The Bright Side

As of today, it's been 10 days since my last run. For me, this is an eternity. I'll find out on Wednesday how long I'll have to wait before returning to the roads. So, in the meantime, I've been trying to find the silver lining in the whole thing.

Call me an optimist.

So, the bright side of not being able to run:

1. Recovery. I can heal, the incision won't split, my heart rate won't spike, the stitches won't come out, blah blah blah yada yada...that's a given. Moving on the more interesting things.

2. Time. Wow, running and training takes a lot of time! You don't really realize how much until you stop. I've been catching up on reading, schoolwork, blogging (yes, even blogging), podcasts, and especially playing with my baby girl...but in most cases (except baby girl, of course), I'd rather be running.

3. Toenails! What a novel idea. At least two of my toes are being-introduced to the concept.

4. Laundry. Okay, so I'm adding this one on Pooh's behalf, since I was banned from the laundry room about nine years ago. Let's face it, folks -- running generates a lot of laundry. At least two -- and sometimes three -- sets of socks and underwear a day, plus one set of sweaty/stinky clothes and at least one other set of clothes each day, plus uniforms...you do the math. And while we're on the topic, has anyone found a detergent that actually gets the stink out? I've tried WIN and SportWash, and neither one made any difference. Don recommends Pro-Wash, but I'm a bit put off by the price...other suggestions?

5. Hmmm. Ummm...shoot...

Okay, so I started this blog on Saturday with the title, "10 Benefits of NOT Running." I figured I could easily come up with 10 benefits of taking a break from training. I'm stuck at four, I've changed the title, and I need your help. What am I forgetting? Help me find The Bright Side! Six more...

Run For Your Life

So, recovery has gone very well so far. It's been nearly a week since my skull reconstruction, and I feel very good...the headaches are gone, I'm off nearly all meds (only seizure suppression remains), and not in any pain. We're not completely out of the woods, as there is still significant risk of infection or other complications, but we haven't seen any signs of them so far. I look pretty good too:

No real swelling or discoloration to speak of. I also maintained my track record of being discharged from the hospital early. So, five surgeries in, I got to thinking -- is having brain surgery something you just get good at? Is a procedure so invasive, injurious, and with such a high risk of complications something your body just "gets used to"?

No way.

What makes my body able to handle these procedures with relative ease? Why do I recover so quickly? Why have my stays in the hospital always been cut short? After removal of the right frontal lobe, why was my stay in the hospital the same as someone who had their tonsils removed? Why am I still the only brain surgery patient in the recorded history of Cedars-Sinai Medical Center to skip ICU completely? How can I have brain surgery and run a half-marathon six weeks later, or train for and run a full marathon while undergoing twelve months of chemotherapy? I've discussed this with my neurosurgeon here, and with those at Cedars and elsewhere...and the answer, quite simply, is fitness.

You all know by now that I'm a man of strong faith, and I believe God has preserved me in this world to serve Him and testify on His behalf. No doubt in my mind that plays a role. But, to bring this blog to a close, let me say it quite clearly:

I believe fitness -- running, in particular -- has saved my life. After my first surgery, I made a decision to put my body in the best possible physical shape to fight cancer, and I think much of my success in the fight is a direct result of that decision.

Would I have made it through five brain surgeries if I had been out of shape? What about 22 rounds of chemotherapy and 42 rounds of radiation? Had I not been in marathon shape through all of it, would I have recovered as quickly? Likely not. Would I have recovered at all? Who knows. Would I even be alive today? Perhaps not. A few months ago, I watched the movie "Run For Your Life," the story of Fred Lebow, the founder of the New York City Marathon. The title of the movie indicates that running defined him, and was his primary reason for living. For me, it's not my reason for living -- it's the reason I'm alive. Don't miss the difference.

Alive and Well!

Hello faithful readers and supporters! It's me, Mike -- out of surgery, out of ICU, and on the recovery floor. Now, if only I could convince the docs to put me on a regular diet and stop the IVs! Yes, I'm still causing problems...but in a good way.

From what I'm told, surgery went just fine. There were some delays initially, but once surgery started it went without any difficulty. ICU was, as always, a difficult time -- you're disturbed every hour for a neuro exam, and you're hooked up to every machine imagineable -- so sleep is basically impossible, and that's all you really want to do. To make matters worse, I was setting off alarms every few minutes -- if your heart rate drops below 60 beats per minute, or if your respiration rate (breaths per minute) drops below a certain number, it sets off an alarm. As many of my endurance athlete friends know very well, a heart rate under 60 beats per minute is quite common for us -- a resting heart rate of 44bpm, in my case. So, even if I could get to sleep for a few minutes, shortly after nodding off my heart rate would drop into the low 50s or high 40s, acting like an alarm clock and waking me up, not to mention the nurses and orderlies rushing in to see what was wrong. Same thing with respiration rate. Well, I guess I've found the downside of being in shape. All this to say that last night was a very long, very restless and very uncomfortable night...but I made it!

The biggest victory today was the removal of the EKG leads and the Foley catheter. With those two things gone, I actually have freedom to move and walk around...even run, if they'd let me! I'm up on the patient recovery floor now, where I have a TV and my own room, without the hourly wakeups and heart rate/respiration alarms. Much more peaceful and restful. I've spent most of the morning napping, and now I'm in the lounge on one of the computers furnished by the Wounded Warrior project. Yes, I'm on the Wounded Warrior wing again -- these guys are just incredible! I even had lunch next to a guy who had lost an arm to an IED. Please support this foundation if you can, and say a prayer for them. Hereos, every one.

So, the goal is to be home in time for the Duke game tomorrow night at 8pm. Any bets? Also, it looks like I'm teaming up with a few friends for my next race...the details are still in work, but stay tuned! Potentially big news shortly, if we can work it. Stay tuned, and thanks for your prayers! Pictures soon, I promise...

And the winner is....

Whew-what a long day! For anyone who has had a loved one undergo surgery, you know what it's like to "wait" and waiting is what we did a lot of today.

Starting at 730am, Mike checked in, changed into a "beautiful" gown and was sent to the "holding" area. Yes, we were definitely in a military hospital this time. No fluff, no pampering, just "get it done". Once settled there, the doctor came in and told us that Mike's surgery had been bumped (much to his dismay) until noon. We were heart-broken. Mike was hungry, tired and begging for coffee. The neurosurgeon is outstanding and was very upset that the hospital had rearranged his schedule, but he was going to do his best to get Mike in early. With a 3 hour wait looming on us before they even came to get Mike, my dad and I decided we'd venture off for some breakfast of our own. Mike welcomed the quiet for some much needed sleep. We returned right at 9am, to find the "orderly" there to take Mike back to surgery. Great news for us-no more waiting for the day to get started!

Once again we said our tearful good-byes and parted ways. Now mind you, we have been smack dab in the middle of Beverly Hills for all but these last 2 surgeries and believe me, the thought, "Todo, we aren't in Kansas anymore" comes to mind. We headed to the "waiting room", which was crowded, loud and HOT! After two hours, which felt like seven by now, my dad and I headed to the desk to see if Mike's case had even begun yet. 11:45am: "yes, they just took him back"...Great news, again, no more waiting on the surgery to begin...

We decided to go downstairs and walk around. An hour later, while talking over lunch, we see the neurosurgeon walk by. I shouted to him "Hey, aren't you supposed to be in surgery?" but, he didn't hear me, so we decided to "follow" him. The whole time thinking "Is Mike already done? Did another surgeon "open" for him? Has he NOT even started yet?" Very confused at this point, we lost him, so we headed back to the desk. This guy must have thought I was nuts, but he politely told me that "yes, they were still "in" there!" Okay, back to WAITING!

Oh the waiting...sleeping, eating, talking, eating, watching TV, reading, eating, praying. Yes, there is a definite pattern here-eating. I eat when I'm bored and nothing was filling that empty, worrying void. Yes, praying helps, but your mind does these weird things. I was SO tired of waiting...

Finally, 230pm: "Mrs Moyles?" "Yes". "Let's step out in the hallway..." (gulp-even knowing this is standard) "Mike did great, he's in ICU, awake, semi-alert and almost completely out of anesthesia." WHOA--what a great surprise. The neurosurgeon had decided to wait an hour after surgery to come tell me things were fine due to the high risk of stroke in "head surgery" patients. Mike had not only come through the surgery fine, but was already well on his way to recovery. The "plate" fit perfectly in the forehead and the skin came together beautifully. The crown is a bit higher than it used to be (says the surgeon), but who cares...he's fine! :) He has a pump, to eliminate the fluid buildup. He'll be in ICU overnight and then to a patient room tomorrow and hopefully home on Sunday.

230: We got to lay eyes on him for the first time since morning. What a wonderful sight, bandages and all! Mike was awake (sort of) and talking. As usual, he wanted to be sure that I knew he was okay, so he says..."where am I?" I say "ICU". Mike-"What? They promised me NO ICU" (insert BIG pouty lip). I just laugh and say "oh dear, they didn't tell you that, but you can think that if you want." After giving the nurses some grief over being in ICU and doing EVERYTHING he can to bribe them to get out, he fell asleep!

I saw him one more time before leaving for the evening. Mike was still complaining about being in ICU and desparately trying to get some ice chips. A quick kiss good-bye and a few more reminders from Mike to get him out of ICU and we parted for the evening. Good luck nurses! :)

Oh, and more reason I know we aren't at Cedars Sinai anymore... 830pm: "Hi, this is Mrs. Moyles...how is my husband doing?" "hold on please"...(silence) "Mrs. Jones, he's resting now". "okay, but I'm Mrs. Moyles", "yes, he's resting now, we'll tell him you called-click!" Hmm... sure hope Mike gets the message! :)

We "Thank you" all for the prayers and support! We couldn't have done any of this without God and all of you. I will end with this....

"And the winner is... Mike!" Praise God for being The Great Physician and keeping Mike safe through another trying time.

Good night all and you'll hear from Mike tomorrow!

Round 5

Well, Michael "Ali" Moyles has been through four rounds and gotten up every time -- tomorrow starts Round Five! Cancer has knocked me down three times, and I've gotten back up, then radiation and subsequent infection, and again I came back strong -- tomorrow, Round Five (reconstructive surgery) begins. I'm ready for it.

Pre-op started on Tuesday. The appointments were long -- over five hours' worth -- but we have a clear road ahead. I spent most of the time with the neurosurgeon and the anesthesiologist, who will be the most critical players in tomorrow's "game". There were a few amusing moments -- first, the EKG showed that I have "sinus bradycardia" -- as some of you other marathoners may know, this simply means my heart doesn't have to beat very often. With a resting heart rate around 44 bpm, I guess the EKG was a bit concerned. Second, my body type -- that is, part wookie -- wreaks havoc on EKG leads, which never stick. Fortunately, I have good veins (large and easily accessible). The nurse politely told me, "The problems you cause in EKG you make up for in labs." In other words, I'm hairy but have good veins. Nice!

Bottom line, everyone is comfortable and confident, and I think the team is the best available. There are three primary concerns:

1. Infection. Apparently, about an hour of the operation is actually replacing the plate, the other three or four hours are all consumed by "infection avoidance" -- sterilization, cleaning, and making sure the plate, sutures, screws, and other items are properly positioned and so forth. The sutures will be internal to minimize the opportunity of bacteria getting under the skin through holes (from staples or stitches). External will be steri-strips only. These surgeries have an extremely high rate of infection...by far the biggest hurdle.

2. Fluid. The body's natural reaction to a foreign body (like an acrylic plate) is to surround it with fluid, much the way an oyster responds to a grain of sand. So, they expect that there will be significant swelling after surgery -- if it's a knee replacement or something else, the swelling eventually just goes down...but they can't afford to let it swell since it's the skull. Therefore, I'll have a drain (like a shunt) placed into my forehead to help drain any excess fluid that builds up around the plate, potentially increasing cranial pressure. The bad part here is that I have to remain in the hospital until the drain is removed and the fluid buildup subsides -- probably at least 2 - 3 days, not the overnight stay I was hoping for.

3. Seizures. The foreign material, the cranial swelling, and pressure differential caused by sealing the brain inside the skull again all create a high risk of seizures. I've never had one and have proven amazingly resistent to seizures, so let's hope that trend continues. I'll be on some pretty powerful seizure suppressants after surgery, which should help.

If we can sidestep those three landmines -- infection, fluid buildup, and seizures -- then I should be in fine shape. I'm second on the schedule Friday morning, with an 8:30am showtime and 10:00am surgery time. I should be in the hospital about two or three days, just long enough to get past the window where infection or dural tears could cause major complications.

Pooh will be keeping up the blog and Facebook regularly...and if past battles are any indication, we all know who's going to win this round. Float like a butterfly...