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!