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.

Exhaling

You know, I didn't realize it until after meeting with the neurosurgeon this morning, but it felt as though we have been holding our breath for the past six days.  It feels good to exhale.  :)

We met with Dr. Riley and Dr. Olson at Emory hospital in Atlanta around 11AM.  They reviewed Tim's CT and MRI results, and took time to answer our questions as well as provide an understandable explanation of Tim's meningioma.  They stated that Tim's tumor is large, but falls within the "normal" range when compared to the sizes of other meningioma tumors he has seen.  It was also reaffirmed that the tumor has a high probability of being non-cancerous.  There are three treatment options: radiation (Tim's tumor is a bit too large for this to be recommended), observation, and surgery.  Since Tim is not suffering from any symptoms at this time, and surgery brings about plenty of risks on its own, we are pursuing the observation route.

You may be thinking, "What?!  You are just going to let the tumor continue to grow?"  Meningioma tumors are very slow growing (Dr. Olson said they grow 1-2mm a year, at the most... sometimes they go for periods of time with almost no growth).  Right now the plan is for Tim to have another MRI in August, at which point we will meet with the neurosurgeon again so he can compare the May and August images.  He will be looking for any growth indicators, and depending on what he sees we will most likely continue with observation (which will mean an MRI in May 2012).  At some point it is possible Tim could begin exhibiting symptoms (ranging from loss of strength on the right side of his body to seizures), and if this happens we will pursue Plan B with the neurosurgeon.  God is in control.

Whew.  Exhaling.  Thank you, Lord!  :)

The immediate future will be filled with the removal of his remaining stitches and taking care of his missing tooth.  While his front left tooth broke off in the accident, the root was pushed further up into his mouth, and it will need to be extracted.  It is looking like he will be having an implant, which is a multi-month process between an oral surgeon and our family dentist.

Thankfully this blog has been short lived, but I will try to update it again in August (I believe the neurosurgeon appointment is on the 9th) in case you want to check in.  Words cannot begin to express our gratitude for your prayers, encouragement, and support.  While thank you seems insufficient, it is what I will close with... thank you, and all glory to God.

Erin :)

1+1=3

That's the way today started....with two appointments, and there was a third scheduled during the first one.  You should have seen the faces of the gals working at the dentist office.  SHOCK!! I'm still a little jacked-up with swelling, cream, and stitches and most people going there wouldn't look as bad as I do.  At the dentist, we found that my tooth broke, but left most of the root behind in the gum.  It's gotta go to prevent infection.  The dentist called the oral surgeon down the street and hooked us up with an appointment with him.  Our second stop today was to have half of the visible stitches removed.  The doc said the lip was healing nicely.  The rest supposedly come out on Friday.  After the visit with the plastic surgeon, we visited the oral surgeon who gave us hope that we would one day be able to replace the tooth.  He encouraged us to focus on my head first.  So that's where we are.  We go to the neurosurgeon on Tues morning (10:15) to see what awaits us. Also, please pray that I am able to sleep at night.  I don't want to lay in bed and think of all the possible things that could be or will go wrong.  I know who my Ultimate Doctor is and I know He's in control. 
Please continue to pray for us.
tg

Welcome

We plan to use this blog to keep you updated and share prayer requests.  God has been working through each moment, providentially revealing His plan for Tim's life.  Thank you for your prayers, support, and encouragement.

The web address for this site is "Who Wood Have Thought" ...a play on words based on the circumstance that revealed the tumor.  Below are pictures of the tree limb that hit Tim's head/face (it may not look extremely large, but add to it the fact that it fell about 30 feet before hitting him).  We never would have thought the word menginioma would become part of our thoughts and vocabulary.

When you check for updates and have a moment, please feel free to leave a comment/note of encouragement for Tim.  Thank you for your prayers and encouragement!