The Suburb Woman
Miracles & "Handfuls"
Posted on October 10th, 2013

I’m sorry it’s been a few days since we’ve posted an update. It’s been important to me that Mike reviews the updates before they’re posted.  He feels comfortable enough tonight to do so.

Monday (Oct. 7) was intense. We were up at 4 AM to be at the hospital for surgery check-in by 5AM.  By my count there were 30 neurosurgeries scheduled just for the morning. Despite the thousands of patients you pass during the day – each doctor, nurse, attendant, assistant, volunteer makes you feel like you’re the only patient they’re working with.

I was able to be with Mike as they prepared him for surgery.  We met the lead anesthesiologist Dr. Radha Arunkumar who would be working with Dr. AmyHeimberger to conduct Mike’s awake craniotomy. They again explained the surgery would take six hours and would start about 7:30 AM.

It was hard telling him goodbye, but Mike was ready and seemed excited.  Family settled into the waiting area.  At 9:45 AM the volunteer called me to the phone – it was Mike! From the operating room!  Dr. Arunkumar explained that they had him awake, opened up, had completed initial testing and was preparing to remove the tumor.  He sounded groggy, but great! Mike spoke clearly telling me what had happened and how impressed he was by the process. He made certain to tell me, “They’ve been touching my brain!”

We had a couple of updates that the surgery was going well. Dr. Heimberger came out around 12:45 PM to provide a summary of the surgery and initial pathology results.

She explained that, “I did the surgery on Mike that I would have wanted for myself.” Although we didn’t share details publicly the day of the consult with her last week, Dr. Heimberger prepared us for the possibility she believed we were dealing with an aggressive form of brain cancer.  Because of her suspicions it was important to be able to do the awake craniotomy so she could be as aggressive as possible in removing the area where the tumor and other abnormalities were without harming his speech, memory, and analytical or motor skills. 

Mike is right-handed, so the left side of his brain is where his skills reside. Needless to say, Wednesday and Thursday were emotionally draining. By Friday, we prayed and were preparing for the worst and hoping for the best.

Dr. Heimberger said she pushed Mike “as far as he could go without causing damage or affecting his quality of life.”  She explained she personally went around to review cards and test him as she removed the area. She assured me he was speaking fine as well as he was sharp with his memory and motor skills.

Unfortunately, initial pathology results confirmed her suspicions. Today, the more intensive pathology was concluded and the report was issued.

The tumor is grade 4 Glioblastoma Multiforme (GBM).  There are only 15,000 new cases every year in the United States – which makes it rare. This type of cancer is not inherited or genetic, but is spontaneous in its development.  As of right now, there is not a cure (remission) for GBM, but it is manageable in some cases.  It is a fast growing cancer.

Dr. Heimberger can’t pinpoint exactly when the tumor started, but suspects it developed in the last two months or less. Mike is considered a “manageable case.”  Although the core part of the tumor was a little more than 16mm, Dr. Heimberger removed approximately a goose egg portion of Mike’s brain tissue – and by the looks of the scans I’ve seen today – nearly the entire front cortex of his left temporal lobe.  By being so aggressive in her approach, she went past the area containing the tumor and visible abnormalities and into healthy brain tissue to get as much of what couldn’t be seen.  The problem with this type of cancer is it remains active in the brain on a cellular level. This is where radiation and chemotherapy will be helpful in slowing future tumor development.

While the diagnosis is hard (gut-wrenching initially) and not what we were hoping to hear, we’ve realized in the past two weeks we’ve experienced some significant blessings and miracles. We have many more thoughts we’d like to expand on at a future date – but these are the miracles we are praising God for today:

First miracle – Mike’s speech was impacted when there was no visible evidence the tumor was close enough to have caused such a reaction.  If not for the couple of brief episodes with his speech, we would not have sought emergency care for the headache.  We would’ve continued thinking it was sinus/allergy-related and went a different route for care.  Since Glioblastoma is so aggressive, everyday counts.

Second miracle – The medical team at INTEGRIS Edmond were relentless in pursuing the cause of Mike’s headache and speech problems.  While we initially thought it was symptomatic of a stroke, the doctors and technicians continued to run tests to locate the source. In less than 24 hours after locating the tumor, Dr. Brian Geister (oncologist) was consulting with us on a plan of action.  Without alarming us, his approach was to be “as aggressive as possible from the beginning.”

Third miracle – It is rare that a tumor occurs in the brain without being the result of having metasticized from another area of the body.  If this had been the case, it would’ve been considered stage four cancer – significantly impacting Mike’s treatment and surgery options.
Fourth miracle – Within four days of finding the tumor, we were driving to MD Anderson in Houston. During our drive we received a call confirming the surgeon (Dr. Amy Heimberger) we requested, based on outstanding referrals, accepted Mike as a patient.  We would have our first consult with her the following day.

Fifth miracle – Within 10 days of finding the tumor, Mike was undergoing surgery with a team of the best doctors in their field in the country. The tumor was completely removed.
Sixth miracle – Amazing advances in science that allowed me to speak to Mike in the middle of surgery and hear him say, “I love you” as always before hanging up the phone. That one call provided the peace I needed for the long wait.

Seventh miracle – Within 48 hours after surgery, we took a stroll today down to the Starbucks in the hospital for coffee and sat outside in the gardens enjoying the evening breeze.
We truly believe that considering the diagnosis we are working with the “best case scenario” option. 

The “survival rate” Mike was given is the statistical information nationally based on new diagnoses of GBM each year. Those statistics include all ages and all scenarios – operable and inoperable. Approximately 50 percent of patients survive 22-24 months after diagnosis.  Again, that includes everyone.  There is a long tail of individuals who are many years past their initial diagnosis.

I’ve also waited to provide the update today because one thing we were not prepared for was how post-operative swelling would significantly impact Mike’s speech and memory. The good news is there are no recognizable issues with any of his motor skills. He’s strong and steady. 
The analogy the surgeon provides is if you get hit hard in the eye, your eye will bruise and swell shut. You might not be able to see out of your eye because of the swelling, but it doesn’t mean that you can’t see or you won’t see again.  Dr. Heimberger feels confident Mike’s language comprehension and memory will return to normal within the next week to 10 days as the swelling subsides. 

Yesterday, Mike was excited to tell people about me.  His intention was to say, while pointing at me, “She’s a real Hatfield!” Instead, each time he made this exclamation, he said, “She’s a real Handful!” – while pointing at me! Today, he admits, “Maybe that’s what I really meant.”
It’s a blessing that Mike is being uncharacteristically patient. He still has his charm and humor as he begins his road to recovery.  

And last, but not least, we can't even begin to properly express our appreciation for all the prayers and well wishes. You will truly never know how much they lift us every second of the day. 

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