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Mi historia

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.


Karl Orscheln posted a new journal entry, "Arrangements".

Arrangements for Karl's Celebration of LifeSunday, September 9, 2012Visitation from 3-8Buchholz Funeral Home2211 Clarkson Rd.Chesterfield, MOMonday, September 10, ... Lea más

Sheryl Orscheln signed Karl's Guestbook.

Dear Karl, I finally realized that this would be the first Mother's Day that you would not be wishing me a Happy Mother's Day.  Let me tell you that I am proud to be your ... Lea más

Cindy Tucker signed Karl's Guestbook.

I just found out about Dr. Orchlein today.  I used to work with him at Cox South.  He was one of the best doctors there.  Approachable and real.  I am so sorry to hear ... Lea más

David Hopkins signed Karl's Guestbook.

SherylWe are so sorry for your loss. Hope it helps that you and your family are in our thoughts and prayers.David and Kelli Hopkins Lea más

Wendy Carter signed Karl's Guestbook.

Jen, There are no words. I am so very, very sad. I will pray that your family be comforted as much as possible... Love, Wendy Carter Lea más

Kara McIlvain signed Karl's Guestbook.

Jennifer,Your grace and love have been so admirable.  You are the strongest woman I know.  I wish I could take away your pain.  I will continue to pray for you all. ... Lea más

Ann Nolan signed Karl's Guestbook.

Hello, My name is Ann Nolan and I have known Karl since 2009 through my organization, the Society of Hospital Medicine.  We worked remotely together on SHM's Glycemic ... Lea más

Anneke Jeffries signed Karl's Guestbook.

Jennifer, You and your family will continue to be in my thoughts and prayers.  I am writing a letter for Nathaniel to share a few memories of Karl that always make me ... Lea más

Kathleen Jeffries signed Karl's Guestbook.

My thoughts and prayers are with you all.  The love of Jesus Christ will help heal the pain and sorrow of this terrible loss. Lea más

Kelly Harding signed Karl's Guestbook.

Jennifer, I don't know if you will remember me but I went to school with you in Moberly.  I just found out about Karl's passing through various facebook posts and ... Lea más

Kim Mellinger signed Karl's Guestbook.

Hi Jennifer, Just read all the entries that you and Karl have posted over the last three years.  I am so impressed with how well you and Karl have been able to stay so ... Lea más

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