A long break

I cannot believe it has been over six weeks since my last entry.

I must be forgiven. Excuses for not writing always abound. But we'll stop for none of that now, only fill-ins of important facts and data and brain tumor happenings from here out.

My last meeting with Dr. Vitaz, my neurosurgeon here in Louisville, well back at end of May, established that it was, unfortunately, inevitable that the tumor come up and out. What was left to be figured was where and how this would happen. There are two approaches, he told me--above the cerebellum, the lower path, or trans-ocular, the high road. Trans-ocular, as you will readily guess, means he must go through the area in the back of the head which deals with vision. Obviously, this is not ideal, so Dr. Vitaz said he would opt for the Cerebellum route. Cerebellum, mostly dealing with balance and coordination, a much less delicate area than vision. I naturally agreed with this logic. As to where: He understood I had family in New York, and so he gave me the names of doctors there, at Memorial Sloan Kettering Hospital, in case I wanted to be near my family. However, he felt completely confident in his ability to perform the surgery. One of the doctors he recommended in NY, should I go that route, normally does pediatric surgeries--my pineal gland tumor is often found in children. (It has even been theorized that my tumor *may* have been growing since I was a boy. Alas, no way to know--no telltale rings.)

And so, after a few weeks of being horribly anxious and fearful and medicating that anxiety and fear with a steady stream, few at-a-time-pills (pain-killing, anxiety-killing, supposedly), Trudi made some phone calls for me (I found myself helplessly, and understandably, unable to deal with any of the pragmatic issues regrading this next surgery) and soon I had an appointment in NYC, at Sloan Kettering, with a Dr. Phil Gutin. We drove up to New York, fourteen hours of dogs sleeping in laps, CDs on repeat, and just that fast we were in the mid-July of NYC. This was no pleasure trip, though, and for my part, not too many social calls. Mostly just the business of the brain, and the doctor.

I liked him. He certainly looked me in the eyes, the ability to do which is a definite asset in a brain surgeon, I've learned, and he even went out of his way to touch my shoulder a few times. My father came and sat in as well, tried to follow along. Trudi came with an arsenal of good questions. I was flanked on either side by support.

What he said was that he would not go the Cerebllum route--that he would, instead, go trans-ocular. This was a surprise. He didn't want to go into details just yet, he said. He wanted to go over it fully with the other doctors. He explained that he and a Dr Soweidane would perform the surgery in tandem. Two for the price of one. I wasn't sure how to feel about this, but it was interesting, at least. He had to speak to Dr. Soweidane and the rest of the board, and then he would get back to me within a few days.

When Dr. Gutin called back the next day, my father and I were browsing around Barnes and Nobles (which my father sometimes calls, to my amused horror, 'the library' "Hey frank, drive me down to the library," he'd said, and for a moment, I thought I'd been teleported straight into some other family). I ran out into the heat and midday bright sunlight of Union Turnpike, plugging a finger into my open ear, trying to block all that Queens nonsense of buses and kids and noise. I was desperate to know something, but what I wasn't sure. I wanted to hear something that would tell me where to have this surgery, one way or the other.

Gutin told me, as he had before, that trans-ocular was the way to go. He gave me three reasons: one, my shoulders were pretty big. Funny. But they'd get in the way if they were doing the cerebellum. Second reason had to do with the angle of my head. It made the supra cerebellum path a bit tighter then was ideal. Finally, he said, Dr. Soweidane felt that the place the tumor was most likely attached would be very difficult to get at from the cerebellum route. And then Gutin said--knowing that I was contemplating surgery in Louisville and that my surgeon here was going to go through the cerebellum--he said, in quite a clear way, that they did NOT feel this was a matter of debate, nor preference. To them, this was the only correct medical option, despite the inherent risks of trans-ocular. My particular case, they felt, was safer this way. Gutin was telling me, in a most professional manner, that my other doctor's opinion was not the correct one.

Vitaz trained in Sloan Kettering. While very good, he did not, to my feeling, have the same level of expertise as the doctors at Sloan Kettering. The level of detail that was presented to me over the phone told me that much at least. It felt as though I had little to debate at this point. I trusted Gutin, and though I'm afraid of anyone touching anything that has to do with my vision, I believe this to be the safest option.

Surgery was scheduled for September 9th, which was the earliest both doctors are available.

Now the only little thing to deal with is the insurance. Which is a whole other story.