Steven Miles

First post: Aug 16, 2020 Latest post: Dec 25, 2020
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Steven is 66 years old and roughly 7 years ago decided to make a change to live a healthier lifestyle. He joined the local Planet Fitness and a few months later, quit his long time smoking habit. In June 2019, Steven married his longtime partner, Kevin Roberts, and they have enjoyed their active lifestyles together. Steven has a Fitbit and always wants to be #1 each week for the most steps, so enjoyed his 3-5 mile walks every morning. About 4-5 months ago, Steven was on a walk, felt dizzy and stumbled to the ground. He was fine, although had a few scrapes. It didn't slow him down. He continued the daily walks and a couple weeks later had a similar dizzy experience and stumbled again. That didn't slow him down either. About 3 months ago, in early May, Steven was taking the garbage out to the street, felt dizzy and tripped on the curb and fell into the street. He couldn't get up due to the pain in his left side. He went to Urgent Care the next morning and they said no broken bones! It was a sprain, they told him to rest for the next 3-5 days. He didn't see a lot of improvement over the next 3 weeks and took a fall at home in the yard and a few days later, inside the home due to his left leg giving out. He decided to call his PCP and had some xrays done. They found 5 hairline fractures in his pelvis and he was referred to an orthopedic.

Over a 2 week period, the orthopedic did a CT scan and MRI of the pelvis and low back area. They realized he also had a bulging disc and pinched nerve in his low back, near the L5 vertebrae. They told him to be sedentary, use the walker and take it easy over the next 1-2 months, to allow the fractures and disc to heal.  In mid-July, Steven was feeling improvement in his pelvis and low back, however, new symptoms started to appear. First it was some numbness and ongoing muscle weakness in his left leg.  He initially thought this was related to the bulging disc in his low back. The numbness and muscle weakness started to move up to his left arm and periodic muscle spasms increased in frequency on the left side. He had a follow-up visit with the orthopedic and they ended up referring him to a spine and back neurosurgeon. 

Steven met with the neurosurgeoon, Dr. Manzano, on 8/5/2020, they scheduled a brain and neck MRI, as the doctor was confident the left side numbness and muscle spasms were not related to the bulging disc or pinched nerve.  The neck MRI was clean, no issues of concern. However, the Brain MRI clearly showed a large tumor mass on the right side. Dr. Manzano said surgery would be needed and referred Steven to Dr. J Christopher Wehman to discuss brain surgery. 

Steven met with Dr. Wehman on 8/13/2020 and they discussed the prognosis and treatment options. Based on the Brain MRI, the symptoms and other CT scan results, Dr. Wehman is pretty confident Steven has a primary glioblastoma tumor mass on his right parietal lobe, bumping up against his primary sensory cortex and posterior frontal lobe. The tumor has "tentacles" that are intertwined into other parts of his brain. Based on where the tumor is, the swelling and its size, it will cause various symptoms on the left side of the body. This can include symptoms like dizziness, numbness, tingling, muscle weakness, focalized seizures on left side of body (these are the muscle spasms Steven was having), fatigue, memory issues, etc. All of which Steven had noticed, to some degree, over the past 4-6 weeks with increased frequency. While Dr. Wehman cannot know when the tumor began, it is an aggressively growing tumor and could very easily have been there the past 4-5 months, which is around when Steven's dizzy symptoms first started. 

Dr Wehman gave 3 options to begin treatment for the brain tumor: 

1) Biopsy only, where they drill a hole in the skull, take a small biopsy and in 2-3 weeks they should know the  exact type of tumor mass it is. It can take time for the skull to heal, so there could be a delay in doing the surgery. Any delay can cause the tumor to continue to grow and increase the debilitating symptoms for Steven. Radiation/Chemotherapy combination treatment would be done as well over a 6 week period. Average life expectancy is 6-15 months.

2) Perform a partial tumor removal, specifically for the main tumor mass, but leave the tentacle parts of the tumor as attempting to remove them can be challenging due to the location of each tentacle. Think of trying to remove the chocolate from a marbled cake. And if you get any of the non-chocolate portion, it significantly increases the permanent disability. A biopsy would be performed to confirm the type of tumor, results in roughly 2-3 weeks, then about 30 days post-surgery, radiation/chemo would begin for 5 days a week for 6 weeks. Average life expectancy is 20-24 months.

3) Perform the full tumor removal, including tentacles and being aware of potential permanent disability and no longer being able to walk, even with a walker.

Steven decided on option 2. He made clear to Dr. Wehman that quality of life was the most important factor. Steven would love to regain full use of his left side to walk without a walker again. The Dr made clear that is likely not possible due to the damage the tumor has caused, even with a partial removal. However, the surgery and treatment can help keep quality of life high and may extend the life expectancy a few months or years...each person is different and it will depend on how well surgery and recovery goes. 

Steven's surgery is scheduled for Monday, 8/17/2020 at ORMC in downtown Orlando, FL.  He is expected to be inpatient for 2-4 days, assuming no major complications. Then depending on how well surgery and recovery goes, he would either go to an Inpatient Rehab Facility for 1-2 weeks of rehab OR be discharged home, where his husband Kevin and a Home Health Aide can help with rehab. Then the radiation/chemo would begin about 30 days post-surgery, for 5 days a week for 6 weeks.

Steven is staying positive and looking forward to continuing a fulfilling life with Kevin and their little chihuahua, Taco. They plan to live their lives with Love, Joy, Happiness and Fun. ❤️🧡💛💚💙💜

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