compressing the very base of my brain.  If I had never seen this MRI, I wouldn’t have known anything was wrong.  I guess I was just lucky to not have any major symptoms yet: seizures, numbness on my left side, etc.   My oncologist put me immediately on steroids to reduce the swelling and I was very happy to take them — although they would lower my immune system which was sort of the opposite thing you want to do when you have cancer.

The following Tuesday, I reviewed the MRI scans with a neurosurgeon and neuro-oncologist.   We agreed on doing an “open incision” biopsy on May 21st to see what was going on with the other side of the tumor bed — it looked massive and angry in the MRI scan dwarfing the original tiny cancer on the opposite side that we had all been focused on for the last two years.  The surgeon explained to me that the best case scenario would be a diagnosis of “radiation necrosis”.  The worse case would be for the biopsy result to be “glioblastoma” — then they would need to go in again and take out about 95% of the tumor.  The difficulty here is that what seems to be angry-looking is very close to my motor-cortex, the part of my brain that controls the my right side of my body.  The surgeon explained that I could be paralyzed on my right side, but I could opt to be awake for the surgery if I wanted to be just to make sure that my motor functions would stay in tack.  “Whatever it takes”, I thought to myself.

Towards the end of my meeting with these doctors, my neuro-oncologist asked if I had read “Anticancer: A New Way of Living”.  I told him I had (didn’t mention this blog) but that I had read an even better book: “The China Study”.  I explained how it became clear that, in a lab mice, you could turn cancer on and off by adjusting the amount of animal protein in their diet.  I noticed the neuro-oncologist shaking his head in agreement (perhaps just to humor me) but the neurosurgeon turn to me and asked: “are you macrobiotic, vegan?”  I looked at him and nodded.  His reply was a comment on how difficult the vegan diet was to keep and that he was a “localvore” himself attempting to grow his own garden.  Needless to say, I wasn’t expecting the topic of plant-based nutrition to come up but the book “Anticancer” seems to have legitimated the conversation on the relationship between food and cancer — even if the “Anticancer” book, which recommends some meat and dairy, did get it wrong.

They signed me up for a special “mapping” MRI of my motor-cortex and a simple MRI for the brain-lab.

===

Later, I met one-on-one with the neurosurgeon to review the results of the mapping MRI.  It turns out the risk of paralysis would be low.  The mapping MRI showed my motor-cortex was a safe distance away from the area they were worried about.  However, he wanted a lab tech to wire up the right side of my body during surgery so as not to harm the bundle of fibers that ran from the motor-cortex to the rest of my body.  Nicking these fibers could cause paralysis for about six weeks.  Overall, I feel like I’ve dodged a bullet.

Looking at the brain-lab MRI, I noticed that the tumor bed was mostly empty, with a combination of protein fluid and blood filling only half way.  So the swelling had gone down, but there was still an angry half-inch margin glowing in the MRI.  Along with a relatively new large area which seems to be the source of the problem.

The neurosurgeon and I had come to an agreement I that could feel good about: he would continue to go in and pull out biopsies and have someone there on-hand to type them.  If they came back, “radiation necrosis” then he’d stop.  If not, then he’d get as much as he could.  That would be the plan.

===

So there I was Friday, May 21th at 6am with my mom, step-father, and my brother being prepped for surgery.  I had to shave my beard off the night before, and get re-aquatinted with the bare face that I haven’t seen since the first incision.  The nurse couldn’t find a vein to tap so she put a warm towel on my arm and left the room.  When she returned, she told me that the doctor was not feeling well and canceled the surgery.

In disbelief, we all went out to breakfast since it was early and I could not have anything after mid-night.

Later, the realization would sink in.  We were going to have to start over: another set of MRIs for the brain lab.  Then there’s the issue of what to do between doctor’s appointments?  Since I’m already doing everything I can with regards to following a strict vegan diet, I’ve decided to focus more on the psychoneuroimmuniology aspects of cancer.  I firmly believe I can shrink, calm down, heal, reverse the angry brain cells.  Where the emphasis used to be green-smoothies, I need to figure out my deeper calling, tap into a deeper meaning, and grab a hold of a deeper passion for life.

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