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Welcome to our CaringBridge website. Jennifer and I have created it to keep friends and family updated about me. Get started by reading the introduction to our website, My Story.
Visit often to read the latest journal entries, visit the photo gallery, and write us a note in our guestbook. We read every entry and appreciate them all, even if we can't respond.
In July I noticed that I was having transient attacks of aphasia (trouble with speech). They were fleeting and gone almost as fast as they started. The first one happened while I was teaching the residents and medical student on the inpatient Internal Medicine service. The second attack happened a couple of weeks later while I was talking to a patient. I thought that it was just stress because of working long hours and driving back-and-forth from home. However, I knew enough to realize that I needed to see my primary care doctor ASAP.
Dr. Michael Schoenwalder was gracious enough to squeeze me in one morning before office hours. After hearing my story he ordered blood work and an MRI of my brain. It took me a few days to schedule the MRI because I did not want to leave work to do it in the middle of the day. I finally got an appointment late in the evening at the scanner located in the hospital.
Nothing I ever heard about MRIs from my patients did justice to the experience. I am not claustrophobic, but it was still an uncomfortably tight squeeze. And it does not just sound like someone beating on a metal trash can. It sounds like you are IN the trash can, along with a kazoo, buzz saw, saber saw, router, belt sander and a few other miscellaneous noisemakers.
The MRI tech pulled me out of the machine after what seemed like forever. He told me that I was 3/4 done, and he gave me an injection of IV contrast. Then he told me that I had 10 more minutes. I was not wearing my watch (metal), and I could not see a clock. However, I could tell that 10 minutes came and went. The banging stopped, and in the rearview mirror I had in the tunnel I could see a second person in the control booth. Then the tech told me over the intercom that he needed some special pictures that would take a few more minutes.
At that point I knew I was in trouble. Sometimes being a doctor is a liability. I started trying to think of all the memorized prayers I could remember from Catholic school. Then it was suddenly over and the table was rolling out of the tunnel. The tech helped me up and showed me where to throw away my ear plugs (yeah, they don't help much). He seemed pretty subdued compared to when I started. Then he led me to the door.
There is a radiologist at St. John's, Dr. David Niebreugge, who went to college with me at Saint Louis U. I had seen his name on radiology reports for my patients, and we had seen each other in the hall a few times. He was there when I walked out of the MRI room. He showed me my pictures. He is a very nice guy, and I feel bad that he had to be the one to break the bad news.
In the left hemisphere of my brain there is a tumor. It is in the area that controls speech. My friend told me that based on how it looks on MRI it is probably a low grade glioma like an astrocytoma (cancer). It doesn't look like an infection or a memingioma (benign). However, until someone goes in there to get a piece of it for a pathologist to look at we simply don't know. To that end I have an appointment with a neurosurgeon named Dr. Yoon on Monday. Now you know as much as I do.... :)
I saw Dr. Yoon today. My tumor is too far in the insula for him to operate on it. He recommended that I talk to someone at Barnes Hospital/Washington University School of Medicine. He suggested "awake" surgery so that they can monitor my brain function while they try to remove the tumor. I see Dr. Rich tomorrow (8/25). I hope that he's not running late. I have to be back at St. John's by noon so that I can give Grand Rounds.