Friday, March 17, 2006
Elvis Meets His Match
(Notes from 3/13/06)
We woke up on Monday the 13th to snow. The largest snowfall of the season, here... nearly a foot. We were pretty much prepared to hunker down for the day. We had faxed the MRI paperwork to the really good neurosurgeon (Dr. Nagib), and didn't have anything we needed to do until the following day. Just to double check, my wife touched bases with Dr. Nagib's office to make sure that they had received the paperwork... they had, but Dr. Nagib was in surgery. He would look at them when he could.
So, we rested. Like a lump, I curled up in the recliner and began reading an amusing travel novel given to me by a coworker (I would recommend it: Neither Here Nor There). The highlight of my morning was having an early lunch of chicken tetrazzini.
And then the phone rang!
If we could get downtown (through the snow) by 1:45, Dr. Nagib would certainly be willing to discuss the MRI in person. Wow! What luck! My wife's mom was willing to run from her desk at her office and watch the kids on short notice, and we were in the van, slowly crawling through traffic.
Ultimately, it seems, much of our lives are built on trust relationships. I'm certainly of the firm belief that all of these medical procedures can only be successful if we have trust in the doctors, including both their opinions and their skills. Since my wife had little to no trust in Flipper, and her whole family had a great deal of trust (and for good reason) in Dr. Nagib, I was excited to meet him.
We were early enough that we could relax in the waiting room for a bit. I like to be early, but I'm also not particularly patient... a catch-22 for me. But there were enough magazines to keep me busy.
After a little while (and one double check with the administrative staff), and to my surprise, Dr. Nagib came out to greet us in the waiting area... I'm used to a nurse calling me back to the little hovel where the doctor is squirreled away doing other important things. It was a really nice gesture (in my estimation) for him to do that. Granted, he was excitedly chatting with my wife about her brother, leaving me as a bit of a tagalong... but it was still a very positive introduction.
I'm pleased to say that his style is extremely relaxed. That meshed well with me. We didn't run immediately to his office... he had arranged to have my films hanging in a little observation area in the hallway so we could, as a group, just nonchalantly pause and he could say, "Now, let's take a look at these, for instance..." and then begin scribbling on them with grease pencil. Telling us what he saw as key features, telling us what indicators he used to give him optimism about the nature of the tumor, etc. In other words, giving us an opportunity to understand why he had some of the opinions that he did. Flipper -- not so much of that.
His estimation was that the tumor is fairly old, and thus likely slow growing. In his opinion, if it had grown quickly, and grown to its current size, I'd be floored. He believes my brain has had an opportunity to slowly adjust to my "guest", helping explain the limited symptoms. The cumulative mass effect (shoving things out of the way) and resulting swelling / pressure was probably enough to trigger the more recent, consistent headaches. No other brain centers were obviously affected, also consistent with limited side effects.
Job number one: remove the tumor. Job number two: rest and recover. In his estimation, he didn't think we would even necessarily need to plan for things like radiation. The lab results of testing the tumor were the only way to know for certain, of course, but he was optimistic. The signs, in his opinion, just didn't seem to be pointing that way. He felt that the bulk of my symptoms could be explained by the mass effect of the tumor... so let's get it out and see how I respond. A few days in the hospital, a few weeks at home, we can do this.
As an added bonus, Dr. Nagib had an extra procedure in mind in conjunction with attacking the tumor. He plans to do an angiogram to map out the blood vessels feeding the tumor before surgery, and (if possible) embollize (block) some of the feeders to the tumor. In this way, he can begin to starve the tumor before surgery, hopefully beginning the shrinkage process.
He also had a neat way to describe the ultimate procedure itself... consider an orange. He reaches in and scoops out the center of the orange, hollowing it until the point that it collapses in on itself. Then he can pluck out the remaining "skin" of the tumor. Take that, Elvis!
All in all, he did an incredible job of (a) enhancing our trust in the process, (b) calming our fears, (c) giving us confidence that we were working with someone that knew what they were doing, knew what needed to be done, and absolutely could do it.
By the time my wife asked whether he could do the surgery, he almost laughed. "Of course! Don't even bother worrying about that! We'll just talk to my scheduling assistant..." We had gone in looking primarily for a second opinion, and walked away with a completely new surgeon and surgery schedule. And felt much better for it.
And the waiting game begins once again...
(Notes from 3/13/06)
We woke up on Monday the 13th to snow. The largest snowfall of the season, here... nearly a foot. We were pretty much prepared to hunker down for the day. We had faxed the MRI paperwork to the really good neurosurgeon (Dr. Nagib), and didn't have anything we needed to do until the following day. Just to double check, my wife touched bases with Dr. Nagib's office to make sure that they had received the paperwork... they had, but Dr. Nagib was in surgery. He would look at them when he could.
So, we rested. Like a lump, I curled up in the recliner and began reading an amusing travel novel given to me by a coworker (I would recommend it: Neither Here Nor There). The highlight of my morning was having an early lunch of chicken tetrazzini.
And then the phone rang!
If we could get downtown (through the snow) by 1:45, Dr. Nagib would certainly be willing to discuss the MRI in person. Wow! What luck! My wife's mom was willing to run from her desk at her office and watch the kids on short notice, and we were in the van, slowly crawling through traffic.
Ultimately, it seems, much of our lives are built on trust relationships. I'm certainly of the firm belief that all of these medical procedures can only be successful if we have trust in the doctors, including both their opinions and their skills. Since my wife had little to no trust in Flipper, and her whole family had a great deal of trust (and for good reason) in Dr. Nagib, I was excited to meet him.
We were early enough that we could relax in the waiting room for a bit. I like to be early, but I'm also not particularly patient... a catch-22 for me. But there were enough magazines to keep me busy.
After a little while (and one double check with the administrative staff), and to my surprise, Dr. Nagib came out to greet us in the waiting area... I'm used to a nurse calling me back to the little hovel where the doctor is squirreled away doing other important things. It was a really nice gesture (in my estimation) for him to do that. Granted, he was excitedly chatting with my wife about her brother, leaving me as a bit of a tagalong... but it was still a very positive introduction.
I'm pleased to say that his style is extremely relaxed. That meshed well with me. We didn't run immediately to his office... he had arranged to have my films hanging in a little observation area in the hallway so we could, as a group, just nonchalantly pause and he could say, "Now, let's take a look at these, for instance..." and then begin scribbling on them with grease pencil. Telling us what he saw as key features, telling us what indicators he used to give him optimism about the nature of the tumor, etc. In other words, giving us an opportunity to understand why he had some of the opinions that he did. Flipper -- not so much of that.
His estimation was that the tumor is fairly old, and thus likely slow growing. In his opinion, if it had grown quickly, and grown to its current size, I'd be floored. He believes my brain has had an opportunity to slowly adjust to my "guest", helping explain the limited symptoms. The cumulative mass effect (shoving things out of the way) and resulting swelling / pressure was probably enough to trigger the more recent, consistent headaches. No other brain centers were obviously affected, also consistent with limited side effects.
Job number one: remove the tumor. Job number two: rest and recover. In his estimation, he didn't think we would even necessarily need to plan for things like radiation. The lab results of testing the tumor were the only way to know for certain, of course, but he was optimistic. The signs, in his opinion, just didn't seem to be pointing that way. He felt that the bulk of my symptoms could be explained by the mass effect of the tumor... so let's get it out and see how I respond. A few days in the hospital, a few weeks at home, we can do this.
As an added bonus, Dr. Nagib had an extra procedure in mind in conjunction with attacking the tumor. He plans to do an angiogram to map out the blood vessels feeding the tumor before surgery, and (if possible) embollize (block) some of the feeders to the tumor. In this way, he can begin to starve the tumor before surgery, hopefully beginning the shrinkage process.
He also had a neat way to describe the ultimate procedure itself... consider an orange. He reaches in and scoops out the center of the orange, hollowing it until the point that it collapses in on itself. Then he can pluck out the remaining "skin" of the tumor. Take that, Elvis!
All in all, he did an incredible job of (a) enhancing our trust in the process, (b) calming our fears, (c) giving us confidence that we were working with someone that knew what they were doing, knew what needed to be done, and absolutely could do it.
By the time my wife asked whether he could do the surgery, he almost laughed. "Of course! Don't even bother worrying about that! We'll just talk to my scheduling assistant..." We had gone in looking primarily for a second opinion, and walked away with a completely new surgeon and surgery schedule. And felt much better for it.
And the waiting game begins once again...
# posted by JamesP3325 @ 2:24 PM 
Comments:
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I am one of your wifes crazy SS friends and I wanted to say that:
1) I love it that you are keeping a blog. Your entries are great and show me that you have a very good attitude about Elvis.
2) You and your precious family are in my families prayers every day.
3) You are gonna be A-Okay!!! My mom had a surgeon like Flipper, and she switched to one that sounds like your new one. They took out a mass the size of a bowling ball along with part of her liver, pancreas, intestines, and... I've forgotten. Basically part of every organ it was touching. The nurses told my brother (who is a nurse) that it was definitely cancer, but the labs came back benign.
The surgeon told her that EVERYBODY has SOMETHING unusual in them somewhere. He said she could have gone her entire life without finding hers, except that it finally grew to the point that it was making her uncomfortable and sick. They did checkups on her as if she had been a cancer patient, but 9 years later she is one of the healthiest 64 year old women you would ever meet.
So... I think you just found your something weird, and once it is gone... all will be well!
{{{{HUGS!}}}}
Amy
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1) I love it that you are keeping a blog. Your entries are great and show me that you have a very good attitude about Elvis.
2) You and your precious family are in my families prayers every day.
3) You are gonna be A-Okay!!! My mom had a surgeon like Flipper, and she switched to one that sounds like your new one. They took out a mass the size of a bowling ball along with part of her liver, pancreas, intestines, and... I've forgotten. Basically part of every organ it was touching. The nurses told my brother (who is a nurse) that it was definitely cancer, but the labs came back benign.
The surgeon told her that EVERYBODY has SOMETHING unusual in them somewhere. He said she could have gone her entire life without finding hers, except that it finally grew to the point that it was making her uncomfortable and sick. They did checkups on her as if she had been a cancer patient, but 9 years later she is one of the healthiest 64 year old women you would ever meet.
So... I think you just found your something weird, and once it is gone... all will be well!
{{{{HUGS!}}}}
Amy
# posted by 
: 8:49 PM
: 8:49 PM << Home
