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!

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

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

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

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.