Questions for your first consultation with the doctor…

Here is a list of questions that I am compiling in preparation for my first consultation with my neurosurgeon.

  • What type of tumor do I have?
  • I’ve been told the tumor is probably benign, do you agree?
  • What is the natural course of my condition if not addressed?
  • What are my treatment options?
  • What are the treatment goals?
  • Do I need additional tests before we can decide on treatment options?
  • Which treatment option do you recommend?
  • Will the treatment eliminate the current symptoms?
  • What are the risks/side effects?
  • What are the pros/cons of beginning treatment sooner rather than waiting?
  • What should I do to prepare for treatment? Can I continue my current exercise routine? Should I add/subtract anything?
  • How long will the treatment/recovery take?
  • How long is the hospital stay?
  • How long will I be out of work?
  • If I need surgery, do you perform the whole procedure? Will students/other surgeons be doing any parts of the operation? If yes, who are they and what are their qualifications? 
  • Who else will assist you in the operation? What are their background and qualifications?
  • How long would I need to stay in Houston?
  • What is the success rate for this treatment?
  • What is the long-term outlook/prognosis for my condition?
  • What type of follow-up will I need after treatment?
  • I am thinking about going for a second opinion. Is there someone there you would recommend?
  • Can I talk to any other patients who have undergone similar treatment?

If I do need surgery:

  • What kind of pain should I expect post-op? And for how long?
  • How long will I be in the hospital?
  • Will I need to have inpatient PT/rehab following the surgery? If yes, for how long?
  • Will I be able to get adequate PT follow up when I get back home?
  • Will I need any special equipment after surgery (i.e. a back brace, a walker)?
  • How often will I need to come to Houston for follow-up care after the surgery?
  • Do you have any previously existing ties with neurosurgeons/neurologists in my area?
  • What will I do (who do I call) if I have problems after I am back home post-surgery?
  • What kind of assistance will I need during the recovery period?
  • When will I be able to drive?
  • If I have surgery to remove the tumor, what is the likelihood that I will develop another one in the future?

Can you think of anything I missed?

Here are some relate links:

https://www.spine-health.com/blog/40-questions-ask-your-surgeon-back-surgery

https://www.spine-health.com/treatment/spine-specialists/specific-questions-ask-your-spine-surgeon

http://www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/questions_to_ask_before_surgery_85,p01409

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Planning for the future… talking to the boss

Being diagnosed with a spinal tumor has turned my world upside-down. Now most of  my waking minutes are consumed with research and planning. One thing that I know I need to deal with sooner rather than later is the inevitable talk with my boss.

I had been planning to wait until I had a treatment plan, but last week something happened that makes me feel that I can’t keep putting this off. We had an all day professional development retreat. On a normal day, I alternate between sedentary seated desk work and teaching (which allows me to walk around the room), but during the retreat, I spent the first three hours seated. By lunch, I was in a lot of pain/discomfort. I stood while eating my lunch, and then I took a walk before the afternoon session began. During the afternoon sessions, I tried to alternate between sitting and standing. The pain/discomfort didn’t go away, but it didn’t get worse either. I watched the clock inch closer to 4 pm… the time when I would go back home and take some medicine to reduce the pain. However, at 3 o’clock, the person organizing the retreat announced that our last activity of the day would involve physical activity. Most of the participants were pleased. They were tired of sitting in their chairs, but his description of the activity made me panic. I was already in pain. How could I possibly participate in this activity?

I told my teammates that I would not be able to participate because I’ve been having back problems. They urged me to give it a try anyway, and I had to explain that I was already in a lot of pain. I couldn’t risk it.

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They let me sit out during the activity, but I felt like I had let the group down. I also felt like I was no longer a full member of the team. I didn’t have the shared experience of facing the challenge with them. And, I suddenly had been singled out a being different from the rest of the team. I noticed my boss watching from the other side of the room, and I knew that I needed to tell him what was going on before he came to his own conclusions.

So, how do you tell your boss that you have a major medical problem like a spinal tumor? Fortunately, there are resources on the web that can help.

Most of the resources are related specifically to cancer. My tumor is probably benign, but  many of the recommendations made for cancer patients also pertain to my situation. A really good resource that I have found is Cancer and Careers. They provide a wealth of information to help a newly diagnosed person decide when and how to share their diagnosis with co-workers and the boss. They also have information to help you navigate Family Medical Leave, the ADA, and your rights.

After reading everything on-line, I think I will wait and talk to my boss after my appointment with the neurosurgeon. Then I should have more information to share.

Here are some of the other resources I found:

http://www.cancerandcareers.org/en/at-work/employers-managers/managers-toolkit

http://www.everydayhealth.com/brain-tumor/telling-your-boss-about-your-brain-tumor.aspx

 

The Jabberwocky – vs – The Dissertation

For the past two years, Saturday mornings have been reserved for my dissertation. I pack up my books and head to the local library to immerse myself in research. But today something different happened. When I logged into the internet, instead of searching for more articles related to my dissertation topic, I found myself googling “schwannoma” – “neurofibroma” – “spinal cord tumor”.

Soon I found myself lost in a labyrinth of information about this thing that is taking over my life. I’ve read stories of people who have had the surgery and come out on the other side satisfied with the results, but I have also read stories that scare me. Stories of people who now realize the rest of their lives will be dictated by pain. Stories of limitations and loss. Stories of good doctors and bad doctors. So much to process. So many decisions to make. I read and read, but the big questions remain. How long will it take for me to recover? How much will this impact my job? My dissertation? My marriage? And I’ll be honest, it is hard to be optimistic and hopeful.

 

 

 

 

 

The Return of the Jabberwocky – Part II

I didn’t recognize the Jabberwocky immediately when he returned. There were big changes happening at work, and in addition to accepting a new position with much more responsibility, I was enrolled in a doctoral program as a full-time student. To say that I was busy is an understatement. I knew that I was tired all the time. I also knew that I was having back pain on and off – but the pain was minor compared to what I experienced with my migraines.

I easily ignored it at first. But with time, I started getting up from my desk more often to stretch. When I bought a new car with seat warmers, I found myself using them all the time. And I was complaining incessantly about uncomfortable chairs. There were even days when I sat on the floor during class because the seats were causing me too much discomfort. But still, the level of pain was not even close to what I’d experienced with the migraines, so it barely registered in my mind.

With the new year, I made a commitment to exercise more. I got a membership at a local gym, and I started working out a couple of nights each week. The gym had a pool, so after about a month of walking the track, I decided to give swimming a try. Two weeks passed, and I started to notice a tightness in my back. I mentioned it to my massage therapist, and she told me that it might be from muscle fatigue. She tried to release the tension, but the attention she was giving to my lower back produced more pain. When I left that session, I thought she might have somehow forced something out of alignment. Unfortunately,  I waited for the pain to subside – but it didn’t.

The next week, after swimming two laps, the pain was more than I could handle. I was halfway across the pool, and I wasn’t sure I would be able to make it to the wall. I did make it, and I tried to stretch. I thought it was a muscle cramp. Stretching didn’t help. I attempted another lap, but I had the same result.

Convinced that I had injured myself, I went to the doctor. He, in turn, sent me to physical therapy. After working with me for a few weeks, the PT told me that we really needed images. He thought some of my symptoms pointed towards a schwannoma, but those were rare and to be honest, I wasn’t suffering from some of the tale tell symptoms.

The MRI was ordered, and I really thought we would find out that I had a pinched nerve – probably from something that had slipped out of alignment. But it wasn’t going to be that simple. It was going to be something called a schwannoma… there was that word again.

I went home and tried to google it. I wanted every bit of information I could find. So I suppose this blog is going to become a way for me to sort and process the information that I find in a way that can help me make the very important decisions that I am going to have to make in the coming weeks regarding treatment.

Careful…

Careful… it is a word that you could use to describe most of my life. I have always been careful. Careful to follow the rules. Careful to not break a bone. Careful to avoid sickness. Always careful.

Afraid… that is another word that has dominated my life. I have been afraid of the consequences that come from not being careful. Afraid of pain. Afraid of loss. Afraid of not being able to live my life as I want to live.

When the plane takes off, I worry about a crash… not because I am afraid of dying. Dying is easy. No, I have been afraid of suffering after surviving a crash. I have feared the broken bones, the surgeries, the inevitable changes to my daily life. And above all, I have feared a life lived with pain.

Same thing when it comes to cancer. I have thought about what I would do if I got a cancer diagnosis, and long ago I decided that I would much rather live my very best life (even if it is a short life) rather than live a long life of pain and sickness.

As you know, pain is not a stranger. I have been experiencing significant levels of pain on a regular basis since the age of 16. That is why pain is one of the few things I really fear. I know what it is like to be in the grips of pain. I know the desperation it can cause. I know that death couldn’t possibly be worse than trying to live with constant debilitating pain. And yet, despite my efforts to avoid pain… this is what keeps pushing its way into my life.

Now that I finally got my migraines under control and was beginning to enjoy a life that was not dictated by pain, it is suddenly back with a vengeance. And this time it promises to be my companion for the rest of my life. My condition probably will not ever kill me, instead it will slowly rob me of the life I currently have. The pain is already here, and it has already forced me to stop swimming. Soon, I suspect it will creep into other corners of my life… keeping me from participating in some of my favorite activities. In the space that was once filled with dancing and laughter… there will be pain.

Yes, I can have a surgery to remove the tumor… or rather, I must have the surgery to remove the tumor, but there are no guarantees that the problem can be fixed. I may undergo surgery and come out on the other side feeling fantastic… but realistically, I should view the surgery as an attempt to keep the problem from getting worse. Yes, I might have some weakness and pain for the rest of my life… but it could be worse. I could lose control of my bladder. Yes, I might even come out of the surgery with even more pain issues than I currently have, but if I don’t have the surgery I know that one day the pain level will increase to the point of being unbearable.

So there really is not a “good” option… only different different shades of the same color… variations on the same pain. And I am left sitting here wondering what kind of quality my life is going to have from this point on… despite years of trying to be careful.