Test results and the plan..

We got home yesterday from our trip to UCLA.  I can’t even begin to explain to you how thrilled I am to be done with that place for awhile.  I’m so ready for life to just settle down and for us to find some sort of normal, whatever that may look like.  I don’t like that when Trent greets me in the morning, the first thing he asks me is what doctor am I going to that day.  My kids are such troopers through all of this.  I’m so thankful that I was diagnosed when Tyler was only one.  This is all he’s ever known and it’s obviously all Trent has ever known, as well.  It has never been as intense as it’s been over the past 6 months, and that has definitely taken an obvious emotional toll on our family, but we’re hoping that things will finally quiet down and we can just focus on being a family and enjoying our time together, rather than upcoming surgeries and trips to doctors, etc.

This past month, since I’ve been home from surgery has been extremely rough for me.  What I thought would only be a couple of weeks of just taking it easy and healing from surgery turned into a month of not feeling well at all and not knowing why for most of it.  After going to a few doctors, Dr. Liau suggested that I go see an ENT to check out my sinuses.  We figured out that I picked up a sinus infection, probably before surgery already, and didn’t know it.  The surgery added fuel to the fire and I now have a very large infection that we’re having a hard time clearing up.  In hindsight, there were definitely early symptoms, but when you’re recovering from brain surgery in the same area as the infection, it’s hard to know what is causing the symptoms.  Unfortunately, I waited too long to get it treated and now have a mess going on in my head.  I had a CT of my sinuses done and if the infection doesn’t clear out in a couple of weeks, then I will have to have surgery to clear out the infection because I’m high risk.  The infection is sitting right next to my surgery site.  We think the infection may be what is causing all of this numbness that is still on the right side of my face.  The ENT thinks the infection is pushing on the maxillary nerve, so it’s probably not a permanent thing.  Love that!  So needless to say, that has been beyond frustrating to not be feeling well at all for so long, and it’s not because of the surgery!  I’m feeling great with all things surgery related!!  I’m on a heavy antibiotic and praying that it clears this thing up because I’m good on the surgery thing for now, thanks.

I finally received pathology news this week from my surgeon.  The tumor has indeed upgraded to a high grade tumor.  It’s not a grade 4, but a grade 3.  The official diagnosis is an Anaplastic Oligoastrocytoma.  I can’t say that I’m too disappointed that it has upgraded.  I fully expected that it had, given the rapid amount of growth in such a short period of time.  The growth was so extreme that it seemed almost impossible that the tumor wouldn’t be a grade 4.  A grade 4 is a Glioblastoma Multiforme, one of the most devastating diagnosis in the world of cancer.  Very fast, very aggressive and very lethal.  I am so inredibly thankful that one of those is not hanging out in my noggin.  I am now only one grade below that, though, so the harder part of the battle has now begun.  There are two pieces of tumor left that are too close to eloquent parts of the brain for Dr. Liau to have been able to remove them safely.  One is close to the Thalamus, which is where she left it during the last surgery, and the other is next to the Basal Ganglia.

We were in California for only 24 hours on this trip.  We wanted to get in and get out, and so we did!  We first met with Dr. Selch.  He is the radiation oncologist at UCLA.  He explained what would need to get radiated and what the side effects might be.  Because the area where the tumor was/is, is quite large now, a very large portion of the right side of my brain will be irradiated.  That is a bummer.  The guaranteed side effect will be that I will lose my hair at the site where the beams go into my head.  Will the hair grow back?  There is a 50/50 chance that it will.  Yeesh.  The other most common side effect during treatment is fatigue, but not everybody experiences that.  I’m still working with Greg, my naturopath, doing naturopathic treatments immediately when I got home from surgery.  There are many ways to offset this fatigue naturally, diet being a big one, so we have a plan.  The long term side effects of radiating this part of the brain are short term memory loss, which I’m already accused of  (: It can also have an effect on emotions.  I’m not sure in which way, but I guess we’ll find out!  They are irradiating the hippocampus, the limbic system, so many crucial structures to my everyday functioning, so there will most likely be deficits that may be a little frustrating down the road.  It’s one of the big bummers of brain cancer.  You’re messing with a part of the body that controls every aspect of your entire body.  Everything they do in there is affecting something else in another area of my body.  These deficits from radiation usually don’t rear their ugly head until several months or maybe even years down the road.  Thankfully the brain is extremely neuroplastic and there are many software programs that have been developed to help with regaining short term memory, etc.  Where there’s a will, there’s a way.  This girl has will.

They did some genetic testing on my tumor, as well.  Based on certain genetic mutations, they can predict how well a tumor will respond to radiation or chemotherapy.  It’s not an exact science because based on the testing from my surgery three years ago, my tumor should have responded well to chemo, but didn’t.  The test on my tumor showed that I have the IDH1 mutation.  This genetic mutation has shown to be associated with a better prognosis and has been shown to have a better response to radiation.  We pray that is true.

We also met with Dr. Cloughesy, a neuro-oncologist.  He is amazing.  He is so warm and personable, much like Dr. Liau.  I feel like I’m in extremely good hands with him overseeing my local treatment.  Based upon the pathology of my tumor, he has decided that chemo is not a good option for me right now.  He doesn’t think that my tumor will respond to it, so we’ll save that as an option for down the road.  We already tried Temodar, which is just a pill and a mild chemo, but is the first choice for brain cancer, no matter the grade.  It did not work for me, so the next chemo that would be coming my way, if necessary, will be the IV heavier stuff.  I’m so thankful that time is not right now.  I’m ready for a break from heavy stuff! (:

So that is hopefully the end of many months of chaos.  I’ll probably start radiation the first week of April.  It will go for 6 1/2 weeks everyday.  We are so incredibly thankful for all of the prayers and support from all of you during this time.  We have felt it all throughout each day.  I can easily say that these past six months have been the most trying months of my life.  It has just been one thing after another for such a long period of time.  There have been so many blessings through it, but geez.  Enough, already!

Thank you, thank you for your prayers, your cards, your phone calls, for all the different ways that you have loved on us and supported us through this time.  We feel so blessed to be loved by so many!

No rest for the weary!

I received an email from Dr. Liau and there was not any additional pathology available this week from my surgery, so they will bring my case up next Wednesday at tumor board to see if there is more information.  This is what I do know, though.  At this point, we will be flying back down to UCLA in a couple of weeks to meet with a couple of new doctors.  Up until this point, my only doctor at UCLA has been Dr. Liau, who is my surgeon.  I have not done radiation, yet, for said reasons, but they are wanting that to be the next step no matter the final pathology.  Because radiation is everyday for six weeks, I will obviously be doing that here locally in Salem.  I will fly down to meet with Dr. Michael Selch, who is a radiation oncologist that specializes in brain tumors.  He will then be able to coordinate and oversee my local treatment here in Salem.  When radiating the body, there are multiple variables that are involved in calculating how much of the tissue to radiate, how many rads to throw at it, etc.  I want to make sure we’re all on the same page here before I do this!

I will also meet with Dr. Timothy Cloughesy.  He is a neuro-oncologist, and an amazing one from what I have heard and read over the years.  He will work with my local oncologist.  I found out that the genetic testing on my tumor that I had mentioned in my previous blog is only being done to decide now on the chemotherapy that will be used later, when/if it is needed.  There are several different chemothefrapies out there, now.  It’s not fool proof by any stretch, but they are finding ways to test cancer cells ahead of time and anticipate which drug they will most likely respond or not respond to.  This limits the pain and misery of the common cancer shotgun approach, which is great!

So at this point, it’s looking like radiation won’t get going until the beginning of April, which is fine with me!  They originally wanted to start in a couple of weeks.  The thought of them radiating this noggin right now just makes it hurt all the more!

Another one down…

I know I wasn’t very diligent about keeping anybody updated while I was down south.  It was killing me, but the biggest reason was that my pain factor is quite a bit more significant with this surgery than it has been with any of the past surgeries.  I was able to jabber a little bit with Facebook, but much more than that felt like more effort than I was capable of.  These surgeries have been getting so easy to bounce back from that I’m trying really hard to not get really frustrated by this limitation.

 

But, wow, what a whiner!  GOD WAS SO FAITHFUL THIS WEEK!  So incredibly faithful.  I ask myself this all the time:  why do I ever doubt?  My worries and fears coming into this surgery that have all been expressed in previous blogs were all covered.  They were ALL covered!  Dr. Liau wasn’t able to remove all of the tumor, but we knew she wouldn’t going into this, so I can’t say this was ever a fear.  My vision!!  There was rather significant swelling in my brain when she did surgery, so there is probably a similar amount of swelling now, which is always common after any surgeries.  This swelling and the tumor was pressing on my optic nerves creating several visual symptoms that have been going on for a couple of years now.  Two of those symptoms have already resolved!  At this point, the vision that she said would most certainly be damaged does not appear to be any different.  It’s not something that might not show up down the road when there is healing and scar tissue buildup, but right now I’m really trying to just hold on and claim God’s protection of that vision during surgery, that He spared it.  It may seem silly, because in the grand scheme of things, I am dealing with brain cancer, but the idea of losing so much vision in one eye was bothering more than anything coming into another surgery.  It has some significant long term implications if it limits that vision.  I consider this a miracle!

The other amazing answer to prayer is that this tumor appears to be mostly low grade at this point.  With the sudden shock we received recently that the tumor we thought had only subtly grown over the last three years had really tripled in size and now showed hot spots, it only seemed inevitable that news would come that it was aggressive.  We’re still waiting for final pathology, which should come this week, but the fact that she had so many tissue samples tested during surgery that were consistent with low grade is very encouraging.

I can never just pass over lightly God’s protection through these surgeries.  It’s brain surgery.  It was a very long surgery and I am home and feeling pretty well, already.  I was doing pre-op appointments only a short week ago, although it seems much longer than that!

Now that I’m home, I’m enjoying reflecting on this past week and seeing God’s hand in the events of the week.  Oh, how I wish that everybody could go through experiences in life where it puts them in a place that allows them to reflect and relish in God’s goodness.  Not that I want you to go through brain surgery, but it’s a beautiful thing to be in a position where you are constantly looking at how God is working out details in your life.  I may only be in my 34th year of life, but I feel like He has allowed me to live  so much more life than that, already, and I have to say I’m so thankful for it.  I’m thankful for the depth of maturity that I’ve been able/forced to acquire because of it.

Our usual routine on our way down to UCLA is to visit Marvin’s family in northern California.  It’s a great way to see everybody and the by far our biggest blessing has always been the opportunity to spend a little bit of time with his Grandpa and Grandma Visser, who are Marvin’s mom’s parents.  I was originally scheduled to have surgery on February 17th.  We all came down with the flu, so the surgery was postponed a week.  If the surgery would have stayed on schedule, we would have been able to see Grandpa one last time.  By the time we had traveled down that way, he had what we thought was a really bad infection and decided not to stop in for fear of me getting sick.  Only a few days later, Grandpa passed away.  It was sad that we weren’t able to see him one last time, but since we were down in California, Marvin was able to go to the funeral, which was such a blessing for him and for his family!  So not only was he able to honor his grandpa by being there for his funeral, but he was also able to see his entire extended family because his crazy huge family had all flown in for it.  I had just gotten out of surgery 40 hours earlier, so I opted to stay behind and rest (:  The timing couldn’t have been better.  Not that I wanted to postpone the surgery one second longer than it had to be, but I have to say that I am thrilled that it was because of this.  Marvin’s uncle is a pastor and performed the service.  He spoke about God’s fingerprints in grandpa’s life, and that is exactly how I would describe this.  He had it all worked out.  There was a reason we got sick.  I’m content with this being it!

Dr. Liau is supposed to get back to me in the next day or two with the pathology of the whole tumor and the recommendations of the tumor board for what I should do next.  At this point, they seem to be really pushing radiation.  They will be doing some genetic testing on my tumor, though.  They are able to tell whether my tumor will be more sensitive to chemo or radiation depending on the results of this testing.  I will post the updated information of what life will look like over the next few months when I get it.

Meanwhile, I just want to say thank you so incredibly much for your constant outpouring of support to us!  We have been overwhelmed with love and it is really carrying us through some trying times.  This surgery has just felt different in so many ways.  It has been a lot harder and so we are so thankful for all of you that have been constantly encouraging us with cards, notes, emails, phone calls….everything!  Thank you for loving on my family.  I’ve always said that it has to be so much easier being the patient than the family member.  My husband is incredible!  My kids are troopers!  Thank you for taking care of them, as well.

I’ll be back with deets soon.  Really, this time. (-;

Surgery is Over

Good news: the surgery went as planned and Charysse is doing well!

We just met with Dr. Liau and she told us that she was able to remove the majority of the tumor. The tumor that is left is simply inoperable. The initial reports from pathology indicate that the tumor is still low grade—yay!—however we will not have final confirmation until the middle of next week. Dr. Liau also reported that the tumor and brain both showed signs of swelling, which would contribute to Charysse’s increased seizure activity. It is her hope that the de-bulking will sharply decrease her seizures activity. We are waiting for Charysse to wake up to find out how much of her vision has been lost. Dr. Liau’s estimates that she’ll lose the peripheral vision in the lower quadrant. However, she will still be able to see out of that eye. This is what we expected and continue to hope for. Finally, they will start testing the tumor tissues to see what kind of treatment it’ll respond to best. This will help guide the treatment course going forward.

We are thankful for this good report. Of course, we wanted to hear that she was able to get 100% of the tumor, but that’s not what this surgery was for. The goal was to de-bulk the tumor and that’s exactly what happened. The best news of all, the tumor appears to be low grade still—BONUS!

Thanks for your continued thoughts and prayers. We are definitely seeing the fruit of them.

Deja vu

The word that sums up these past several days perfectly.  This is the third time that we have traveled this road.  This will be the fourth surgery, but only the third here at UCLA. We arrived here late Monday night.  I had pre-op appointments on Tuseday which cleared me to have surgery tomorrow.  This includes bloodwork, chest x-rays, EKG, blahblahblah.  I’m healthy.  Well, from the neck down, anyways.

Our experiences here, really, are so rich whenever we come.  I am blessed with the most amazing soul in my neurosurgeon and she brings so much warmth and comfort whenever we meet with her.  Yesterday I had the crazy longest MRI of my entire life.  The tech was getting ready to take me back and Marvin was going to wait.  He told Marvin that it should only take me about an hour and a half to finish.  What??!!  An hour and a half??  I can’t move for that long?  I can’t scratch anything that is inevitably going to start itching because I know I can’t scratch it for an hour and a half?

The test was significantly longer than usual because it produced several images that were crucial for mapping out how the tumor would be able to be accessed when she does the surgery tomorrow.  We went over that with her today when we met with her.  One of the pictures gave us a clear view of how the tumor has intertwined with structures of my brain.  The first thing, and extremely crucial and a HUGE answer to prayer is that the tumor has remained stable in the four weeks since the last scan I had done when I was down here.  Some of you may be thinking four weeks?  That is hardly a significant period of time to allow anything to grow.  Not so in the world of brain tumors.  When these tumors become a grade 4, they are capable of doubling in size overnight.  I am not exaggerating.  Overnight.  The fact that it has remained stable definitely favors a less aggressive tumor than a grade 4, in which we are so incredibly thankful!  We won’t know for sure what the grade is until she takes the tumor out tomorrow and we get some pathology, but at this point, we’ll remain optimistic that it is a lower grade.

The bummer part of this tumor is where it lies and what it is wrapped around.  Because it has been a low grade tumor for so long and because these tumors don’t grow as round balls like most cancers do, they grow tentacles and this one has had time to wrap it’s tentacles around brain structures and nerve fibers.  Unfortunately it has wrapped itself around my optic nerve fibers.  I have already had some peripheral visual loss in the left eye in the upper quadrant.  With the removal of the tumor that has wrapped itself around those nerves, I will almost certainly lose the rest of my peripheral vision in my lower quadrant.  This means that I will have no peripheral vision at all in my left eye.  It is definitely a noticeable deficit, as it is, already, but it’s not anything that I can’t get used to.  My body will eventually learn to compensate for it by learning to turn my head more, etc. to see what I would normally see without having to do that.  She does recommend not driving for several months, which pretty much sucks.  No other way to put that.  I’m used to getting my driving privileges removed, but not for several months at a time.

The other bummer is the amount of tumor that can’t be removed.  The original part of the tumor that was left behind from the surgery 3 years ago because it was too close to the brainstem will still remain, as well as some tumor that is too close to the motor strip.  They will have some needles connected all along the left side of my body to monitor twitching movement while she is operating around this area.  If she gets too close to a motor area, the left side (because the tumor is one the right) will start to twitch, so she will know that she’s too close and needs to leave that tissue alone.

I have to say, though, with the what-if’s that we were facing coming into this appointment today, that I’m so thankful and feel like God has really answered so many of our prayers!  I’m so excited for surgery tomorrow.  I have so much peace about it.  God has proven faithful continuously, of course, and I eagerly wait to see how He’s going to continue to use my circumstances for His glory.  It’s hard, yes.  I struggle to hold it together, especially lately, yes.  But in the end, God reminds me that He’s still in control and I can’t help but be thankful for this journey and the things I am learning and the blessings that I have received because of it.  We are so grateful to so many of you that  are praying us through this.  You have know idea what you mean to us.  I wish I could hug each of you personally and tell you how much you mean to me, how much I appreciate you.  I pray that God blesses you for it!

It is late.  I have some stuff going on tomorrow, so I’m signing off, but just wanted to update you all.  Thank you so much for loving us.  We love you.  I’ll be back so soon to tell you how great I’m doing and what the next step is.  Until then…

UCLA (dis)appointment

We went to UCLA this past week to get some follow up scans done on their MRI and PET scanner and then had a follow up appointment with Dr. Liau.  We did this down there because their PET scanner is more sensitive to low grade glioma cells, which is what we assumed my tumor was because it has presented and acted that way for so many years.  We wanted to see if that was truly the case and the PET scanner at the local hospital here wouldn’t show that.

Well, the news we were dealt was shocking, to say the least.  I really felt like we would be walking away from UCLA with the recommendation to do further surgery to debulk what had subtly grown over the past few years to hopefully decrease my visual symptoms and seizures and then to continue on the Temodar to either keep the tumor stable or try to get some regression if there wasn’t any, already.  When Dr. Liau walked into the room to greet us, she put down a piece of paper that was clearly a copy of my PET scan.  My eyes were immediately drawn to the glaringly large areas of bright red on my brain scan.  Hot spots.  I knew that wasn’t good.  Not only had my tumor continued to grow since the prior scan, which was only two months ago, but the tumor has now become more aggressive, which is logical considering the amount of tumor growth since last August.  So is it a grade 3 or a grade 4?  We’re not sure.  The only way to know for sure is to operate and get some pathology on the tumor.

The tumor board had just reviewed my scans prior to my appointment with her.  There were several recommendations.  One was to go straight to radiation to slow down the increasing growth and aggressiveness of the tumor.  Another was to do an IV chemo, which has much more severe side effects, similar to what one imagines when they think of chemo (i.e. hair loss, vomiting, etc).  The one that we have decided to do is surgery so she can take out as much as she can and then follow that up with radiation.  If you read my past post, I talked about putting off the radiation card because my tumor wouldn’t be that responsive to radiation because the cells weren’t abnormal enough and we weren’t at the point.  We’re there now.  How quickly things can change.  Surgery is scheduled for February 17th.  Almost exactly 3 years to the day as my prior surgery.  This will be surgery number four.  I can’t believe it!  We figured out from these scans that what we thought were two separate tumors is really one large tumor extending into different portions of my brain.  It’s the original inoperable tumor that has made it’s own path into a deeper part of my brain and created another cluster of cells.  I asked her what she thinks she can get out.  She said she thinks she can get out most of the hot spots, which is so important.  There are some that she can’t touch, though.  If these hot spots are grade 4 cells, it would be devastating.  That renames this tumor to a Glioblastoma Multiforme.  It is a horrible diagnosis and I don’t even want to entertain the thought of that by going into detail about implications of it here.  After about a month of healing from surgery, I will begin radiation either in Salem or up in Portland.  It’s 5 days every week for six weeks.  Ugh.  If there is still tumor after all of this, then IV chemo will probably be next.  The fact that my tumor is inoperable and a high grade puts me into a completely different treatment regimen, now.  We can’t just wait around and see what the tumor is going to do.  We have to keep treating the tumor until it’s gone on the scan.

These tumors are notorious to recur within weeks.  It’s going to be a tough battle.  I knew this day would most certainly come when the tumor upgrades.  I guess I just thought after being stable and low grade for seven years, that it wouldn’t all change so quickly.

We really need prayer for peace and comfort right now.  Our kids will be away from us for awhile while we’re down at UCLA for surgery.  Tyler is older and will understand a little more and be able to see by looking at my head how serious my sickness is.  We don’t talk about it much with him.  We know God’s grace is sufficient.  It’s brought us this far.  But I won’t lie.  We’re scared.  It’s really scary to think of what might be.  We try to rest in God, but we’re human and our emotions are strong.  Thank you for loving on us and continuing to pray for us.  We appreciate it more than you’ll ever know.

So much to talk about!

I’ve learned about myself over these past few years that when the going gets tough, I tend to internalize.  I could have written about 10 blog entries over the past two months with all of the latest drama that I have mustered up, but I guess I haven’t really been to the point where I actually want to sit down and talk about it.  I don’t really like to now, but I know that a lot of friends and family come here to keep up to date, so here it is!

It started on an evening back in October.  I was sitting in the living room with the boys and my visual seizure aura popped into my vision.  I hate that thing!  I’m so incredibly thankful for these auras, though.  I know at the point that aura comes on, that I have about 30 seconds to find a safe place to lay down before everything in my vision is swirling so much that I have to close my eyes to keep the pain away of my eyes trying to focus on one thing.  So I run into my bedroom and laid down on my bed.  I know it’s a safe place for me when I finally go into the seizure and become unconscious.  Marvin runs to my side while I’m lying on the bed.  I’m actually able to get my breathing under control while my aura is still circling in my vision.  Usually my heart is racing and I am panicking by now.  I was praying that the aura would subside and that the seizure would never progress.  Not at all to be.  Not only did I have one seizure, but my seizure progressed into status epilepticus.  What?  Status epilepticus??  I’ve read about that!  Do you know that people often die from being in that state?  Those thoughts all ran through my head in about .9 seconds.  What that meant for me was that my original seizure kept rolling into another seizure, which turned into three seizures.  I never regained consciousness for more than a few seconds between each one and not at all between one of them.  Scary.  What was even more disturbing was that at the end of my seizure, I lost all functioning on the left side of my body, from my head down to my toes.  I woke up and heard Marvin keep telling me to wiggle my left toes.  I was wiggling my toes and was getting so irritated with him because he kept making the request, but what I thought were my left toes I was wiggling, were merely just the right.  He called the paramedics and I went to the hospital to make sure that all of my blood work and vitals were good, which they were, so then I could go home and sleep.  If I would have been more alert, I would have pushed for a scan to make sure that the tumor was behaving.  Any ordinary breakthrough seizure can signal tumor growth, let alone a seizure that turns into epilepticus.  It was really late at night and the ER doctor thought it would be too much of a hassle to try and get a read, so he just sent us home.

The next day, I started having some lingering numbing sensations throughout the left side of my body, which absolutely frightened me, so I went back to the ER.  This time, though, I wasn’t leaving until somebody stuck me in a MRI machine to see what was going on in my noggin’.  Thankfully the people at the hospital are so absolutely wonderful to me and they were able to squeeze me into a slot to get a scan right away.  It didn’t take too long for the ER doc to come over and tell us what I had already suspected:  tumor growth.  He sat down with the radiologist and the radiologist had just told him that there was small growth of the tumor.  I had 20 other questions about this new “growth” that the ER doctor didn’t know the answer to, so I called the radiologist the next day.  He was great and went over my scan with me.  He said that yes, there is an increase in the signal abnormality (that is how tumors show up on MRIs), indicating growth.  Ok.  But, there was a bigger issue he was concerned about.  Ugh.  I have some ventricles in the right side of my brain that had slightly enlarged.  Was it trapping of cerebral spinal fluid, or could it be an “extension of disease”?  He wasn’t sure, so scans were sent to UCLA for their review.

It was an eternity until I was finally able to speak with Dr. Liau on the phone about what the consensus of the tumor board was about my scan.  She had already mentioned to me in a prior email that they said there was growth, so my gut had been twisting for a few days, already, in anticipation for what they were going to say.

Finally, around 10 am on a Thursday morning, I got the call.  It is the sweetest voice on the other end.  She stammers a little bit and asks how I’m feeling.  She is so incredibly compassionate.  Neurosurgeons don’t make personal phone calls, especially when you’re a nationally renowned neurosurgeon.  She wanted me to know that, yes, there was some growth in the tumor.  I couldn’t bare the anticipation any longer, so I asked her before she could say it.  Is there another tumor?  Yes, she says.  I asked how big and she said that she thought around the same size as the other, which is a little less than one inch.  The new tumor is in the Insula.  It is too deep to operate, much like the original tumor, so removing it isn’t an option.  My gut is sick and now on the floor for the remainder of the conversation.  But she is just so sweet.  I’m talking to this woman, and she is handing me the most horrible news anybody has probably ever handed me, and I just want to reach through the phone and hug her!

So what’s the recommendation?  The tumor board, which I guess I should explain what that is.  The tumor board is a group of radiologists, doctors, oncologists, neurologists and professors that work at UCLA and gather together every Wednesday morning to review patient scans.  They reviewed my scan and the consensus was surgery and radiation.  Confused, I told her that I thought the tumors were inoperable, holding out the very, very slightest (I knew) of hope that maybe something changed and it was all of a sudden operable.  She told me the original tumor has had very subtle growth since my last surgery in February of 2008, so they recommended her taking out that tiny growth.  Bummer.  I was shooting for her taking the whole thing out.  They would go after this small of a tumor for two reasons.  One is to get some pathology to see what the exact grade of the tumor is.  The other would be to alleviate some of these symptoms that I have.  The biggest bummer about tumors in the brain is that it doesn’t take much of anything to disrupt something else in a big way.  The tiniest amount of growth that I’ve had has affected my vision enormously.  This tiny growth has caused my seizures to have gotten to the point where I’m now on  3 seizure medications to try and control them!

What did we decide?  She knows that I’m not willing to use the radiation card, yet.  I will do radiation at the point when the tumor is high grade and will more likely respond to the damaging effects of the radiation.  With low grade tumors, which we’re assuming mine are, the cells are not extremely abnormal, as they are in higher grades.  The more abnormal the cell, the more fragile the cell and susceptible to whatever is being thrown it’s way to kill it.  We’re not there, yet.

We decided that surgery is too aggressive right now.  The risks outweigh the benefits and we wouldn’t treat any differently than what we’re already going to do, anyways.  We’ll put that off.

So Temodar, it is.  I started my first round of chemo, after being off for a couple of years, a couple of weeks ago.  I got quite sick from it this time around.  Everybody swears that I was this sick last time I was doing it, too, but I don’t remember it being anything like this.  I guess that’s the part of your brain that blocks out the bad, remembers the good.  I have a much better game plan in place for when I start this next round to hopefully stay ahead and ward off any of the side effects from it.  The next round begins the day after Christmas.

I was quite thankful that Dr. Liau and I were on the same page about which treatment to pursue right now.  Any of you who know me or who have read my blog know that I am definitely one to make my own decisions.  I am in constant contact with several doctors that manage different aspects of my disease.  I love having that many people because I can get several different opinions and then pick out what I agree with and what I don’t.  Ultimately, it’s my body and these are my decisions.  I have been so blessed with Dr. Liau because she has been supportive in all of my decisions, namely the one to go off of chemo and stay only on homeopathic IV treatment.  She is a gem.

And speaking of the homeopathic stuff, my naturopath and I have started that up again in full force.  If you’ve been following this blog, that has been my main treatment since I visited a natural cancer clinic in Oklahoma a couple of years ago.  Since we were having such success with it, we decided to cut back on the aggressiveness of the treatment this past summer to see if we could back off, but still keep the tumor in check.  A big part of this decision was because of the expense.  It’s not a cheap decision to go the homeopathic road, but I believe in it with all of my heart!  The other reason was the time/emotional commitment of being hooked up to an IV pole everyday, although I am fortunate enough to be able to do that at home while watching football.

So after taking much of the summer off of doing any treatment, which was a much needed/loved break, we’re hitting it as heavy as we can right now.  I know enough about these tumors to allow my mind to be satan’s playground right now.  I’m really struggling with trust.  I know what these tumors can do, how quickly they can kill.  What if that’s God’s will?  I’m having such a hard time letting that go and laying it down at His feet.  I know, I know, I KNOW that His grace is so sufficient.  It has been so evident in our life when this journey started almost 7 years ago.  He has a plan.  He has a purpose.  I need to be ok with whatever that might look like.

Many of you are asking what the next step is.  Marvin and I will fly down to UCLA in January so that I can get an MRI and a DOPA PET scan done on their machines.  The DOPA PET, as opposed to the more common FDG PET, is more sensitive to low grade tumor cells.  It can better distinguish low grade tumor cells from swelling, scar tissue, or anything else that may just be something benign.  It’s an easier way to know exactly what we’re dealing with, without having to go under the knife at this point.  If those scans show some significant growth, then surgery will most likely ensue ASAP to get out whatever she can.  A decision will have to be made at that point of whether to do radiation or not.  Dr. Liau said that if there is just some minor growth on this next scan, that we will likely just continue on the Temodar to see if we can get some response from the tumors.

So that is the plan at this point.  Temodar, homeopathic IVs and a TON of prayer.  There is no treatment more hopeful than prayer!  Thank you so much for your outpouring of love upon me and my family.  I am continually in awe and humbled by the cards, the calls, the meals, the hugs, absolutely everything that you guys shower upon us all of the time.  It’s only by God’s grace and with friends and family wrapping their arms around us like you do, that is getting us through this extremely difficult time.  Just to let you know, we are not sharing a whole lot with our kids about this.  Trent is too young.  Tyler knows I have a tumor.  He knows it causes the seizures that he unfortunately has had to witness on more than one occasion.  We haven’t told Tyler about the second tumor.  We figure, why?  If there comes a time when we need to sit down and talk about it more, then we will do that.  We are wholeheartedly believing, though, that it will never come to that time.  We are believing in God’s faithfulness and His healing hand in my life!

Thank you, again, for all you do.  We cling to your prayers and covet them every single minute of every single day.

With so much love….

Charysse

Here’s the plan

After consulting with my plethora of doctors, here is the plan we came up with.  Dr. Liau is concerned that the chemo may not be working for my tumor, as it’s grown slightly since I started chemo in February, albeit slight.  She first recommended that I proceed with radiation, but after a phone conference with her she agreed with my appeal to give chemo a couple more months to kick in, scan again and then go from there.  I’m still hesitant to play the radiation card for a couple of reasons.  First, it’s still only a low grade tumor.  I can only do radiation once, so if it happens to upgrade down the road, I don’t have this option.  Radiation is generally not used for low grade tumors because of this reason.  Second, she said that radiation will not shrink this tumor, it should just keep it from transforming to a higher grade tumor and hopefully keep it from growing more.  My thought was that I’ve had this thing for 5 years now and it’s mostly remained low grade so that wasn’t too concerning for me, even though it’s always a risk.  If radiation would actually shrink this thing and get it out of my brain, then I might be more willing to jump on that bandwagon.  I asked her what the deficits would be radiating the area that needs to be radiated.  She said that I will possibly have more visual deficits than what I already have, as well as memory issues and hair loss at the insertion site.  Not too bad, but still not my choice at this time.  I’m so thankful that she’s open to just giving me her advice, but still willing to let me make the decision and supporting me in what I decide.  I can’t imagine going through this whole mess without her!

On the alternative front, we’re going to keep on keeping on.  We’ve been keeping DMSO out of the mix for the most part since last November, so we’ve thrown that back in at quite a high level.  It stinks, literally, but it seems to have been effective during last summer and fall, so we’re going to see what we can do with it back in the schedule.  I am alternating the DMSO and high dose Vitamin C on the days that I’m not on chemo to throw something at this tumor every single day.  Since I’ve been told by my surgeon that there is nothing out there right now that can shrink this tumor, I’m going to try anything I can to make that happen.  For those of you wondering, she is aware of what I’m doing and supportive, as is my oncologist.  I’ve been blessed with several doctors in my life that will let me make a lot of my own treatment decisions with their guidance, but support me in whatever I decide.  LOVE that.

Thanks for all of your emails, phone calls, cards etc….it’s great to feel loved and supported.  Next scan is June 30th….you’ll be seeing me before then (-;

Quick Update

I received an email from Dr. Liau at UCLA and she has recommended that I proceed with radiation at this point.  The tumor has grown only slightly since February, but since the chemotherapy hasn’t controlled the growth, she’s concerned about more growth.  This news is a little devastating.  It’s not a card that we wanted to play right now.  It can only be done once and it is usually quite damaging, considering that your cognitive functioning is being radiated.  I have a phone conference setup on Wednesday with her so that we can discuss things further.  I have many questions before making this decision.  I’ll probably make a decision by Wednesday, so I’ll post then what that is.  Please pray for comfort and wisdom right now.  So appreciative for all of you…

Scan Results

The local radiology report says that the tumor has mild growth. It’s still presenting as a low grade tumor (yay!), but it still appears to be on the move. Bummer. We’re doing really well. After a bit of processing, we’re back in the frame of mind where it is what it is, and we’re on to the next step. What is the next step? Not sure yet. We’re waiting to hear back from Dr. Linda Liau at UCLA, whom we deem the final opinion. Once we get word about their read of the scan and recommendations, then we’ll decide what to do. Hopefully that will be rather soon. I’ll post when we know more. Thanks for your prayers!