After the results

Short version: Last week I got the biopsy results and they came back benign. This means that radiation will be ineffective, so the move is open-skull surgery. The goal is to completely remove the tumor, and hope for a 100 percent cure--snip, snip, suck and done.

It is a tricky lay; the tumor is in the middle of my head. The plan, as it was showed to me on computer screens, is to position me on my stomach, then cut a nice square of bone out of the back of my skull. Then they reach in, cradle my thalamus, snip and tie-off a few arteries, then dislodge my thalamus enough so that they can gain access to the channel leading to the Center of My Brain and the sneaky little tumor hiding there.

Then they take out as much of the tumor as possible. Knifes, suckers, snippers, grabbers. I imagine they look like miniature versions of my house tools.

The snag is that the tumor sits on my brain stem, and that last one percent of tumor bit that's attached to the stem could be very dangerous to remove. So sometimes they will leave that bit--the doctor would not want to risk doing any real damage, like leaving me paralyzed or in a coma. The risk, however, in leaving that last bit is that it might eventually decide to grow again, and some day, we'll have to go through this show again. Still, that's better than poking the inside of my stem and turning me into a breathing sponge.

How tricky this will be will only reveal itself during the surgery. It's one of the many calls the neurosurgeon cannot prepare for. All things are decided while my head is open and I am in that fast and deep anesthetic sleep.

Other facts:
It's an eight to ten hour surgery. The rehab will be more significant than the last surgery, which was quite easy. This time I will have to go to a rehab center and stay for a week or two. There will probably be some balance and coordination issues that might take some months to get back to 100 percent. Everyone is different, is what they tell me. So there's no telling precisely how easy or hard this will be.

There is good news in all this--the doctor did seem to feel that there was a 2 percent of less chance of anything going Very Wrong. (This is the death, coma, permanent disability type-stuff). Going into this, with the research Trudi and I had done, we had found a meta-study of this type of surgery, and in it the red zone percentages were closer to 10 percent. Hence why I've been so afraid of having this surgery.

But our doctor explained that those numbers included all cases--severe or desperate(did he call them hopeless?) cases who were most likely to die anyway, and old people, all of which makes a significant difference in the morbidity numbers. For me, he said, ten percent is not a realistic number. So, in the way of catastrophic possibilities, it's the same as the first procedure--2 percent. Frightening, but doable. So we roll the dice again.


Now, it's a matter of choosing when and where and with whom to have this surgery. I am unable to make any such decisions right now, or indeed, think about things like that at all.

Since Friday I have been very anxious and lethargic. I sleep a lot and do not answer my phone. I don't know why exactly--I was told almost exactly what I expected I would be told.

The previous stage- waiting for the biopsy results--was a safe place. I had made it through the first surgery, and though I knew that more difficult things were to come, I still felt some sense of strength. I had brain surgery; I was fine. I could sit and wait. I could watch TV, play guitar hero, watch movies, walk the dogs, even start a small amount of house work again.

And then the biopsy results. I am filled with tremors. I can feel them in my stomach, in my hands. I have these itches, which I can't place. They're in my hands, but I can't scratch them. They're inside my skin, in places I can't find.

I find it difficult to sit still. I want to do things with the house, but I find that even thinking about a choice, any choice--buy a desk? from where? for how much? Where will I put it? What about the sofa? and when are we doing the painting in the kitchen? did we buy the paint already?

All these things were so easy to deal with before. They were nothing. They were just questions. I thought them over, talked about it with Trudi, weighed the pros and cons and Blam--made a choice. So simple. Things got done.

Now? I feel everything--any one question and its many possibilities, the possibilities of what I could choose, or what it all could become. The possibilities come like an hammering waterfall, pressing and beating on me.

It's been hard to write, hence the week-plus layoff. I start something, then stop, then start again. I cannot finish.

My parents are also filled with anxiety, and talking to them makes my arms itch and I want to hang up the phone.

Here's an example from the house. We have an impressive barge of trash floating in our yard--our discarded carpets, sheet rock, boxes and boxes and tons of bags filled with all manner of house debris. I've been waiting for the pile to accumulate enough to hire a dumpster, and then get rid of it in one big shot.

Well, the other day we had some local boys--not boys by their age but by their good-ole sounding demeanor--who wanted to trim our lawn which had grown up to knee-height in some spots, and also offered to move our trash out to the edge of our property in the alley behind our house. They wanted ten bucks to move this mountain of trash. "Nah," I said. I said no because I had seen what happened to our neighbors who had put a few trash bags at the end of their property line in the alley--someone came along and dumped a ton of crap on them--furniture, bags, boxes, moldy mattresses. I didn't want to see this to happen to me. So I told the guy not to move the trash over. Plus I didn't think that the city would pick up that stuff anyway, and I'd still have to hire a dumpster. What was the point?

This morning, brush and bulky came, and like magic, with a mini-crane, they lifted all the neighbor's trash away. Trudi had called me over, ecstatic to watch. "Wow, look at that!" she said. She clapped and giggled. "It's like the prize game at arcades, where you have to grab the toy with the mechanical arm." We watched it lift a small dresser, hover it over the dumpster, then crush it flat in one squeeze.
"Isn't that cool?" she said.
I sighed. "Fuck, fuck."
"What's the matter."
"Nothing," I said. "It's just I could have had those guys take all this trash out there." I looked at the twin piles of garbage in my yard, just outside my back windows, sixty feet away from the mobile dumpster passing through our alley. It was too late.
"I could have had those guys drag all this out there. We could have been rid of all this stuff. Goddammit. Why didn't I let them take it out?"
Trudi looked at me. I could tell she was shocked. This is not my normal self. I have learned some good ways of dealing with things in life. Partly from learning to deal with my rageing father as a child, partly from twelve step stuff when I was older. But I have learned how to deal with these little life things, how to not let them derail me. It's simple--there's no sense in regretting something's that's done. Learn from it for next time, then move on. I was a pro at this. Not only was the whole garbage situation upsetting, but I understood my reaction to it to be a regression of sorts. I could not handle things I used to handle. I knew better than to be upset over this. I made a choice, it was a mistake, but nothing I couldn't fix. So I'd just have to hire a dumpster and clean it out myself. I knew it wasn't a big deal.

But it felt like it was. I had fucked up. I had not thought things through correctly. I had made things harder on myself, things I would have to deal with in the future.
I walked away from the kitchen, not wanting to see the pile of junk sitting in the backyard.
Trudi came up behind me quick, and gave me her positive thinking stuff. "It's fine, it's no big deal." Of course, I knew this. Which angered me more. I knew this, yet still felt crippled with regret over such a little thing. I wanted to run away from that backyard, get it out of my sight.

I know this is all about the tumor. I know I am afraid if might make the wrong choice, an inefficient choice, like I did here--what would this mean for my life? This place, where I live now, is not as easy a place as it once was.