Three Years Ago Today

May the 4th has rolled around once again on the calendar, and it marks the third "anniversary" of Tim's tree accident/incident.  In an attempt to keep the situation light, we enjoyed some cake from Publix (with, as Kaleb put it, a "tipped over Christmas tree" on the top).

A lot has happened in the past three years.  God has worked and provided in some pretty amazing ways, and we know He is definitely not finished yet.  Mason has been added to our family (here's a crazy thought--when Tim had his accident, Kaleb was Mason's current age), Tim's job has changed, and Kaleb has continued to grow like a weed.

We haven't posted an update for quite awhile, primarily because (thankfully!) there hasn't been much to write about.  Tim went back to Emory last fall for his MRI and appointment with Dr. Olson.  He discovered that the mass has continued to grow, but Tim continues to be asymptomatic.  Dr. Olson continued to insist on traveling the path which included the least intervention, and even gave Tim the option to stretch out his "check-ups" to every 18 months (instead of every 12 months). So, Lord willing, 2014will not include a visit to Emory, and Tim won't be seeing the inside of the Emory neurosurgeon office until sometime in 2015.

Three of my favorite guys, all smiles for the picture. :)

August 2012 Check-Up

This morning Tim met with Dr. Olson to review/discuss his most recent MRI (7.16.12).  First, he met with two different nurses.  One checked his vital signs (which were great!), and the second asked more specific questions and repeated the cognitive/coordination/etc. testing from last year (also great!).  Now that they have a baseline, they are able to make yearly comparisons.

Dr. Olson explained that the mass has grown over the course of the year.  Because it is not a "neat" shape, it is hard to describe its growth (he said the best visual he could give someone would be to describe its outline as a russet potato).  Basically, the mass has grown between 2mm and 6mm in various places.  This is considered "normal" when it comes to the growth rate of a meningioma.

As long as Tim is asymptomatic, and the growth remains at a normal pace, we will continue with the route of observation.  Hopefully our next update on this blog will be July or August of  2013.  :)

One Year Later

Yesterday (5.4.12) marked the one year "anniversary" of Tim's accident.  What a year it has been!  To remember the day, I got Tim a small cake from Publix.  It may sound odd, and we weren't really celebrating the fact that Tim has a mass (besides his brain) in his head, but we were celebrating God's goodness through it all.

 It is kind of hard to see, but the top has two pine trees on it.

One pine tree is standing up, the other has "fallen" down.

Tim with his mini-cake.

Just because life is about more than coincidences, I have to include this story on this blog.  Thursday (5.3.12) night while we were in the midst of getting K ready for bed, we received a text message from Tim's twin sister, J.  She and her daughter had hit heads during the day, and she ended up getting a concussion from it.  In her text she said that she would be going to get a CT scan the next day (5.4.12), and that she was a bit nervous knowing Tim's history with having a CT scan and "incidentaloma" (as Tim's friend, Dr. Archie calls it).  

When Tim read the text we just looked at each other and said, "No way!"  J would be having her CT exactly one year after Tim's accident.  So crazy!  We are praising the Lord with Joy, because her scan showed no tumor!  It is something how God used one year to reveal the tumor in Tim's head, and the following year to give his twin sister peace of mind knowing that she is brain-tumor-free.  

Neurosurgeon Update

I'll share the big news first... the tumor has NOT grown in three months!  Can I just say that we wanted to jump up and down when the doc shared that info with us?!  We managed to keep our composure though.  :) 

Here was our morning, in a nutshell:
Thanks to Tim's savvy googlemap skills, he figured out a new route to the hospital.  We got to Emory with a great cushion of time before the scheduled appointment time.  Tim checked in, and was even called back to see Dr. Olson a few minutes early.

A friendly nurses aid greeted us, and walked Tim back to check his weight, temperature, heart rate, and blood pressure.  Everything was in the healthy range, which was reassuring.  :)

Karen, Dr. Olson's nurse, came into the room first.  She was a very kind woman who was personable and professional.  During the fifteen minutes she spent with us, she did some tests to determine what the mass has impacted.  He did a variety of strength tests, vision tests, hearing tests, coordination tests, etc.  After a few minutes she would lean over his file and write several notes, but she reassured us that they were GOOD notes and that we had no reason to be concerned.  The goal was go get a solid baseline, that way in future visits the exercises/tests can be repeated and compared to the previous results. 

After she left, a few minutes later Dr. Olson entered the room.  He immediately explained his findings when observing/comparing the images on the two MRI's.  There was a slight difference between the images, but he said that it was extremely minimal and due to variations in head position between the MRI's.  Tim may have had his head slightly tilted to one side while in the MRI machine in May vs. August.  If the size discrepancy had been larger, or he could see that the mass was somewhat changing form, then it would be time to take a more aggressive course of action.

We asked several questions, here are a few...
     Q: How many meningiomas has he (Dr. Olson) surgically removed?

     A:  At least one a week.

     Q:  If Tim required surgery, what type of procedure would be performed?

     A:  A craniotomy.

     Q:  Can Tim's tumor become too large for an uncomplicated operation/recovery?

     A:  There is the possibility; but the possibility is just as great that Tim could undergo surgery next week and have just as many complications.  Dr. Olson has worked with a wide range of patients, varying from a seven year old with a mass larger than Tim's, to a 70+ year old with a mass smaller than Tim's.   We can't focus solely on size, location is also key.

     Q:  How does the location of the tumor in Tim's head compare with other possible locations?
     A:  If you had to have a brain tumor, the mass in Tim's head is in one of the best possible places.  Compared with other locations (like those near optic nerves or the spinal cord), the mass in Tim's head is showing us that it is able to exist (at a large size) while Tim remains asymptomatic. 
     Q:  What will "symptoms" look like for Tim?

     A:  Headaches (frequent and intense), nausea, dizziness, balance problems, memory/concentration problems, dexterity problems, speech problems, hearing and vision problems.  There is also a possibility Tim could experience seizures, which could range from minimal (a staring spell) to more intense.

     Q:  Can Dr. Olson currently tell us the grade of Tim's tumor?
     A:  Short of looking at the cellular composition of the mass, no.  Dr. Olson reassured us that while size is a factor, it is not a sole indicator of size.  Based on the images (no abnormal shape, no growth in the past three months), he thinks it would be reasonable to think the mass would be considered low-grade (Grade I... the best option out of all the grades).

     Q:  Will Tim need to have the mass surgically removed in the not-too-distant future?

     A:  Meningiomas grow at unpredictable rates.  Many people pass away from old age before having their meningioma removed, and Dr. Olson said this could very likely be what happens for Tim.  Or, Tim could become symptomatic in the next 1-50+ years.  It's just impossible to tell.


You may be thinking, "So, what is the next step?"  We will continue with the observation route until Tim becomes symptomatic.  The current plan is for Tim to have another MRI next August, and return to Emory at that time for another follow-up appointment.

We are thankful and praising God for the lack of growth of the tumor.  Your prayers over the next year truly mean so much to us, we know that we serve a Mighty God who is revealing Himself in an incredible testimony through Tim's life.

Dr. Olson

For those of you who are interested, I thought I would provide a face and background information for the neurosurgeon with which we have been meeting.  By clicking on his name, Dr. Olson, you will open another browser to view some of his medical background.

A few weeks ago Tim was able to get a second and third opinion through something called Best Doctors (again, if you click on the previous words, a browser with more info will open for you).  Over the course of several weeks, Best Doctors compiled a file with all of Tim's recent medical info (neuro, oral, and plastic surgeon info, as well as records from his ER and overnight stay at the local hospital).  A doctor (Dr. Robert M. Friedlander) from the University of Pittsburgh read over the compiled information and created a report with his observation/recommendation.  Once Tim got the report, a different doctor (Dr. Lewis) called and spoke with Tim to answer questions and provide further explanation.

Dr. Friedlander advised surgery, while Dr. Lewis agreed that observation is the better route at this time.  When Dr. Friedlander read the report from the ER, he interpreted Tim's fainting as a symptom of the tumor (when it was most likely caused by no breakfast or lunch, a concussion, undergoing pretty major face/mouth repair, and lying on his back for several hours).  When Dr. Friedlander sees patients, they are typical very symptomatic, and he performs surgery on them within a small window of time.  Tim has not had any symptoms (that we are aware of)-- he certainly hasn't passed out or fainted since that day back in May.

Currently, we are at peace with the decision to observe the mass, and are wondering what tomorrow will hold.  It may very well be that we continue with the observation route, as Tim is asymptomatic.  Right now we are wanting to make sure that Tim is seeing the very BEST doctor possible.  We are confident in the medical opinions/advice we have received thus far, but when it comes to thinking about brain surgery we want to make sure we have learned all we can on the front end to make the best possible decision.

We find ourselves asking, "How in the world do you know which neurosurgeon is the best?!"  The advice we have been given is to inquire about quantity.  Along with a lot of prayer, we plan to also ask Dr. Olson questions regarding quantity (eg: How many patients with meningiomas has he operated on?  Is there a neurosurgeon in their practice who operates on meningiomas more than anyone else? etc.)

Thank you for your prayers--they are tremendously comforting and encouraging!

All I Want for Christmas is My Two Front Teeth

On Thursday (6.2.11) Tim had oral surgery at the UAB (University of Alabama at Birmingham) Dental School.  We arrived at the clinic around 8AM Central Time.  Once the paperwork was filled out, Tim was seen by a dental student around 10:00.  They set up an appointment for oral surgery for 1:00 in the afternoon.

Tim was on time, however the oral surgeon was not.  He ended up waiting an hour before he was seen.  Earlier in the morning the dentist had told Tim that he had two options regarding pain management-- local anesthesia or an iv.  After talking about the two choices Tim opted for the local anesthesia.  Now that he has been through it, I think if he had to do it over again he'd opt for the iv.

For an hour and a half, two men worked on Tim's mouth.  They extracted the root (which was no easy feat), inserted the implant screw where the root had been, packed the remaining space around the screw with bone (it was either bovine, sheep, or cadaver bone), and then stitched up the wound.  Accomplishing all of this in one surgery will save Tim four months down the road (typically, a tooth implant process lasts 8-12 months because of the healing time between procedures).  He keeps reminding himself of that, because at the time it wasn't very reassuring.

His mouth and face were swollen and quite tender, but he has said that the pain is lessening.  He will go back to the UAB Dental School for a follow up appointment in a few weeks.  The way they described it to Tim, there aren't many people who have the root extracted AND get the implant screw in the same procedure.  Since his case is unique, they want to make sure the implant is successful and that the antibiotic is warding off all infection.

By Christmas Tim should have both of his front teeth, and I'm sure he'll be sure to smile big and smile often... as he will have gone through quite a bit to maintain that smile!

-Erin

The Story

I realize some people who are viewing this blog may not know or understand what happened on May 4th.  Now that appointments are spaced out and I have a few minutes of down time (yay for Kaleb's nap time!), I thought I would share Tim's story.

On Wednesday, May 4th, Tim and his dad were working to cut down a dead pine tree on our property.  Tim was manning the chain saw, and his dad was on the tractor.  The tree was cut, and it fell exactly where they had intended; however, in the process of falling, a limb was caught on a nearby tree.  This limb snapped off, falling 20-30 feet, and hit Tim on his head/face.

Tim was knocked out for a minute or two, his lip and mouth were cut quite badly, and his front left tooth was missing.  The first responders (fire department) were on the scene in about five to ten minutes, followed by the ambulance.  By this point, Tim was awake and responding to questions (although, he doesn't remember any of it), and the paramedics took him to the local hospital.

While he was at the hospital he had a CT scan of his brain to make sure everything was okay.  The results showed no damage from the morning's accident, but it did reveal a mass in the space between his skull and brain.  Low and behold, God literally hit Tim over the head to reveal a more pressing issue.

The ER doctor who shared and explained the results is a member of the church we attend--he was such a blessing to us!  He recommended Tim have an MRI so more info about the mass could be revealed, and within about an hour Tim had the MRI.  We learned that it is something called a meningioma, a non-cancerous mass that slowly grows without rhyme or reason.

While he was in the ER, Tim saw a plastic surgeon and ended up getting 30-40 stitches in his lip and inside his mouth.  The plastic surgeon was a very talented man, as the limb created anything but a clean cut and left debris embedded in his lip.

As Tim was being discharged he ended up fainting/passing out, and it was decided that he would spend the night in the hospital as a precautionary measure.  Over the course of the night he became stronger on his feet and was slowly feeling a little bit better.

Our time post-hospital stay has been filled with appointments seeing the plastic surgeon (all of Tim's stitches were removed within 8 days of the accident), the dentist, an oral surgeon (he needs to have his root extracted and begin the process of getting a tooth implant), and a neurosurgeon.

There were definitely moments when we were afraid, but through everything, God proved Himself faithful.   I could go on and on about God's faithfulness, but here are a few examples:
-After discovering the mass, Tim needed an MRI, within an hour he was on his way to have an MRI.
-Tim's trauma to his face was quite extensive, and the plastic surgeon (recommended by the ER doctor) was able to come in a few hours later.
-Without the accident we would have no way of knowing about the mass, until symptoms began exhibiting themselves (headaches, loss of strength on his right side, seizures).  Who knows if Tim would have begun exhibiting symptoms, but without realizing their cause, how long they would have been ignored.