Surgery Update #2

Good news! The MD just came out. Mike did well and is stable and in recovery. He will be moved to the ICU in about 2 hours. The tumor appears to still be low grade, but final pathology won't be done until next week. We won't know about deficits until later today. They didn't have to remove all of the right frontal lobe, and we're still able to get clear margins around each tumor (there were two). We should be able to see him in the next few hours, so stay tuned for an update after I see him!

Surgery Update #1

To everyone that we promised updates too...here is the first!

Mike went into surgery at 7:15 and we just, moments ago, got word from the OR that things are going great. I assume that means they are about 1/2 way through, so stay tuned to more updates!

Thanks to everyone for your prayers and concerns...we couldn't do it without you!

Brain Scan, Surgery Thoughts, and Thanks

Greetings from sunny Los Angeles, California! I just returned from my brain scan, which went without incident. A brain scan, for those who don't know, is really just an MRI of the brain, often done with a break between sessions for an injection of Gadolinium, a radioactive agent that highlights malignancies or other cell anomalies in the brain. These are things I have several times every year, and have had for about ten years...so I pretty much sleep through them, although they're quite loud and quite uncomfortable. However, pre-operative brain scans are a bit different -- they are accompanied by things called fiducials, which are small markers placed on the face and skull. These markers make for a curious appearance:

These little facial markers actually show up on the MRI, and make it possible for the neurosurgeon to establish the relationship between the inside and the outside of the skull. A bit intimidating, but oh well...
I realized, after posting yesterday, that my post was pretty clinical and descriptive, but didn't talk a lot about how I think about this whole thing. It's really quite strange...the things I'm most concerned about aren't the things you'd expect. I really don't worry much about the surgery itself, and the removal of most of the right frontal lobe. I'm pretty sure it's dormant, and I think the two prior surgeries have confirmed that. The things I'm concerned with seem almost petty:

I don't want a catheter. It's uncomfortable, and somewhat degrading and embarrasing.
I don't want an IV for three days. It's inconvenient, occasionally painful, and very restrictive.
I don't want leg compressors -- for those who haven't had surgery recently, these compressors are wonderful "attachments" reminiscent of medieval torture...they look like big knee-high socks, but they pneumatically compress every few minutes to force teh blood out of your legs and into your torso, preventing blood clots from developing. It sounds great in theory, but it's really pretty nasty in practice. Not painful, but it's very hard to get comfortable, and absolutely impossible to sleep.
I don't want to deal with the medications -- anti-seizure meds, pain killers, stool softeners, steroids, the works. For those who don't know me well, I don't do medications -- AT ALL. Not even Motrin or Advil. To the chagrin of my wife and doctor, I don't even take vitamins. Nothing. To go from that to getting pills pushed on me every hour on the hour is quite an adjustment.
So, as you can see, my concerns aren't over those things you'd expect. Of course, fear plays a part. The chance of neurological deficit -- likely speech or vision -- is always there, and weighs on the mind a bit...but the chances are small enough that they're easy (perhaps too easy) to dismiss. At this point, with less than 12 hours to go, I just want to get it over with. The anxiety and anticipation are at their worst right now...if they would do surgery NOW, I'd sign up!

Finally, Stronger, Momo, and a number of other outstanding Bloggers in Bloggers Against Cancer sent me the most wonderful care package, which arrived this evening, the night before my surgery. Treats, a monkey, and some great running gear...I can't tell you how much it means to me. I owe the entire community a huge debt of gratitude for their caring, their thoughts, their prayers, and their kind gifts. Thank you SO MUCH -- and you'll hear from me soon!

We've Arrived! (Plus Status Update)

Well, the last few days have certainly been busy, but we’ve made it so far! Early Sunday morning, Pooh and I said a tearful goodbye to Monkey (who is staying in DC with grandma and grandpa) and headed for the airport. After arriving in Los Angeles, we went straight to the hotel and “set up camp” for the next 16 days. The hotel is just perfect for us, and we wish we’d found this place for the last two surgeries – the rooms are larger and nicer, unfortunately, no microwaves…and believe me, living/eating in Beverly Hills can get a little expensive if you’re going to restaurants all the time. Let’s just say that in this area, there’s not necessarily a Taco Bell on every corner. Problem solved by a quick trip to Wal-Mart…against hotel regulations? Probably. Is that my primary concern at this point? Probably not. ;-)
Okay, so we arrived at the Maxine Dunitz Neurosurgical Institute:

Yesterday started with what’s called a “pre-operative teaching” at 11:00am. An OR nurse walks you through the entire process, and tries to answer all of your questions. Everything was pretty standard, and although it’s been three years since my last surgery, I remember pretty well how things go. She gave me my “special shampoo” that I have to use before my pre-op brain scan (which disinfects the scalp and hair), and a whole stack of paperwork – consent forms, referrals, and so forth. From there, on to pre-admissions, where I go through the entire admissions process – contact info, next-of-kin, insurance, medical history, the works. After admissions, on to the lab, where they do standard bloodwork – the phlebotomist even told me I have “juicy veins!” I took it as a compliment. After a quick lunch break, Pooh and I headed up to the internist, who does the entire physical. Urinalysis, exam, interview, then the EKG and chest X-Ray. Everything went just fine, except the EKG…which they couldn’t get to stick, so they had to shave parts of my chest. Now, this could easily turn into a separate blog that would almost certainly have TMI, but I’ll summarize by saying that my Air Force callsign (nickname) is “Chewie” – yes, as in “Chewbacca.” So, I look rather amusing at the moment, with two significant shaved areas in the middle of my chest…oh, well. It will grow back.
The last appointment of the day was the actual consultation with the neurosurgeon. We had a great talk – I’m always amazed and how the surgeons here can really put you at ease, even with regard to a procedure this major. He explained the procedure and all the associated risks…they’re essentially the same as last time. Brain surgery always has a risk of stroke, coma, or even death, but they’re actually very small risks…the removal of this portion of the brain (the right frontal lobe) can introduce some memory or personality differences, but the doc reassured us that in right-handed males, language is in the left frontal lobe, so he doesn’t anticipate any language of speech difficulties. They’ll do a biopsy during surgery to determine the pathology and grade of the tumor, and make other decisions at that time – if the tumor has upgraded to WHO Grade III/IV, they’ll likely insert chemotherapy wafers (called Gliadel) into the brain before closing me up. Radiation is also an option after surgery, but one we’ll likely save for the future – and, hopefully, never need! He couldn’t promise a quick recovery, but I’ll likely be discharged over the weekend. If there’s anyone in the LA area who wants to visit after that, I’d love to see you!
At the end of the day, what this all means is that I’m medically cleared for surgery. At this point, there’s pretty much no stopping this train…unless I get seriously ill in the next 48 hours, we’re going to do this thing. I have one more appointment – my brain scan tomorrow at 1:00pm – but other than that, I’m pretty much done until I check in for surgery at 5:15am on Thursday. My wife may blog while I’m still in the hospital, but other than that, the next time you hear from me, I’ll be tumor-free!

Race Report -- Seattle Marathon

We're back! Pooh, Monkey and I flew in from Seattle late last night, and I'm slowly managing to do stairs again. ;-) For those who haven't looked up the results already, I completed the Seattle Marathon -- but missed my goal time by a good 20 minutes or so, finishing in 4:08. The full story:

THE RACE

The morning dawned cool and foggy, with light rain...typical Seattle November. The rain had mostly stopped by race time, but thick fog and mist remained, especially along the lake. JD (in the middle with our training partner AA):

The night before, I was notified that King 5 (the local NBC affiliate) was going to use my story as a personal-interest piece on the evening news, and I spent the last 15 minutes prior to race start interviewing with NBC for the spot.

You can see it here. My friend JD was there with me (you can read about him in my previous blog), and we had a great time laughing and joking before the start.

Just prior to the start, I switched from long sleeves to short, remembering the mantra to always "dress for the finish." The course was a lot of out-and-back -- from the Seattle Center (basically the Space Needle) across the floating bridge to Mercer Island, then back across the bridge again to Lake Washington, down Lake Washington Boulevard to Seward Park, and back up Lake Washington Boulevard to finish in Memorial Stadium at the Seattle Center.

THE PLAN

In every previous marathon, I've carried all my hydration and gels with me, but this was my "hometown" marathon (where all my family lives), and this seemed like a good course for them to come and meet me on the course. So, I arranged for my wife and father to meet me at the 10-mile point, which is also the 15-mile point -- a perfect place for two passes where I could high-five and replenish fluids/gels. Mom, dad, and Pooh (with Monkey in tow) would then move ahead to the 20-mile point, and finally meet me with the rest of the family (all 20+ of them) at the finish. They even got T-Shirts made!

THE RESULT

As most of you know, my goal was 3:45. I trained at 8-minute miles (a 3:30 marathon), knowing that I'd need to make a pit stop or two, and that I usually spend the first mile or two just getting up to pace. That plan worked perfectly for about the first eight miles...at which point my quads really began to burn, which I attribute to lactic acid buildup...entirely unexpected that early in the race. I was barely breaking a sweat or breathing hard, and already my legs were going? By mile 9, my quads were cramping considerably, and I did something I never thought I'd do.

I gave up.

I called Pooh, and told her to have the car at the 10-mile point, and I was done. With quad cramps at mile 10, there was no way I could do another 16+. Well, as fate would have it, she couldn't get through the barricades to the 10-mile point. She called back shortly thereafter, in tears, and explained that she couldn't get to me. Two problems here -- first, she had my gels. If I was going to continue, I needed carbs. Second, I didn't plan to continue. If she wasn't there, I'd have to keep going...and keep going I did. I took a brief detour, running about a quarter-mile back to the last water station, one of only two on the course with gels. Fortunately, they had Vanilla Bean Gu -- my favorite! It added a half-mile to my race, but so be it...without Pooh to pick me up, I had to keep going, and I needed carbs. I passed the half-marathon mark at 1:51, right on pace for my 3:45. At the 15-mile point, Pooh was finally able to get through the crowds and barricades with gels and fluids (my arrival at Mile 15 below).

She and my father were a welcome sight, but my cramps were still pretty severe...I told them to go ahead to 20, and if I could make it that far, I could at least walk the last 6. By 20 miles, I was executing what I not-so-affectionately call my "550 plan," which is running 500 paces, then walking 50. That's how the last six miles went...almost two and a half hours' worth. Miserable quad cramps...one of those things I'll always question. I never had that problem in any other marathon, and never in any training run -- was it fatigue? Nutrition? Hydration? Cold weather? Who knows...anyone ever experience anything similar?

THE FINISH

Of course, I had saved up enough energy to run the last half-mile, up a small hill to Memorial Stadium, into the stadium, and across the finish line. As I approached the stadium, I saw my wife and baby girl standing outside -- I made my way over to the crowd, picked up my baby girl, and my wife hopped the barricade...and we crossed the finish line together!

My brother-in-law even managed to get it on video:

My time, about 4:08, was very disappointing...but it was tough to think about that when I looked around and saw all the family around me, and saw my baby girl in my arms and my wife beside me. I collapsed shortly thereafter, but had quite a crowd to keep my spirits up...

They even all had their "Running With Cancer" shirts on, and Monkey had her own made that said "Run Daddy Run" on the back! SO cute...and of course, she had to check to make sure the finisher's medal was real gold...

JD

My buddy JD did an amazing job. After losing over a hundred pounds, he completed his first marathon. We've now been friends for 27 years, and it was an amazing experience to motivate each other during training, inspire each other during the race, and congratulate each other at the finish line. He crossed in just over four and a half hours, and is now an addicted runner. He may even join me (and many of you) at Rock-N-Roll Seattle in June!

Well, that's all for now...I'll blog again before surgery next Thursday, but it's odd to consider that running a marathon is the smaller of the two hurdles I have to clear this week...onward and upward!

Hell Week

Just a short post today -- "Hell Week" is over!  For the uninitiated, "Hell Week" is the training week that usually falls 2 - 3 weeks prior to race day, where you're at maximum mileage, usually without any rest days...well, Hell Week culminated yesterday with a 20-something mile run, and ended today with my first rest day in what feels like forever.  

Despite my tendonitis fears, everything went perfectly.  I got started late, so ended up running half of it in the dark (which isn't good for me), but I felt great for the entire run.  My pace was a bit off -- 20.12 miles in 2:46.09 (about 8:14/mile), rather than the sub-8 pace I like to keep -- but I felt great the entire race, and even managed a 7:32 mile at mile 19, and 7:46 mile at mile 20.  Even at 8:14, that's still about a 3:35 marathon in Seattle...we're on track, and now...the three words many marathoners (or marathoners-in-training) live for...

IT'S TAPER TIME!

The Forbidden Question

Okay, let's talk running first.  It's going very well -- I've been totally motivated, and have turned in some wicked runs (for me) in the past few weeks.  I did my 18-miler at Burke Lake Park in Virginia, and it was absolutely beautiful...fall colors everywhere.  

I felt great -- it was a bit slow, averaging 8:12, but still on track for about 3:45 at Seattle.  The colors were so great that Pooh and I went back the next day with Monkey...she loved it!

I followed the 18-miler with a good 50-mile week, even turning in a 12-mile run at 7:32 pace...a PR for me!  All ready for the 20+ mile run this weekend -- I'll probably try to hit 22, just to make sure I'm ready for 26.2 in a few weeks.  So, I've been putting in a lot of miles...and am now battling what appears to be some pretty nasty tendonitis in my left Achilles.  I've never had that before, and I'm a little worried that it may put a kink in the Seattle Marathon plans.  Now welcome advice from BlogLand...

So, that's the news from the training side...on the side of the cancer battle, it's been a bit tough lately.  In general, there is a question that is off limits for most cancer patients -- the unmentionable "WHY?"  I stay away from it...it does no good to ponder the question, and the likelihood that you'll ever know the answer is basically zero.  Well, let's just say I've been thinking about it a lot lately -- perhaps due to Monkey, perhaps due to the pending surgery, probably both.  As a man of faith, it's been a subject of frequent prayer...and, for a number of years now, I've thought I know the answer.  What I've been through, what I'm going through, gives me a tremendously powerful testimony that can be used to inspire and motivate people.  It inspires and motivates some to run -- I can count about a dozen people who have run marathons (and more) after hearing my story.  There is at least another dozen people who have been inspired to run or get in shape, though probably not marathons.  More importantly, I think my testimony could perhaps even strengthen the faith of others.  

In all honesty, that's where I've focused most of my testimony...but I'm having trouble reconciling it this time.  Isn't there a "point of diminishing returns" on the power of this kind of testimony?  In other words, is the testimony of someone who has had three brain surgeries really that much more powerful than the testimony of someone who has had only two?  In Biblical terms, thinking of 1 Corinthians 11:23 - 27, would Paul's testimony have been any less powerful if he had been beaten with rods only twice?  Would his testimony have been that much more powerful if he had been stoned twice instead of only once?  I don't think so.  I guess I'm just frustrated because I think my story is inspirational enough with only two surgeries...why go through a third?  What's the point?  If I'm correct, and the reason -- the why -- I'm going through this is to have a powerful testimony to inspire and motivate others, is a third surgery and recovery really necessary to achieve that end?  

Well, enough lamenting...I have to keep my head on straight (yeah, I know...easy joke...).  Now is not the time to get depressed or upset.  Paul also suffered an affliction of some kind, and prayed for it to be removed.  God's answer was simply, "My grace is sufficient for you, for my power is made perfect in your weakness."  Roger, Boss -- my suffering will somehow glorify You -- and I may not ever know how or why.  It's just...that can be a tough pill to swallow sometimes.