Background and overview

I learnt more about the health system from being an inpatient than I had in 20 years of working as a neuropsychologist. I was unexpectedly diagnosed with two brain tumours on 4/9/13. They turned out to be grade IV Gliomas (glioblastoma multiforme (GBM)). After removal of the right parietal and left occipital tumours, I received the standard treatment under the Stupp protocol (combined Temozolamide (TMZ) and conformal radiotherapy 5 days/week for 6 weeks), but the TMZ had to be ceased after 5 weeks because I had started to develop pancytopenia, where more than one of my blood counts had begun to drop. By Christmas 2013, I had become anaemic and needed a couple of blood transfusions. I ended up in hospital for 3 weeks of the 2014 new year after experiencing my first seizure (suggestive of a right temporal lobe focus) on 31/12/13). They were so worried about my bone marrow, they did a biopsy. Luckily, it was all clear of any nasty disorders. It had just been suppressed by the TMZ My blood counts slowly returned to normal with daily injections of GCSF, which stimulate bone marrow function, for several months. For 17 months I was doing better each day, without any physical impairments or major cognitive problems A third brain tumour was found in the right temporal lobe on 2/1/15, and removed 6/1/15, only to reappear on 17/2/15 after I started to feel vague symptoms at the end of 2014. I had my 4th round of brain surgery on 1/3/15, followed by stereotaxic radio surgery of a residual, inoperable, tumour, on 17/4/15. I've been feeling like my old self again since that highly precise form of radiotherapy, and it feels fabulous.

My way of coping.
I choose to live in hope that everything will work out for the best. I've learnt that even though things are sometimes unpleasant, life and love go on forever. I put my faith in the life force that created and unites us all in love, across all time, space, and dimensions. I refuse to succumb to fear, which is an invention of our imaginations. There are an infinite number of things to fear, both in this world an in our imaginations, and most of them never eventuate. I choose not to dwell on them, and to focus instead on counting my many blessings, current and past, and to have faith and hope that if I look after the present moment, the future will look after itself.

If you're reading, and haven't been in touch, please don't be shy, send me a brief private message using the contact form on the right. It's nice to know who's out there. Blogging can leave me feeling a little isolated at times (I used to have recurrent dreams of being out on a limb over a canyon, or of starting to strip off in a crowded waiting room). Your emails are appreciated, although I can't necessarily answer all of them.


Friday, 17 April 2015

leading up to stereotactic radiosurgery

Friday April 17th.
It's 1040pm, about 10 hours after I had my stereotaxic radio surgery today. It's a form of radiotherapy that is more precise than the conformal RT I had for my first two tumours. The oncologist said it fuses the CT and MRI images and allows a highly focussed dose of gamma radiation to precisely target the residual tumour. He showed us lots of before and after images where the treatment seemed to have resulted in the tumour disappearing completely. I hope that happens for me. The chirpy nurse who told us about the treatment said I am likely to get tired, and walked us through an information sheet on brain RT for the first time ever. If I get a headache that becomes increasingly severe despite taking paracetamol, if I get nausea, vomiting, unsteadiness in my movements, or other general or focal neurological signs, I have to call the after hours service at the hospital and possibly return there.

Nothing like that has happened yet, and I had a good sleep this afternoon, after sleeping very poorly last night.

I haven't been feeling overtly anxious, but I haven't been feeling right these last few days. Any tensions or arguments, or potential arguments, within our small family unit have been very distressing to me, and have made me wonder, at times, if life is worth living. Of course it is. I've had a wonderful life up until this recent recurrence of GBM, and I don't want it to end. I want to continue to enjoy the company of friends and family, and to experience this wonderful world that we live in.

We came to Melbourne on Monday evening, after Ben finished work, and are staying with his friends Fowzia and David in Montmorency, a suburb near our old house in Eltham. They are being very good to drive us around to various places, and have been looking after our boys while we've attended appointments. Fowzia is a spectacularly good cook, so we've all been enjoying ourselves at the dinner table, including David and Nathaniel, who have been sampling and enjoying a range of different dishes. We had dinner at a fantastic Thai restaurant in Watsonia last night, where the food was better than anything I've had since I went to Thailand in 1990.

Tuesday was spent going to see the new oncologist at the Epworth private hospital in Melbourne, where I had a CT scan for him to do treatment planning for today, and where they made a new mask for the treament itself. The mask was lime green this time, and had a base structure that reminded me of Hannibal Lecter's in Silence of the Lambs: horizontal bands over the forehead, upper lip, and chin, and vertical bands down the middle and sides. They put a hot plastic sheet over all of it and it set into shape. Like the first one in Launceston, I was able to breathe and see through the diamond-shaped holes in the plastic. The mask clips into the headrest on the treatment table, and prevents the head from moving during the treatment. I found it very firm when they put it on today, and although my jaw had been relaxed when they made the mask, it felt extremely firm on my chin. It was more comfortable if I held my jaw shut, but I didn't want to risk moving my head even a fraction from the position used for treatment planning, lest the gamma radiation miss its target zone.

Wednesday was spent on a trip to the city - we took a 2-hour cruise on the Yarra river in the sunshine. It went all the way down to the docks, and back up to Heron Island, with a good commentary given by a handsome and tall young man from Cleveland, Ohio. He said he'd been working there for a few weeks, and did an impressive job of remembering many facts. Travelling on the river reminded me of my first year at uni, when I rowed in the bow seat in the first 8s for Queen's College. Rowing (usually starting at 6 or 630am) was far more peaceful than the cruise, with the mix of many chattering voices.
The cruise made me realise that we've spent too little time doing pleasant experiences in recent years. Experiences like the cruise, or even taking the train in Melbourne, are more meaningful than eating out at various places, which we've had to do a lot recently because I've not been up to cooking

I caught up with an old friend at the National Gallery for lunch on Thursday, and Ben and the boys found some things to enjoy in the Gallery, which saw me flooded with unexpected tears at the beauty of paintings and other works which were created by people in Europe, Egypt, Asia, and South America hundreds of years ago. It felt like being in a kind of time machine that allows glimpses of the past. I've sometimes been moved to quiet tears of awe in art galleries, but this was the first time I've ever felt overwhelmed and cried openly. David and  Nathaniel sat next to me, wrapped an arm around my back, and patted ny shoulders and made soothing noises, while Ben looked uncomfortable because peopke were watching and I had a black eye after fainting and falling after getting out of a hot bath last week. Apparently  people had been giving him funny looks all day. I had no idea,and hadn't   thought of wearing my sun  glasses to hide the bruising. Poor Ben, this time has been very stressful for him.