Saturday, December 13, 2008

Surgery Update #4

Well, it appears I'm back at the hotel without Mike again, but there is good news on the horizon-actually there has been nothing but good news-Praise God!

Mike was finally transferred from ICU about 7 pm tonight, just as his long awaited dinner arrived. No, he wasn't excited about that. He's been SO hungry since his surgery and, finally, he was able to eat real food, only to have it postponed until after the "move"-how rude! He was also up and walking around this morning (much to my surprise). He had already been able to convince the staff to remove his catheter and part of his IVs. The walking also meant no more leg compressor things. This evening we got him out of the awful hospital gown and into some Duke clothes...that should make him all better!

This evening, after the "move" and dinner, we did laps down the hallway and he is, surprisingly, strong. I think he is even stronger than he was in the first two surgeries. He is begging for coffee, but that's not on the menu yet, hopefully tomorrow. I left him some books and magazines for entertainment. Mike even convinced me to leave his iphone there. I know he's bored silly, so I couldn't resist.

The doctor read the MRI and it appears there is no tumor visible. Also, he said he'd talk to us in the morning about discharging him since he is doing so well. Much to Mike's delight! Mike is quite proud of the fact that Dr. Chu called him his "poster child for brain surgery". He said "all surgeries should go like this." That made Mike feel good. The plan was to discharge him on Sunday, so, this will be the third time he was released a day early (assuming they go ahead and let him go tomorrow). The final pathology won't be done until next week, but they are optimistic about that too.

Mike has absolutely no deficits...sorry for not mentioning that earlier-lack of sleep I think. He is 100% Mike Moyles and we couldn't be more delighted! I truly believe he is acting better after this surgery than the previous 2-could it be that you get "good" at surgery? Hmm..let's not go there! :)

Well, good night to all and thanks once again for your continued support and prayers. Praise God and the next time you get an update it will be from Mike! YAY!

Friday, December 12, 2008

Surgery Update #3

Well, I'm back at the hotel now. Unfortunately, without Mike, but he is still doing quite well.

We finally got him into ICU and I was able to spend some "quality" time with him. I'm not sure if there is such a thing as "quality time" when your loved one is in the hospital, but hey, we'll take it! For those of you who know Mike, let's just say he's back...for those of you who don't, I'll explain! He is joking, trying to entertain anyone who steps into his room, smiling and hating his catheter and IV. Although, he did persuade the RN to take the leg compressor things off for at least an hour, so that made him happy. He's asking about his blog, wanting to make sure I've updated it, making sure I've called everyone that I should have (even naming them by name--good sign!), asking for his phone...not a chance in .... he's getting that yet! I know him TOO well for that trick! He said, "it's just incase I need you for something"... ya, right! :)

His vital signs were good, there is a small concern that his respirations aren't staying stable, but the resident on call said that it was because he was a marathoner and since he didn't need to take as deep a breath as most folks the machine was "confused". Okay, for all you medical folks, I know that's not exactly what the MD said, or the correct medical terms, but I think you get the idea. Once, again he's in TOO good of health for the machines. He's had this problem in the past! He is running a slight temp of about 100, but this too is normal for only less than 24hrs after surgery. He is able to bend his legs some to exercise them...he says he's a bit sore and stiff-can you imagine? His main complaint, other than the catheter and IV, is the headache! Oh, I can't imagine how that feels, but the meds are helping, finally, and hopefully he'll be able to rest some tonight.

I think that's about it for now. I'm sure he'll be "itching" to get on the computer tomorrow, so I'll bet you get a post from him soon. (He made me take a picture of him in ICU to post so that everyone would know he REALLY IS OKAY, but I can't figure it out, so it'll have to wait-sorry!)

Thanks again for all your support!
PS...And moments later, I figured it out...here he is!

Thursday, December 11, 2008

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!

Wednesday, December 10, 2008

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!

Tuesday, December 9, 2008

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!

Wednesday, December 3, 2008

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!