Friday, December 7, 2007

Back in the Day




This is a photo that I took on a Kodak disposable camera when I was in East Timor. We were on a hike up Mount Ramelau and this scene emerged from the fog.

Sunday, December 2, 2007

ahemmm...

Happy birthday to me
Happy birthday tooo me
Happy birthday dear Michael...
Happy birthday to me!!!

ah thank you.

Friday, November 30, 2007

The morning before

I'm not really sure where the title of this musing came from or what it is wanting to explain, but I'm going to leave it up there anyhow. Take that. Chew on it for a while. Spit it like camels do.

Yes, yes... I know it's been an actual month since I last posted that Peter Atkins quote up here and I completely missed the 2000th visitor to the site. I'm actually hanging my head in shame. Seriously... it's below the keyboard right now and if you like to try these things, that's hard to do. We (the managers of this site [actually it's just me {how many people remember the orders of brackets like that}]) actually like to think in orders of magnitude, so 2000 isn't that great. 10000 is the next big thang.

That still leaves me with a complete lack of things to talk about. I even wrote a musing somewhere around here that notes how hard it is to find things to talk about. So, no more of thaaat. Hmmm....

Okay. Lets play a game. I'll think of a word that most people should know. You have to guess the word. For each guess you give, you'll get a number of points depending on # of letters you get right irrespective of order. For example if my word is "LOSING" then you might guess "CLOSER," which would give you three points. "LOSERS" would also give you three points. "LONGER" would give you four points, whereas "GAMERS" would only give you two points and "MURDER" would get zero points. The points are cumulative and the person who picks the right word gets 10 points extra, the person with the most points wins and may get a beer from me. So, I'll keep score on this page as words come in by comment. If you want to play, just give me some initials (or random letters) to refer to you by.

I've chosen another 6 letter word and I'll even throw in a definition. (or two)
1: "a contributing cause in any action"
2: "one of the components that, by multiplication, make up a number or expression"

We'll see if people like this at all...

AH - "motive" - 2 pts
anonymous - "factor" is correct - 6 pts + 10 pts = 16 pts

Sunday, October 28, 2007

Well... something like that...

"There are four Laws. The third of them, the Second Law, was recognized first; the Zeroth Law, was formulated last; the First Law was second; the Third Law might not even be a law in the same sense as the others." -P.W. Atkins in his book "The 2nd Law"-

Ahahahaha... physicists are so weird.

Thursday, October 25, 2007

Never, ever, ever..... ever!

I've come to the conclusion that one should never, ever go to see the doctor. If I actually make it through med school, you should definitely not come see me. In fact, I recommend against following my recommendations!*

So I went to a dermatologist a couple of weeks ago for hair loss on the sides of my legs (ultimately a result of the chemo). They weren't too impressed with that, but they lopped every mole off my back just for the fun of it. I knew that the path report would say "atypical" and "dysplastic" meaning precancerous. I've been in a path lab and they always say that just to avoid the liability of being wrong.

Today, I got a call from the dermatologist who said my path report proclaimed my nevi to be "dysplastic" and "atypical." Surprise. She wants to go in and hack away at me some more--to take a few inches off around the holes in my skin. The question is... how much more of this do I care to do? I've already got stage four brain cancer, how much more can a few little dysplastic nevi hurt me? I've got news for you skin folks; I'm an atypical sort of guy. I always have been. Quit picking on me!

Jerks.

*Is that my own liar's paradox?

Sunday, October 14, 2007

Thirtieth Post....

I haven't got a whole lot to say right now. Things on the brain tumor front have been going well. The last round of temazolamide wasn't too bad and I've got another MRI coming up on Friday. I spoke at a caregiver conference a few weeks ago and that was well received. I'm going to talk to some classmates about GMBs and what it's like to actually have one of these diseases you only read about in textbooks. Really, things are good. Another person said I should write a book... any suggestions for a title?

Sunday, October 7, 2007

BBQ Tetun

Hey all... In my searching through my files today, I found a thing that made me long for my time in East Timor. It's a set of translations by a Scotish/Australian doctor I met there, Jim Hudson, with whom I became good friends. I could never understand a word he said. He wrote this up for a barbeque after our trip. With regards to the Dorich, your guess is as good as mine! I copied it exactly as was written 'cept that which appears in [brackets].

-------------------

BBQ TETUN

All words and phrases given first in TETUN, followed by 'Strine/English/Dorich

GREETINGS

Botarde
Gi'dday/Good afternoon/Fooz yer dooz?

Diak Ka Lie
Howyagoin'/How are you/fit like min

Diak
Good/Very well thank you/Chavin awa

CONVERSATION

Ha'u naran
My name is....../Ahm........

Ha'u hakarak....... hahan/hemu/toba hamutuk ita nia oan-feto
I would like to..... eat/drink/sleep with your daughter
Widdnae' min'ah.. feed/swallay/shag wu yur quine

Sei, 'nee hau cerveja
Sod off that's my beer/I'm sorry old boy that's my beer/Pishaff tha's ma pin'

Hau.... malaria/paraparo/lepra....... lie ha
I do not..... have malaria/tuberculosis/leprosy

Ita moras macas ida?
Do you suffer from any transmissible diseases?

FOOD AND DRINK

Hu'a hakarak cerveja ida
Gimme a stubbie mate/Could I please have a glass of beer/geesa pint min

Fo ha'u na'an ho pa'un
Gimme a hamburger mate/I would like a piece of meat with that bread please/geesa peece min

Belle fo modo ta'han ha'u
Pass the veggies/salad/rubbit food

Cerveja iha nee hanesan mi busa
This beer tastes like catspiss/I'm afraid your beer is off/gads min yer beerstaff

Ha'u lanu
I'm pissed/I'm tired and emotional/Ahm pesht [USA: I'm drunk]

Ita lanu
You're pissed/you're innebriated my man/Yer pesht min

Nia lanu
He's pissed/he's innebriated/ees pesht

Imi lanu
You're all pissed, I'm not/You are all innebriated whilst I am not/Yur aw pesht 'sept me

Ami lanu
We're all pissed, except you/We are all tired and emotional with the exception of yourself/Wir aw pesht 'sept yoo

WEATHER

Ha'u manas ohin
Flammin' hot mate/I say, it's a little warm today/Its affa hate

Ha'u malirin macas
F***in' freezin' mate/I say, its rather cold today/could freeze the baas affa brass monkey

Udan la mais/rain maran
Jeez its dry as a **** with no **** play/Very dry for this time of year old boy/(no Dorich equivalents, as always raining in Scotland)

WORK

Halo Saida?
What dya do furra crust?/What is your business old boy?/Go'ajob?

H'au...... enfermiera/mestre/halo uma/dotor/puta/estudante/polisi/bispu bello
I'm a...... Nurse/Teacher/Builder/Doctor/Prostitute/Estudante/Policeman/Bishop Bello of Dili/(No Dorich equivalents)

H'au halo la buat ida
Buggerall/I am unemployed/Ahmonrabroo Pal

GOODBYES

Ate... logo/amanya
See you... later/tomorrow

Maromak sie selu ita
God bless you

Het hotu
Get stuffed/go forth and multiply/peschaff

Haree Dalan
Watch out for the breathalizer/Be careful on the road old boy/Ge'atakasi

--Dr. Jim Hudson--

Thursday, October 4, 2007

Blah blah...

I know, I know. I haven't been doing this whole "blog" thing. It's not like it was my idea, yeesh. Or maybe it was my idea.... hmmm....

Anyhow, things are good. My parents are back from stopping Xerxes. I'm in West Virginia hanging out with my dog. Another person told me I should write a book... so if med school doesn't work out, that's another option.

That's all for now. I'm on my period now (read: taking the chemo), so once I feel better I'll post something better than this. Just so you know, cancer blows. I don't recommend it.

m

Wednesday, September 19, 2007

Jon's Favorite Things

If you don't know, Jon is my little brother. I warned him that if he wouldn't give everybody the answer to the trivia question, I'd put a post about my favorite ways to psychologically torture him. I hope his friends read some of this and perhaps you can add a few of your favorite ways to torture your little sibs.

My current favorite is picking a topic he knows a lot about (he's an engineering major) and telling him about it, preferably in front of our parents, Katie (our older sister), or his friends. If I disagree with whatever he says, that helps to feed the flames. An alternative is to take a subject he knows a lot about, remind him that Einstein said "If you can't explain it to your grandmother, you don't really understand it," and proceed to never understand it. That last one is a technique I favored in his last visit to Oak Park. I call this the "I know more than you" and the "Reverse I know more than you."

Oldies but goodies include torturing him about whatever lady interest he has now. I've never really been attached to that one because I've also been pretty shy about my lady interests. However, if you're determined to go down that path, your strategy can be just repeating "Jon and XXX sittin' in a tree. K-I-S-S-I-N-G..." That's a good solid strategy if you're still in grade school, but can also be used when you're our age with a sense of rediculous humor. Another strategy (especially if he doesn't know you're aware of her) is to tell him you went on a date with a girl of her exact description. Whoops! But again... these aren't my favorites. These are called the "Jon and XXX sittin' in a tree" for obvious reasons and the "Oh God my 6 foot something brother is going to kill me but it was worth it."

When we were little, Jon was often too little to play sports with us (he's a lot bigger than me now HA!), so we would let him be the referee. Of course, he didn't know any of the rules of the sport (usually we didn't either), so naturally, we hated him. That also didn't last too long because (a) it was pretty mean to make all the big kids hate him and (b) we had another kid down the road who whined about everything... so it was much easier to hate that guy. This was one of my earliest days of torturing him so I haven't thought of a good name for it yet.

Finally, I think my all time favorite is using the parents. For example, both his and my favorite chair in the living room is constantly contested. I typically would drop down to the floor (I love laying on the floor and playing with the dog) and clearly be out of the chair. Jon would, of course, come down from his bedroom and sit in the chair. I then, would immediately want the chair back and appeal to Mom and Dad. Usually that involved some 5, or 10, or 30 minutes long rule depending on how long I'd been out of the chair. Jon would always, predictably and understandably, flip his freaking lid. That always made cool calm me sound much better and usually Mom would side with me based solely on Jon yelling. Dad couldn't possibly care less. The effect was always amplified by me covertly sticking my tongue out at him as he surrendered the chair. You have to be careful with this method though. You don't want to win too often, lest the parents feel bad. So you can set up contests that you don't care about and let him win. HA! That one is known as "the parent's authority rules all so I'm going to use it to get a chair." I tended to have long names.

However, I should say Jon is an excellent guy despite my psychological torture growing up. It's a miracle that he doesn't have anger issues. Plus, I probably can't ever use any of these again... 'cept maybe the "I know more than you" and "Reverse I know more than you." Those are just brilliant and he gets so mad!! I love it!

But anyhow... Jon, I love you man. And the answer was John Brown Fort.

Monday, September 17, 2007

τοις δέ στρατιώταις παρήγγειλεν αριστοποιεϊσθαι ως εν Αδου δειπνησομένοις

As with Thermopylae and Leonidas, my parents head to Greece to defend against the Persians! I'm sure Xerxes will be there to meet them. I was so worried that they wouldn't take this trip on account of me, but it finally happened! They're going with a few couples and they'll get to spend 10 days on a boat. I'm just very happy for them. They deserve it!

Bon Voyage!

-m-

PS... There's a building on roughly Michigan Ave and Illinois in downtown Chicago that has stones from famous pieces of architecture from around the world. What is the stone from West Virginia? yes... there is one...

Saturday, September 8, 2007

If you've been counting...

If you've been counting, it's been a solid two months since my last MRI. That's the first time I've gone two months without one since I quit radiation a while back. Given, I chose the new way of doing it and I asked for it, but it just made this picture yesterday that much more nerve racking...

The tumor did, however, shrink!!! I'm so happy. I dunno how I'm supposed to thank you all for your thoughts and prayers but I do. I do. I do. I do.

Much Love...

Michael

PS... Trivia: who had a GBM, composed along with his lyricist brother, and had his music covered by Louis Armstrong, Ella Fitzgerald, Bing Crosby, John Coltrane, Frank Sinatra, Billie Holiday, Miles Davis, Herbie Hancock, Judy Garland, Julie Andrews, Barbra Streisand, Marni Nixon, Natalie Cole, Nina Simone, John Fahey, and Sting. He'da loved the summertime, when the livin' is easy.

PPS... by popular demand... This is a home video I made for my cousin in Actual Virginia (not West Virginia).

Wednesday, September 5, 2007

Amazing Grace...

Amazing grace, how sweet the sound
That sav’d a wretch like me!
I once was lost, but now am found,
Was blind, but now I see.

’Twas grace that taught my heart to fear,
And grace my fears reliev’d;
How precious did that grace appear,
The hour I first believ’d!

Thro’ many dangers, toils and snares,
I have already come;
’Tis grace has brought me safe thus far,
And grace will lead me home.

The Lord has promis’d good to me,
His word my hope secures;
He will my shield and portion be,
As long as life endures.

Yes, when this flesh and heart shall fail,
And mortal life shall cease;
I shall possess, within the veil,
A life of joy and peace.

The earth shall soon dissolve like snow,
The sun forbear to shine;
But God, who call’d me here below,
Will be forever mine.

--John Newton (1725-1807)

Wednesday, August 22, 2007

Next Blog!

So... I've had flashes of thoughts throughout the day of what to write in my blog. I should really write them down because I can't ever remember good ideas after I think of them. Anyhow, what lies before you is definitely a pretty boring idea, but I felt I needed something positive at the top of the page for a while. It's that 4 week thing... ya know.

The whole notion of coming up with blogs is strange to me. First, how can you ever know what people care about? You have virtually no feedback other than the counter (I'm watching you Jonathan!) and comments. I thought I'd write about my cancer, but honest to God I'm healthy. I have some issues every once in a while, but they're usually all in my head. What I'm left with is a rambling of whatever is bouncing around in my noggin and that's typically pretty weird.

That weird stuff is what worries me. So many people get online and use their blogs as a personal diary (making them diarrhea). They just get on here and spill their guts out for the whole world to see. Maybe that's nice for them, but c'mon... nobody else wants to see that. And it's amazing how many people do that--just click on the "next blog" at the top of this page.

I've been trying, sometimes successfully and sometimes unsuccessfully, to stay away from that diary feel. I've tried to put things together so that people can understand what this is like and so that other folks with cancer can understand the ups and downs that it puts you through, and how that's normal.

The other thing that people tend to do is try to be funny in their blog when they're very, very clearly not. I'm one of these people. I try to lighten the mood and painfully put out whatever I think is funny when I'm sitting alone unable to sleep on a weeknight. It almost never works and I'm so sorry for wasting your time by having you read it. I will, however, continue to do so.

Next Blog!

Monday, August 20, 2007

Some more thoughts

Here's a thought on cancer. It blows. It's not fun, it's not funny, and I definitely can't get away from it. I thought of a some nice anecdotes to descibe my experience thus far. Cancer's like a joke that is too drawn out and doesn't have a punchline. It's one of those situations where you want to laugh and say "hey, remember when..." but the times you want to laugh at aren't funny. I've had a hangover for seven months and despite what you may think, actually getting a hangover doesn't reverse the effect, it just makes it worse.

No, I don't have any bad news. I'm just tired, cranky and am not getting enough studying done. I'm just sick of this nonsense.

Saturday, August 11, 2007

just in case you were wondering...

Just in case you were wondering, these depressing sorts of posts tend to come in about 4 week cycles. That's because the Temodar (the chemo that I'm on) comes in 4 week cycles and it depresses the hell out of me. Ech. So don't mind me, I'll just crawl in a hole and die for the next week. Hopefully then, I'll reemerge happy and go-lucky. It'll be like a polar bear or the phoenix of legend.

Until then, peace....

Mike

It's all fine and dandy...

When I interviewed for medical school, my second interviewer gave me one of the questions I thought was the best of my interview trail. He asked, "if you were stricken with a terrible illness during your time here, would you continue with your medical education?" Ignore for a second my current situation; I thought this was a particularly good question because it obviously highlighted the students committment to medicine and their resolve to complete the degree irrespective of the challenges they might face. I answered "absolutely," with no qualifiers, and he thought that was an excellent answer. Clearly, I got into the school!

However, it's never quite so simple. Medical school isn't just about passing, failing, and earning a degree. You work with real people, real patients, patients you can hurt. This is a conundrum that medical education faces constantly. We can talk about how many safeguards there are when medical students are doing the operating, but do you really think if the chief of surgery's own kid is splayed out on the table a medical student is going to make the incision? There is an inherent risk to having medical students at all in an operating room, learning any procedure, or participating in a clinic. But we accept that risk (knowingly or unknowingly) because it's necessary for future generations to have doctors at all.

This is all fine and dandy and is the subject of chapters if not whole books on medical education. However, the whole idea presumes that medical students are continually getting better and more adept at their chosen profession. What do we do then, if a medical student isn't getting better? What if the illness my interviewer talked about affected my abilities to do manual tasks, to understand instructions, to learn? How will I know when it does?

My fear is, whether I'm just biding my time until that happens with none of the benefit for patients. While I don't believe I have the problems above, I am well aware that they could pop up very suddenly and at any time. What I'm not willing to do is put patients at unnecessary risk. What is their benefit from me being in the clinic or the operating room? If I make a tragic mistake, where is the benefit I could point to that says, "I needed to be there?"

My point is, as I walk into the wards a year from now with as little responsibility as I will have, I still can cause a "screw up." I know every medical student can, and likely will, cause a "screw up." But if I allow that to happen just because I'm too proud to give up my education for a brain tumor, how is that okay? The current answer is that I'm not just being babysat. I'm like every other medical student going on to become a doctor. That's the thought that keeps me here now.

Either way, maybe some qualifiers would have been wise on my interview three years ago. Or at least I could have thought about how unbelievably hard that question has proven to be.

Mike

Saturday, August 4, 2007

Scrubs

It's funny how we find inspiration. Some people find it by looking to inspiring figures; presidents, heros, parents, and... well... whatever historical figure you can find in the encyclopedia. Others look to imaginary characters like Dumbeldore and Snow White. Doctors tend to look to something more profound, more deeply moving, people like those on the smash hit TV show Scrubs.

We* fall into the following categories or rather, category. Every last med student is a JTurkCoxelTonIot D Reed, MD. The name is eastern European. We are all very strange like JD... drifting off into our.........

Turkelton tends to bring out the cool surgeon in us. We want to be calm and cool and collected, yet still geeky under our scrubs, and who know all "the Bunch" episodes. How did that become cool? Plus he's been with Carla and you've got to love that. Chris Turk is the man.

Cox is the doctor we all want to be, but we never ever ever ever want to be. He seems to know all of the board questions, can PIMP anybody on anything, but can never seem to end a goshdarn, run-on, overuse-of-the-commas-and-hyphens, uselessly insulting for the recipient, who is clearly not paying attention because he's so bored with this 10,000'th rant, and how many times can he call me a girl's name, oh God please love me Dr. Cox. Uh... what?

Eliot. I don't have, like, anything to say about Eliot because I'm, well, nothing like her. 'Cept she's, like, totally best friends with Carla and Carla is smokin'. Oh yeah, and Eliot knows everything and is completely insecure but we already have somebody like that (see above).

I didn't mention Dr. Jan Itor, The Todd, or many of the other characters because, well I'm tired of writing now. In the end, we all find our inspiration in those most importortant people, television characters. Really, they all represent the good and the bad in us medical students. And good and bad and the ins and outs and in and out and in and out. High five for the stretch on the sex joke.

And I love Carla.

J.D.

* med students = doctors... Scrubs doctors! duh

Saturday, July 21, 2007

American Chestnut Tree

Considering that last post was kindof serious and considering I’m no longer in such a serious mood, I thought I’d post something funny or interesting. First of all, the fact that I’m in a good mood is entirely weird. I spent the first half of the day locked in a room with a bunch of dead bodies and their spinal cords. Surprisingly, that put me in a good mood. Make of that what you will.

I should tell you about the American Chestnut Tree. DO YOU know about the American Chestnut Tree?

Prior to the 1900’s, there existed a tree that dominated the eastern United States. It accounted for one in four trees in the Appalachians. The American Chestnut Tree was a major cash crop as it could be used for fence posts, furniture, sticks to hit your brother with, flooring, and bar tops! It was also a beautiful wood for those of us who like woodworking. And they were huge. They could be over 100 feet tall and 10 feet in diameter. They were the Giant Redwoods of the East.

Linked from the Forest History Society Image Database

The chestnuts were apparently amazing! Ever heard of the song “Chestnuts roasting on an open fire?” Well it’s about the American Chestnut. I guess they were sweet and you could either roast them in the oven or just pluck ‘em off the ground.

But then in 1904, in New York City*, they introduced** the chestnut blight. Cryphonectria parasitica was just a common fungus and native to the Chinese Chestnut, which is the tree most people have nowadays.*** However, the American Chestnut was overwhelmed by the non-native infection and the entire population of 4 billion trees was completely decimated in a few decades. Deforestation and replantation over the years has eliminated almost any trace that the trees even existed. It makes national headlines when a single tree is discovered nowadays.

There are several efforts to cross breed the American Chestnut Tree with the Chinese Chestnut to get the resistance mechanisms and maintain all the other characteristics of the American Chestnut. It takes a long time—at least five years per generation—and there aren’t very many people who know enough to miss the old giants. The effort is small, but it’s there, and in several years they’ll have trees to start repopulating.

There ya go. Now you know about the American Chestnut Tree. At least I didn’t tell you about my fun morning alone in the Anatomy Lab… egh.

Mike!

* damn city dwellers
** “ooh I swear it wasn’t me… it must have been Jersey”
*** it’s a weakling… tiny, poor wood, and the nuts don’t taste good… yuck

Thursday, July 19, 2007

Uncertainty

My Mom said something to me today. She said that we can so easily become lost in the things to come that we forget to focus on what we’re doing now. I suppose I’ve been doing the former at the expense of the latter. The most difficult problem with my cancer has been that I have been so focused on the future that I’ve often stopped enjoying the moment.

Your response might be that all medical students are like that. Perhaps mine are expounded because I’ve had to take a half-year off and have all the time in the world to ponder my situation. But I don’t think that’s that case. I don’t just think about how hard school will be; I’m terrified that I’ve lost too much cognitive ability to do it at all. I don’t just think about residencies; I think about residencies I can go into with my disease. I don’t just think about whether I can provide good care; I worry about hurting patients down the road. I could go on and on and write a book about each of them. They are very real concerns and I will come to face them sometime.

I’ve always been one to plan ahead. If I thought about something long enough, I’d come to the right answer. No matter how big a problem seemed to be, no matter how many there were, I could always just put a little bit of time into it. Now, I’ve spent months looking at so many uncertainties without any logical answers. Without having had realized it, I’ve driven myself into a really bad place. I’ve considered not providing care, not attending residency, driving back home and not doing school at all.

My Mom in her sweet, unassuming sort of wisdom sprung the idea on me that it’s okay to leave extremely important things uncertain. It’s fine to proceed without having any idea how you’re going to deal with the later stuff. I don’t have put “a little bit of time into it,” not because those things are unimportant, but because I can’t answer them now. And I guess that’s okay too.

Thanks Mom.

Wednesday, July 11, 2007

Shortest Post of All Time

This'll be my shortest post ever. Both the solid tumor and the cystic part shrank during the last month! Woohoo!

Also, we're approaching the landmark of 1000 people having had visited this site since it's inception. While I thank you very much for your support... the internet has many more interesting things out there. Look up youtube.com. It's interesting too.

Mike

Thursday, July 5, 2007

Putzing Around School

Hey all...

Sorry I've been so neglectful of the blog, but there's just not much to say! My brain is pretty normal (well, normal for me haha) and the tumor still stable. I'm going to have another MRI tomorrow, moreso to ensure that I'm okay to reduce the steroids (I'm on dexamethazone) than anything.* Losing the steroids will be great because they are the reason for pretty much all of the ill effects of my drugs.

From here on out I hopefully will have the MRI's on 2 month cycles rather than 1 month. If there's anything going on in my pretty little head, I'll know before the MRI does and can alert the doctors.

For all of you who have seen me around school moping about... looking lost and sad and confused... there's actually been a reason for me being there besides me pretending to be a third year. I have been getting research started in the neuropath department, maybe some with a neurosurg resident (I haven't heard back from him yet), going to grand rounds, and have been observing the Neuro Oncology Tumor Board, which hopefully I'll help manage in a few weeks. So really, there's a reason for me to be there other than steal your cookies and cranberry juice.

I can't really think of much else to say. Maybe I'll amuse you with my musings at another date. For a blog that's supposed to be about my cancer, I thank God there's not much to say. Perhaps I'll expand further into other topics... such as why I spent 4 hours today listening to my heart beat on the stethoscope and waiting for somebody to page me on my brand new pager. My mom did once I asked her to. And my brother. How sad.

Mike!

*For all you medical dorks out there, the dex reduces the mass effect from the tumor. On my last MRI the mass effect appeared to be going down and I feel significantly better... so we're gonna reduce the dex and hopefully drop it.

Tuesday, June 19, 2007

To Houston and Back

Hi all,

My parents and I went down to Houston and it was pretty much what was expected. The doctors looked at my record and saw that everything was working fine. The tumor hasn't grown, the temazolamide is reasonably well tolerated, and I'm neurologically intact. They said literally, "if it ain't broke, don't fix it." I agreed.

For some interesting statistics about my trip (gulp). Here are the final totals:

I traveled through 21 different states from Chicago to Colorado to California to Washington to West Virginia and back to Chicago
put 8043.8 miles on my car
burned 245.992 gallons of gas
spent 795.93 dollars on that gas
which actually left me with an impressive 32.76 miles to the gallon! On a 10 year old car!
The gas cost an average of 3.260 dollar/gallon ranging from 2.579 in wonderful Wyoming to a whopping 3.689 on June 3 here in Chicago.

That made me tired just thinking of it... yeesh!

Monday, June 11, 2007

From West Virginia to Chicago

After that long drive to West Virginia, I needed some R&R and there was no better place to get it. We spent two days at home, four days at a nice cabin on Bluestone Lake, and two more days back home. The first two days were nice and relaxing as Memorial Day weekend should be. We went up to our family plot to visit the relatives and my Dad gave us the rundown on who they are. Probably we should learn that too, but it's fun to see him get so excited!

Bluestone Lake was pretty exciting too. We finally caught some fish as you can see in the picture to the left. I guess large mouth bass have to start somewhere! And damnit... we'll catch 'em when they're that young. Catch and release of course.

We also had some of that salmon that I brought out from Seattle. That was deeeeeelicious. But enough with the food references.

The Friday we got back from the lake I took my car over to get the brake lights fixed (they had been out for pretty much the whole trip) and the window sticker updated. I also went to see the DMV to get a breast cancer awareness lisence plate. Why, you ask? Because they don't have brain cancer lisence plates, so I chose the closest thing to my mind...

Anyhow, the brake lights, the sticker, and the plates went fine. But when I got into my car after they finished up, the check engine light was on. Now it's even weirder than that. I had him take the car back and run a diagnostics check on it. It said the oxygen sensor was bad in the exhaust. Huh? The exhaust is definitely nowhere near the brake light switch so how could I blame them??? I couldn't, so we ordered an oxygen sensor (one expensive SOB). An hour later, it arrived and they plugged it in and they still had the check engine light for the same reason. Unfortunately, now it's closing time and the boss had gone to his daughter's softball game. They sent me on with my car, but without charging us for the O2 sensor.

Okay, well whatever. I can drive back to Chicago with a bad O2 sensor. Or at least that's what I thought. About a half a block away from the car care place I notice that none of my guages are working. Not the speedometer, the tachometer, nothing. Thirty seconds later... the car dies. It's completely dead with no electrical activity at all. I manage to get the car pulled off the road and call my house.

I'm supposed to go up to Chicago on Sunday to have an MRI on Monday. It's now Friday night and we have to find someone to fix my car on a Saturday. Egh. One of our finest friends, Danny, is a retired car fellow who's been in the business for longer than my parents have been alive. My Mom calls Danny to come rescue me and he sure does. He puts enough charge on the battery to get me to his house where we can make an appropriate diagnosis. When we get there, after much hemming and hawing, we (read: Danny) determined that it's either the voltage regulator or the alternator... and they're both in the same unit. Fortunately, he said that once we got that replaced, everything else would fall in line.

We actually managed to find a shop that was open Saturday morning, they replaced the alternator, and we managed to drive on back. Danny was absolutely right about everything falling back into line. We got sent out from the garage with a bad O2 sensor and it turned out to be the alternator... go figure. What I still can't figure out is why the heck the thing started happening when it did. I just took the car in to get the brake lights fixed!

That Sunday I drove back to Chicago, uneventfully, and got settled in. The MRI hadn't changed a bit since the previous one, which is phenominal. My speech problems are non-existant now and I feel better than ever. I've even gone to the gym a couple of times and while I'm a pile of dough, it feels good to be working out again.

Tomorrow, I'll go down to MD Anderson to meet with the neurosurgeon and neuro-oncologist down there. The neurosurgeon will probably say, "what do you want to do? Surgery or no surgery?" And I'll probably say, "no surgery." I'm not sure about that, but I can't bear the thought of another 6 months of recovery for limited benefit. I'll let you know what happens after.

Mike

Friday, June 1, 2007

From Seattle to West Virginia...

I suppose "tomorrow" didn't work out so well... sorry!

Anyhow, my cruise out to Seattle was very cool. Katie (my sister) and I ate at this Paco's or Potato's or Peso's (I can't quite remember) three times in two days! Why'd we do that? They had these breakfast and dinner happy hours that you just couldn't beat! We had crab benedict for breakfast for only $6. Holy crap and I love breakfast.

Speaking of food... we also ate at this Greek place that was also amazing. Apparently they're open whenever they feel like it and fortunately they were open when we were there. With my sister's friends we drank two bottles of wine and downed countless appetizers. It was great fun!

Finally on the menu (can you tell a theme?) was some of the salmon from the fish market. Copper River salmon was some of the finest I've ever tasted... fresh from the river and into our mouths! It was so delicious I decided to take some back to West Virginia. Yummm.... Maybe I can order some to take back to Chicago.

Anyhow... zip! I drove all the way back to West Virginia. That was pretty aweful because all I did was drive, then drive, then drive some more. When I got tired of driving, I still drove some more. Four full days of driving on interstates... but 2600 + miles later I arrived in West Virginia.

West Virginia will have to wait to a later date. Hahaha... maybe tomorrow!

For those of you who want to know about my GBM... no news is good news! I still haven't changed in form or function. That's as good as I can be!

Mike

Saturday, May 26, 2007

On Up to Seattle

Well, I've made it quite a round trip from Colorado, to the North Rim of the Grand Canyon, to Seattle, and all the way back here to West Virginia!

After spending Mother's Day with my Grandma in Boulder, I drove down to Glenwood Springs to fly fish some. I love fly fishing, but I'm terrible at it. I walked into this fly shop and the guys told me what to buy and where to fish. I didn't catch a thing. Oh well... the beautiful scenery and calm mountain air was good enough.

My rusty steed and I then headed south to the North Rim of the Grand Canyon and I got there just as the sun was setting. You haven't lived until you've seen the sun set on the Grand Canyon. The next morning I woke up to find the same site to the East and just as breath taking. On to the Redwood Forests!

That took me up toward Salt Lake where I hung a left onto Interstate 80. Now, I thought this would be a pretty boring part of my drive, but let me tell you, it wasn't. Western Utah is by far the strangest place I've been. The ground is white as snow; apparently it's entirely salt. People find these black rocks to write illegible messages in the salt. It's completely absurd. As far as the eye can see in any direction there's nothing but salt. No plants. No animals. No hills. No people. No nothing. Wild.

Oh yeah, in the middle of all of this I came upon a huge, manmade thing. As I'm heading down the road, barely speeding, I'm inspecting this giant contraption and thinking... "Well, is it artwork? Yeah sure... must be." Then I almost hit the guy in front of me who had almost stopped because of the... um... artwork. Fortunately, I didn't hit him, but I was inclined to stop barely speeding.

I finally made it to the Redwood Forests in northwestern California. Those trees are absolutely beautiful. I was kindof filled with mixed emotions though. While those trees were enormous, big enough to drive through, bigger than any tree I've ever seen, the stumps left from the loggers were even bigger. They were larger than my imagination. Interestingly, they had sprouts coming from them. They are the 800 or 1000 year old trees, cut down in their glory, only to spring forth new sprouts from their roots. The sprouts aren't very big yet... but wait another 800 years!

I went to Seattle next to visit me sister for the next few days. That'll have to be next time... perhaps tomorrow. I'm going to bed now. For all of you who are board studying, best of luck!

Mike

Tuesday, May 22, 2007

Life and Death in the Southern United States

Lord, make me an instrument of your peace,

Where there is hatred, let me sow love;
where there is injury, pardon;
where there is doubt, faith;
where there is despair, hope;
where there is darkness, light;
where there is sadness, joy;

O Divine Master, grant that I may not so much seek to be consoled as to console;
to be understood as to understand;
to be loved as to love.

For it is in giving that we receive;
it is in pardoning that we are pardoned;
and it is in dying that we are born to eternal life.

-The Prayer of St Francis of Assisi-


I was riding down US Route 47A on a beautiful Sunday morning when a young girl stepped out to wave me down. When I asked what was the matter, she said "are you a doctor?" "No, but I am a medical student." She pointed down the road a few meters and said, "go there."

I saw the truck first, then the old man thrown out of the truck. There was a small croud of people around him trying to hold him still. He was conscious, but clearly completely unaware of his surroundings. I asked the guy next to me to try to maintain his c-spine and we waited. The others had already called an air-medic for transport.

That's when things started to go really bad. He stopped breathing and the two people feeling for pulses, stopped feeling them. He vomited blood. I tried to clear the vomit and start CPR. Airway. Breathing. Circulation. Those become so confused when you're staring down at somebody who needs them. I started to do compressions, then mouth-to-mouth, then compressions, then he'd throw up blood. Somebody said later that lasted just 8 minutes. There was no greater eternity when I had no idea what I was doing. 8 minutes.

That's when the air-medics landed. You would think that I'd remember them landing, but I don't. She handed me a BVM so I could stop with the mouth-to-mouth; I have never loved a person more. I continued with the airway, another guy took over the compressions, and the air-medic tried to put in some lines. She had trouble with the lines because apparently his humeri and his femurs were broken. All of them. I hadn't even noticed.

We continued until they attempted to put in an endotracheal tube. They tried twice and then switched to a combitube, a tube that will enter both the esophagus and the trachea. By this time, something like 20 minutes had passed since he stopped breathing and stopped having a pulse. There was blood coming from his ears. The EKG on him said asystole. That's not a shockable rhythm. Shit.

The air-medic called it. I guess they can call it in this state. That was it. He was dead on the side of the road. I'm kneeling beside of him like a vulture, covered in his blood from my mouth to my shirt to my jeans. My knees burned as I stood up. I didn't know what to do. While once he was alive, now he is dead. I asked for an alcohol whipe for my face.

After I got cleaned up and changed my clothes, the flight nurse came over to say thank you. We hugged afterwards. I don't know if that's standard procedure, but it was nice.

Now, what do I do about my obvious pathogen exposure in my obviously immunocompromised state. Yikes. I've gotta say I normally wouldn't care, but I just stopped a round of temazolamide yesterday. So, I went to the local ER and called my own oncologist. The ER had a Physician's Assistant on duty who really didn't know what the deal was and my Loyola oncologist was in a conference. So I had to wait about 2.5 hours for my oncologist to give me a call and say it's not worth taking the drugs.

I don't know whether I did the right thing with this patient. I'm writing this as I'm trying to work them out. Did I get his airway open; there were times when it wasn't open enough. Did I do compressions right; sometimes I just lost count. I didn't maintain his c-spine when I was trying to clear his airway. I can't stop thinking about it right now, as much as I try. I guess I have to go back to that original conversation with the young girl. "Are you a doctor?" "No, but I'm a medical student."

I'm not a doctor.

Saturday, May 5, 2007

Continuing the trip...

Hi all,

My road trip has gone spectacularly so far. I went up across South Dakota and Wyoming, which I had mentioned before, but which was far more amazing than I can describe here. I can just say it's breathtaking... other than that you have to see for your self. Next I spent some time in Boulder and Colorado Springs. That was amazing because I got to see my family and even my new cousin... the future Dr. Shea. Then, my mom & her kin got up and went down to Santa Fe with me, which is where I am now!

In the future, I fly back to Chicago for a few days around 5/10 and then back out to Boulder. I'll then traverse the country westward and arrive in Seattle for a few days around 5/20. On 5/23 I'll go back to other direction to arrive in West Virginia and spend the memorial day week on a lake. I'll head back up to Chicago around the 4th of June.

In GBM news... we finally got the call from MD Anderson to tell us that my tumor is V3 negative. I actually took quite a bit of relief knowing this because it means I don't have the most aggressive of tumors. However, that result means that I'm not able to have the viral vaccine. That may seem disappionting, but I'm actually quite pleased with it. We'll wait until we think about it some more to decide whether to have to surgery in June...

Most importantly, congrats to all who finished their finals and are entering boards study time!

I'll try to post more later...

Mike

Tuesday, April 24, 2007

On To Summer Break...

Hey all,

All of you here at Loyola are probably starting to get into your finals and then onto your board review stuff. That's excellent, but it means that I need to stay away from your laps. If I don't see you again until late July or August, it's been an unbelievable trip working with you. Especially, Boyce who completely I missed his birthday (damn)! If all goes as planned, I'll be back in August to audit the classes then take them for real in January.

My plan thus far is to go on Thursday or Friday out to South Dakota and Wyoming to see some very rural areas and then head south to Boulder, CO for my Grandma's birthday. My poor grandmother hasn't seen me since all of this happened. Anyhow, hopefully I'll get to see the entire Colorado contingent of my family who I miss an aweful lot.

Then I'll need to be back here on May 10 to routinely chat with my oncologist here. I don't expect anything to be a problem there. After a day or two I'd like to head back and spend some time with the family and my brother who will be in West Virginia. I've got to say I still cannot believe I haven't been up to see him at school (in Pennsylvania)... but I guess there'll be time for everthing. I'd also like to spend some time out the Seattle with my sister, who I also haven't seen in her Seattle self. Anyway... that'll be for the roughly 1 month after I see the oncologist.

From there on, I'll have another MRI around the beginning of the month (of June) at Loyola, have lots of appointment, and go to a great wedding; congrats Jenn! I'll also go back down to Houston to see what this neurosugeon has to say again... I don't know what he's going to say, but that's an aweful long way off to be thinking about it.

After June 10th ish, I don't really know. Surgery looks like a good possibility, but so does another big road trip. Who'da ever thought I'd ever say that? Hopefully everything will all be peachy and I'll go on from there. I'll probably be slowing down on these blogs as an update for my GBM... it's just not too exciting right now. Hopefully, I'll keep it like that!

Peace, and all the best!

Mike

P.S. If you're one of the poor, unfortunate souls who lent me some items way, way, way back in January as a generous giving but expected them back... you'll have them shortly. I'll put them in my Loyola locker... which I think is #20 in Curie. I'll let you know when they get there.

PPS!!! The Loyola locker is loaded, but it is #40 in Curie. Thanks a bunch!

Wednesday, April 18, 2007

Irregularly Irregular

I've come to realize that I bunch you don't know how the treatment process is supposed to work. Please allow me to explain. We'll use a completely normal Glioblastoma Multiforme in the Sylvian Fissure to explain it first and then we'll move on up into mine.

The Sylvian Fissure is the groove that runs horizontally along either size of your head. It separates several of the lobes of the your head from the temporal lobe. Most importantly, it ends towards the back end in the Broca's Area. Inside the Sylvian Fissure if you go deeply, you'll find the middle cerebral artery, any one of the branches of which can cause a major stroke. Back to this shortly....

Now, imagine yourself hopping along one day and you have a funny feeling in your arm. It doesn't hurt; it isn't numb; it's just this kindof strange sensation. Furthermore, it just lasts 15 or so seconds then goes away. It happens two or three times a day. You embarrassingly go to your doctor, quite sure that this is a problem about your tests coming up in December but you're scared enough that you want to talk to him anyway. He gives you a thorough exam and he tells you that he does't think he should do something now, but if you have more problems come back in roughly a month. I can't imagine anywhere he could have done better.

A month later he sends you off into neurology clinic. Here's where I'll deviate from my story a little bit. All the drama happens just like mine, but on Wed. they decide to go ahead and take the tumor out. The tumor is clean and they appear to have all of it and they close the head back up. The patient continues to go on radiation as well as chemo and after one month the MRI appears good. This patient will still continue on 23 days off and 5 day on temodar pulses for the forseeable future. The pulse is double and/or triple what the temodar was during the radiation.

During the patient's surgery, the tumor appeared to be before the MCA and entirely within the Sylvian Fissure. That made it super easy to take out. Mine, unfortunatly, is below the MCA, is large, and is difficult to take out. It has several groups receive branches from the MCA, which it's behind. In order to take it out, you'd have to split that fissure wide and risk damaging Broca Area, as well as taking the chance or damaging or stroking the MCA.

I haven't found which direction I'm going to go. I didn't have the surgery, but I did have the radiation and the chemotherepy. I even had my first pulse! I can have the surgery if I wan't to... but I just don't know yet. I probably repeated everthing I said before, but I really don't care... maybe this is just a good way to go out and vent!

Peace,

Mike

Thursday, April 12, 2007

Back at it again!

Hey all...

I dropped my parents off at the airport a little while ago and I'm sitting back here for the rest of this Thursday afternoon. My sister also came into town, which I think was the best thing for all of us because the tension was so high as we waited for the MRI Monday and Tuesday morning. Katie (my sister) makes us laugh so much that it was a riot to have her in town.

Anyhow... the MRI went spectacular, both in my execution (ah thank you), and in the doctor's reading it. They said that the darker brain mass... that is the glioblastoma multiforme... had shrunk down to nearly 1 cm in diameter from just over 3 cm in diameter. Heck yeah that was exciting. Even Dr. Barton who never says anything positive was excited about that. For comparison, usually on the unresected tumors, there's either some minor shrinkage, no change, or growth. That can be sad... and that's what I was kindof preparing myself for. Fortunately, I have the above situation.

For those of you who are wondering what that 1 cm block is, it's still GBM, we just haven't any idea whether it's still alive or shrinking or completely dead. I guess we'll get a good look at the next MRI in 8 weeks.

Unfortunately, that doesn't mean I'm off the big gallows yet, but I sure as shoot am happy for right now!

Mike

Thursday, April 5, 2007

Easter & Them Egg Layin' Bunnies...

Hi all!

I've taken these two days off before Easter Weekend to take a road trip out West. Hopefully, this'll be the first of many! I really enjoy road trips and this is the first one where I have no idea where in the world I'm going. Usually, there is some semblance of a destination in mind, but I haven't the foggiest idea of where I'm going tomorrow. Shoot... other than La Something, Wisconsin or Coreanything, Iowa.... I don't even know where I am now. I really kindof like it... who'da thought?

Anyhow, I should be back on Saturday to get my folks at the airport. After Easter we have a handful of tests Monday, then we meet with doctors on Tuesday and Wednesday. Then, I'll be back at school Thursday or Friday next week.

The handful of test are the MRI and some associated blood work. The standard of treatment is to give the radiation and chemo, then follow it with an MRI a month after to see where you are. The reason being that you want your radiation to have plenty of time to settle with regards to the swelling as well as to give it time to work.

The reason I really don't particularly care what this one says is that 1: according to the first one, I should have been on the floor drooling, and 2: I already saw the one that they took at MD Anderson and it looked pretty good. Perhaps I should be a little more nervous, but I'm just not.

All the best!

Mike

Saturday, March 31, 2007

Sweet Home Chicago!

Hi all...

I'm back in Chicago after a great week home in West Virginia. The weather was warm and it smelled and looked like spring. Who can complain about that? I even carved half a bowl!

As many of you know, we also went down to MD Anderson to check out the prospects there. My tumor is on the left half of my brain in the insula/sylvian fissure region. This makes is extremely difficult to operate on and along with my high level of functioning, it's why the neurosurgeons here decided not to do a craniotomy. That is, their entry route would have been through the Sylvian fissure and it would have been extremely difficult to preserve my speach.

One of the reasons I went down to MD Anderson was to speak with Dr. Lang, who is very well known for this ability to take out these tumors. His general opinion was that it was possible to resect, but that he still had the same reservations that Dr. Prabhu and Dr. Shea had here at Loyola. His inclination, to which I eventually agreed, was to wait 8 weeks until the radiation had taken some time to do its stuff, namely reduce the swelling and shrink the bastard.

My whole problem with waiting is this. I want to have taken the biggest swing at this as I possibly can and do it now. I realize there's a risk (a large one at that) to my speach and to my cognitive abilities, but if I want to have a chance at continuing my career in medicine I need to be recovered by the middle of July. If I don't have the faculties to come back, that's okay, but I will have given it my damn best shot.

The other reason I want surgery now is for a slew of trials. The whole glioblastoma multiforme world stood still for about 50 years as they failed and failed and failed to create treatments. That all changed about two years ago when a few agents showed promise. Now, that means they're all in phase I and II trials now, which means I have to fit their protocol amost exactly to get the treatment. That means surgery if I want to have a shot at these things.

Anyhow, so we decided to wait 8 weeks until we can see another MRI. Now I'm back here and I'll audit classes (to see how my own cognitive ability is coming along.) I'll probably miss a good portion of the classes for Drs. appointments and road trips, but that's all good by me. And you can be sure that I'll be out of your hair by the end of April so that you can get excellent board studying done!

Anyhow, peace out!

Mike

P.S. It's come to my attention that there's some distress about HIPAA and privacy laws with regards to my case. I want you to know that you are all my friends and you should feel free to speak to whomever you like and whenever you like. All of this and everything I've told you is free to talk about. I'd much rather have this crappy truth out there than crappy rumors. There is no HIPAA between us. All I ask is that you should respect people's personal feeling with regard to my situation. That is, if someone doesn't want to talk about it, just don't talk about it. Also, I appreciate my official medical record and people involved in my care to be kept private. Thanks so much!

Tuesday, March 13, 2007

Starting off on a new foot!

So I've finished with the chemo and radiation... which is daaaamn good! It's already one day past and I feel spectacular. I still have a little headache which comes and goes and I'm still a little tired... but all of that is quickly fading.

I spoke with the neurologist today and he reaffirmed that I'm clear to drive and (on alternative times ha!) drink. So pretty much med school is back on!! I'll just be shadowing classes until I pick up where I left off last year. All of you who are out there wondering... I should be back on April 2.

In the interim, I'll be heading out to West "by god" Virginia for a little relaxation and belated spring break. In the middle of that, I'll be going down to Houston to take part in a little fundraiser for brain cancer folks as well as a chat with some folks at MD Anderson who have some clinical trials.

Anyhow... that's the update! Take it easy!

Introduction

Well lets talk about the other top stuff. Basically, I didn't think there was anything wrong with me along my birthday last year 12-2-06. At 12-5-06 I started having some dysthesias along my right side. My Primary Care Practitioner felt that it probably wasn't anything, so he felt that I should let it go for a month and if there was anything thing still up, I should call him back.

A month later, the episodes were still happening so I called up my PCP to find out what to do. He felt that I could still go to see a neurologist. I got on for the next weekend. The neurologist also didn't feel like there was anything to worry about but there where something with my olefactory halucinations which made her curious. She scheduled an MRI for the end of the week. That MRI was on Friday... and Saturday would change my life for ever.

Ultimately, I have a Glioblastoma Multiforme. It's stage IV, the highest you can get. It's a primary brain tumor of the central nervous system, so the rest of my body is normal. There are a handful of things which we can do to help placate it... most of which we are doing now. I've been on chemo and radiation and and will be on those for another month or so.

So anyhow, I'm young and hopeful and I'm resiliant!!! I really appreciate everybody who's come to wish me luck... my stack of papers is just too high. All the best, and I'll keep updating this with the latest and greatest news from me. I'll try to alter it more than once a year! And yes... for those of you who are wondering, 2009 was a little too low... 2010 is quite for me!

Sunday, February 18, 2007

Test test... one two three...

I layed in front of the camera... creepy.