We've spotted something on your scan...

So a word of warning, this isn’t a blog post about web performance. I’m afraid those posts may need to be paused for the moment.

If you’ve already read the original post you can jump straight to the latest update here, or all updates here.


Note: I feel the need to point this out. This post is about a brain tumor and cancer. It’s important to realise that the doctors considerations, and ultimately treatment, are unique to my situation. Anything mentioned in this post shouldn’t be taken as gospel. If a reader finds themselves in a similar situation, please do take the advice of your own specialists. What works (or doesn’t work) for me will 100% be different for other people.


Diagnosis

To be fully upfront about all this, on Wednesday 21st April 2021 I was diagnosed with a brain tumor. Completely out of the blue. In the morning I was busy working away still trying to get Brotli compression tested and enabled on GOV.UK, 7 hours later I was given the news that I had a large brain tumor on my right frontal lobe. Hell of a day, huh!

So you may be asking: “Why are you writing about this?”. Well, there are 3 main reasons:

  1. I want to get this info out of my head (hah!) while I can still remember it.
  2. From the conversations I’ve had with people since this happened, people are fascinated with how it was discovered.
  3. To offer help to others in a similar situation that I (and my family) are currently in.

I’ve seemingly learned a fair amount about myself and the topic in the past 3 weeks. If you’d like to know more feel free to read on, or if you’d prefer to stick to web performance I have plenty of blog posts here which are much more light hearted!

Note: We have now enabled Brotli on GOV.UK, thanks to Jake Archibald for the humorous reminder :)

What happened?

This is a question I’ve been asked a lot. From nurses, doctors, pharmacists, out of hours doctors, and family and friends. So I’ll give you a rundown of what happened below:

Initial signs something “wasn’t right”

Back in October 2020 I started to develop issues with my lower left back and left leg. Multiple consultations with the doctors were of the opinion it was sciatica. I was given strong painkillers, told to look at getting physio, and make adjustments to my working environment. This actually all made sense at the time. Working from home for 8 months, with less physical exercise, and generally working more hours than usual, all could have easily caused this issue. Unfortunately, no matter what I tried it didn’t solve the issue. I tried: a standing desk, new office chair, new shoes, lots more walks, physio. Nothing seemed to be helping. It got so bad at one point I was crawling on my hands and knees at 3am to go to the bathroom because I was in so much pain. Not exactly what you expect to be doing at the age of 39!

After several months the back and leg pain seemed to fade, but it then turned into extreme heel pain in my left foot, which the doctor said was likely to be plantar fasciitis. Apparently runners tend to get this a lot, but I certainly wasn’t running! So yes, a fun 6 months!

But things have developed further and over the past 4 - 6 weeks I have experienced 3 seemingly very minor seizures. Throughout each I was fully conscious. I will try to describe each of them as I remember them the best I can.

Seizure 1: Standing at my desk

I now have a desk that allows me to both sit and stand very easily. I’ve got into the habit of standing for meetings with people while on a video call, but when it comes to “real work”, I always sit. This tends to give me a good balance of both sitting and standing throughout the day.

For the meeting in question I just so happened to be on mute and wasn’t speaking at the time. I suddenly felt quite dizzy and had to lean on my desk a little. At first I thought I was having some sort of panic attack. I don’t remember the topic of discussion for the meeting, but at the time it happened I was thinking “maybe this is making me anxious?”. I do remember having a really strange out-of-body experience (OBE) while it was happening. It’s hard to describe, but it’s almost like coming to the realisation that that “you are fully in control of everything you are doing” and “you have an effect on your surroundings and the people you interact with”. It feels more like a powerful emotion than anything physical. Or another way I’ve described it is imagine someone turned off the auto-pilot in your head. You are now having to consciously breathe and blink for yourself, as well as think about all the other things going on too.

Within 10 - 12 seconds this intense feeling had passed and I suddenly felt fine again. It was the first seizure I’d had, so I thought nothing of it, and simply moved on with the rest of the day.

Seizure 2: Driving in the car

This was around 2 weeks later. Now this one scares me now that I know more! Technically I wasn’t moving at the time, I was parked at traffic lights waiting for the light to turn green so I could then pull across a carriageway into the local supermarket.

Suddenly, I had the same OBE I’d felt before, where I felt like someone had pulled “me” out of the back of my own head. In front of me the lights turned green and I managed to pull forwards and start moving a little, so I had some control of my feet. Unfortunately I didn’t have the strength in my left arm to fully disengage the handbrake, so the warning alarm sounded in the car to tell me it was still engaged. I was fully conscious. My brain was telling my hand to push down and release the handbrake, but my hand simply couldn’t. It was a very strange experience where your arm and hand seemingly has a mind of its own.

Because the alarm was beeping, my wife looked over and mentioned that the handbrake wasn’t down, but she didn’t notice anything else in me that looked different. I didn’t try to speak to her, and I’m not even sure if I’d have been able too if I’d tried. Again, within 10 - 12 seconds this had all passed and I was fully able to move and control the car. We went to the shops and returned home with no further issues. Once again I put it down to a panic attack, but as it all happened so quickly I dismissed it and carried on with life. At this point I hadn’t linked the 2 separate events together.

Seizure 3: Sitting at my desk

This is the one that happened on the 21st April, the day I was diagnosed. It was around 10:50am and I was sitting at my desk working on a document. Suddenly the OBE I’d felt before came back. Only this time I lost control of both lower arms. I was unable to raise them to the keyboard to continue typing. It then developed further and I felt like I’d lost control of the lower half of my face. Almost like someone was gently pulling down on both sides of my cheeks and I was unable to stop them.

I realised this was happening, as I was fully conscious. During this time I must have tried to move, as I’d started to lean to the right side of my chair. I was rotating slowly, unable to really control my movements. Again as with the other seizures, within 10 - 12 seconds this all passed and I could again control what I was doing. But this time it was different.

With this seizure I’d been sitting at my desk, nothing strenuous was happening at all. It was quiet and I was calm. Because of this I was able to notice that I simply couldn’t control my hands and that my face had “drooped”. This immediately alerted me into thinking that I was having a mini-stroke. Now, I’ve seen the FAST campaign adverts on TV, and realised a stroke can become very serious if not acted on quickly, so that really freaked me out!

NHS 111

I immediately opened the NHS 111 website (the UK non-emergency advice service), to fill in the details of what had just happened.

Right on the front page of this service it says:

Check it’s not an emergency - Call 999 now if you have: signs of a stroke - face dropping on one side, can’t hold both arms up, difficulty speaking seizure (fit) - someone is shaking or jerking because of a fit

At this point I was thinking, “okay.. I’m going to have to phone 999” (for the first time ever in my life). But before I did I thought I’d best discuss it with my wife downstairs. I walked downstairs and calmly told her about what had just happened and also the other brief episodes I’d had weeks before (as I hadn’t mentioned them to her). We both agreed that 999 would be the best option.

It was a strange conversation with the 999 dispatcher. They were talking to me, “the patient”, asking if I was fully conscious and able to lift my arms, move my face etc. These are all standard checks for a stroke. I was able to do everything they were asking me to do with ease. At this point I felt like a total fraud, and I was simply wasting their time. I further described what had happened and that it had now passed, but I still felt a little weak in my lower arms.

I was categorised as a priority 2 (I believe) and told an ambulance would be with us within the next 5 minutes. So I quickly started to pack a few things just incase I needed to leave with them for the hospital sharpish.

Ambulance

Within 5 minutes there was an ambulance outside the door. Two very nice paramedics came in the house and questioned me about how I was feeling and what had happened. They checked my blood pressure, checked my blood oxygenation level, asked me to focus on their fingers, push & pull with my arms against theirs etc. These are all standard checks for suspected stroke patients. It turns out they couldn’t find any issues, which was embarrassing. It got me thinking: “had I just imagined this all happening?” and “am I just overacting and wasting their time?”.

One of the paramedics decided to speak to the specialist unit at the hospital to ask for advice, as they were unsure what would be best (and so was I!). After a 5-10 minute discussion I had 2 options:

  1. the paramedics would leave and I’d take this up with my doctor to see what was happening. This could take weeks.
  2. come with them in the ambulance and go to hospital for additional checks.

As I was still thinking this could be early signs of a stroke, I (thankfully!) decided that going to the hospital was the best course of action. Even if just to rule out the possibility of a stroke! So that’s what I did. I got in the back of the ambulance and 20 minutes later I arrived at the hospital and was admitted to a very busy ward.

Hospital

I’m afraid not much really happened at this point for an hour or so. I had chats with nurses and the doctors on duty, describing what had happened as I mentioned above. The doctor looking after me was a little perplexed by it all, as it was very unusual. I can’t remember the exact term he used, but I believe he was thinking these symptoms sounded like some sort of dissociative disorder. This was because of the OBE I’d described to him.

Computerized Tomography (CT) scan

As part of the standard checks I was given a CT scan. Not only that, they injected me with a special dye called ‘contrast material’. One of the side effects of this contrast is you feel like you’ve wet yourself about 20 seconds after they inject you with it. I honestly thought I’d had an accident when it happened. Apparently it’s related to the kidneys flushing the dye through your system. Either way, it feels weird!

Due to the ward being extremely busy I needed to wait for the results to be examined. This probably took around 5 hours. The first four hours seemed to go quite quickly. I had my noise cancelling headphones and a good book I was enjoying, so I was entertained (although slightly uncomfortable in the high back chairs and a face mask for COVID).

We’ve spotted something

About 5 minutes before being shown into a private room, the doctor looking after me came up to me and said the sentence:

We’ve not forgotten about you, we’ve just spotted something on your scan

Strangely enough, I couldn’t concentrate on my book or music anymore. That was a long 5 minute wait! Well, the 5 minutes passed and the doctor came back over and asked me to follow him into one of the rooms. “Fine”, I thought, “how bad could it be?”. But a few seconds later I could immediately tell something wasn’t right about his body language and manner. He seemed to be struggling to find the right words. And then he came out with it:

I’m really sorry to tell you this, but we’ve found a brain tumor on your right frontal lobe

I have to admit the rest of the conversation is mostly lost due to the enormity of what I’d just been told. It felt like the ground dropped from beneath me. But I do remember him saying it “was large”, and that “if you were to wish to have a brain tumor, this would be the type you would want to have”. A strange statement now I think about it, but one that has been confirmed since.

After about 3 or 4 minutes of chatting about who knows what, I just wanted to get out of the room. I actually felt quite sorry for the doctor. He must have done this so many times with patients over the years. I can’t imagine it ever gets any easier. I have a huge respect for anyone who has to do this on a daily basis, it must be totally crushing at times.

I quickly managed to find the words to thank him for letting me know and promptly left the room to try and work out how the hell I was going to tell my wife this over the phone. We’d been in constant communication all day via messenger, since due to the COVID restrictions she wasn’t allowed to stay with me. I knew she would be worried sick at home. It was around 7pm and she’d be getting the kids ready for bed.

I finally mustered up the courage to phone her and tell her what had been said. Again, I don’t really remember the conversation at all. But an hour or so later she’d managed to arrange childcare and she was on her way over to pick me up. She arrived and I think we were both still in shock. We didn’t really say much, other than repeating exactly what I remembered from the doctors conversation. That evening I was sent away with a concoction of drugs to start taking immediately, and then told to return to the hospital tomorrow morning 9am for an Magnetic resonance imaging (MRI) scan.

So what is it?

See, now that’s the million dollar (pound) question isn’t it. Not all tumors are the same. Some are benign, some are fast growing, slow growing, large, small etc. The CT scan could only show something was there, but not in the detail needed for a more conclusive result of exactly what.

At this point I’m going to skip ahead. I had the MRI scan the next day. Then a few days later another ‘wet yourself’ inducing CT scan. The full body CT scan was clean, showing that there were no other tumors or areas of concern in my body. Great news!

Meet my tumor

Time to cut to the chase. This is my brain tumor. There are many like it, but this one is mine. I’ve nicknamed him Gary Glia. Gary because it is a seemingly unpopular name nowadays in the UK (can’t imagine why…), so it seemed quite appropriate. And Glia because it is the type of cell in my brain that has gone tumorous.

Gary is an unpaying tenant that has taken up residence in my head. What a prick!

Top view of the tumor.
Gary from the top.
Side view of the tumor.
Gary from the side.
Back view of the tumor.
Gary from the back.

A few days later I had a meeting with the neurosurgeon where I was shown the above images. Now full respect to the neurosurgeon I spoke too, I like him. He was straight down the line and straight to the point. No sugar coating, no forewarning about the size of the tumor. After 30 minutes of chatting about all of the above, he simply pulled his phone out and showed me image number 1 you see above. You could say I wasn’t exactly prepared for the image, a understatement if ever there was one. But in all honesty I don’t think I ever would be. So it was a good tactic. Make it quick and painless, just like ripping off a band-aid!

So, what do we know about Gary?

  • He’s big… look at the size of this unit. I’m amazed I can even function at all to be honest!
  • He’s of the type called oligodendroglioma and currently believed to be a Grade 2 (slow growing) tumor. Wondering how you pronounce that? Isn’t YouTube great!
  • He’s very rare, with only 1,217 people diagnosed with this type in the US every year out of a population of 328 million!
  • He’s a number of years old. The neurosurgeon said a couple of years, but I personally suspect he could be 7 or 8 years old due to other symptoms in my past I now think could be related.
  • He’s a prick.

So I’ve basically won a really shit version of the lottery… but then again maybe not. It could be so, so much worse! I actually have options that I go into in the next section. There are people out there who are given this devastating news that include words like: ‘Stage 4’, ‘aggressive’, ‘inoperable location’ and are literally given months to live, and there’s nothing that can be done. Thankfully, I’m not in that place!

The positives

I don’t want to depress everyone, so let’s focus on some of the positives I’ve since found out:

  • It’s believed to be a slow growing tumor, that is currently classed as the less aggressive type (oligodendroglioma rather than anaplastic oligodendriogliomas).
  • It originated and is primarily located in my brain. I have no other areas in my body showing tumors.
  • It responds really well to chemotherapy. If I turn out to be 1p/19q Codeleted then chemotherapy is even better.
  • My symptoms (seizures) can be managed via drugs, which now look to have minimal side effects.

What happens next?

I’ve had a really great set of meetings with some very knowledgeable folks from Oxford University and the John Radcliffe hospital in Oxford. There are three options available to me:

1 - Do nothing and active monitoring

Basically manage the symptoms and look at how the tumor progresses over time. Go for regular checkups and see how long I hold out.

2 - Biopsy to determine the exact type

At the moment Grade 2 is suspected because the CT scan hasn’t shown the usual telltale signs of Grade 3 (which is bright white ‘spots’ in the scans). Doing this would require brain surgery to remove a small portion of the tumor to be tested. I’d then need to recover from this, before a more specific treatment plan is created.

3 - Remove as much as possible via major surgery

This is the last option, and the one I’ve decided to go for. This is where the surgeon open’s my head and will try to remove as much of the tumor as safely as possible. Once completed, additional surgery may be required to remove any tumor that is left over, or radiotherapy and (or) chemotherapy can be used to finish it off.

This surgery can sometimes take up to 9 hours, and it will most likely involve me being awake for it too (so not under general anaesthetic). I find that part both fascinating and terrifying all at the same time! The reason for this is because they want to be able to ask me questions while they are operating e.g. “move your left hand”, “blink your eyes”, “speak to us”. That way, they can be sure they are minimising the damage to the good parts of my brain. It blows my mind (hah!) that it’s possible to even do this, but I’m very glad they can!

But, as with all types of surgery (especially on the brain) there are some inherent risks:

  • 10-15% chance that it could cause a stroke or paralysis
  • less than 5% chance of a seizure occurring during surgery. This can be very bad indeed, and will result in the operation being stopped immediately
  • small chance of temporary paralysis on my left hand side
  • small chance of infection due to the head being open for a number of hours

Decision

As mentioned above, looking at the size of Gary, and weighing up the risks, 3 seems like the only viable option to me that could lead to the best overall outcome. Considering I’m 39 and not in my 70’s, compared to the alternative of doing nothing, it feels like a simple decision to make. So that’s what I’m doing. I refuse to go gentle into that good night, so it’s time to make plans to evict Gary Glia from my head.

It’s also worth remembering: neurosurgeons are amazing people and they do this day in, day out, as their job! This is just a walk in the park for them…

Moving forwards

So what happens now? Well I’m now on the waiting list for the surgery, and I have additional monitoring and scans coming up. It’s basically a case of waiting for a date and managing the symptoms. If it is that the seizures come back, or anything else gets worse, then things get reassessed by the specialists and the plan changes. I’m continuing to work as much as possible, and spending time with family. For me it’s all about keeping my thoughts away from the dark places they could so very easily slip into, which I fully admit they did for the first week after diagnosis.

Support

So here’s a section I’ve compiled for readers who may find themselves in the same position as I’m now in. Thankfully, brain tumors are rare, even more so if of the type oligodendroglioma and anaplastic oligodendroglioma, so there may not be many of you out there. But if there are, here are a few support links to help you out:

As you can see, there’s lots of support out there. Macmillan and the Brain Tumour Charity have been fantastic over the past few weeks. The work they do for people needs to be talked about more. They really are unsung heros working behind the scenes to make people’s lives better, in some of the most challenging times they will ever face.

Pro tip: Be very very wary of ‘Googling’ your type of tumour and reading random forums. There’s a lot of scary stats and topics out there that may be totally fictional, or only apply for that specific individuals case! A ‘random Google’ is a dangerous path to take. Trust me I did it and quickly stopped! If you can, stick with approved sources and those recommended by some of the charities listed above. Or speak to the team looking after you for advice.

Practical steps

Now, I realise there are some really terrible topics to have to talk about in the section below, but unfortunately they need to be considered. I’ve actually found the practical side of dealing with all this really useful. I’m completely powerless in terms of a future date for the surgery and the results of said surgery. But what I can do is make preparations for eventualities that may happen. It may not seem like much, but with the practical side it feels like I’m actually doing something useful. I’m moving the ball ever so slightly forwards.

So here are a few topics you could (should) start to think about:

Admin tasks

  • Make sure you share passwords with your other half! I recommend setting up a family 1Password account. With a shared vault you can securely share documents, passwords, notes, all in the cloud. No need for unsecure notebooks with written passwords that could be lost or stolen!
  • Cancel your driving licence and remove yourself from the car insurance. In the UK you won’t be allowed to drive if you have a brain tumor / seizures.
  • Make sure your partner is listed on household bills, and can talk to the companies.
  • Is your paperwork filed away in a single place and ordered logically?
    • Does your partner have easy access to it all?
  • Do you have a safe? If so, do they know how to get into it? Share the combination / backup key with them.
  • Start to make a list of what you will need to (eventually) take to the hospital. Maybe even start to pack a bag straight away. It’s not much, but at least it’s there ready to go when needed. Involve your partner in this planning too.

Finances

  • Check if your employer offers any pension scheme / death in service benefits. Is your partner listed correctly on these?
  • Ensure your partner can speak / access bank accounts if required.
  • Share details with your partner about your life insurance, income protection, mortgage payment protection etc. Maybe even speak to an Independent Financial Adviser (IFAs) about all this to check it is all in order.
  • Are there any extra benefits you are now eligible for e.g. Personal Independence Payment (PIP)? The charities listed above can help you with advice on this.
  • Consider setting up a joint account with your partner, and have shared money “just in case”.
  • Create a spreadsheet with information about your household utility providers e.g. who’s your electricity provider. Include account numbers, contact numbers, cost per month, payment method etc
    • On the same sheet you could include details about finances (Credit Cards, loans, higher purchases etc)
    • Include details about pensions, banks, building societies you are with including account numbers and contact details.
    • Remember to securely store this information (see the 1Password recommendation above)
  • If in the UK you will now most likely be eligible for free prescriptions on the NHS. You can apply for this through your local doctors surgery. So make sure you do this, as you’ll likely going to need a fair few drugs over the coming months / years!

Documents

  • Make sure you have a last will and testament prepared. Make sure executor’s are informed and listed correctly.
  • Ensure you have your Lasting Power of Attorney in place with your partner listed, as well as backups. You can ‘do it yourself’, or speak to an specialist advisor for this. I opted for an advisor, I don’t have the mental capacity or time at the moment to do it manually.
  • Make a list of questions to ask nurses / doctors etc. I’ve shared the list I made here that you can copy if you are struggling.

Above all else remember, you can make plans and be prepared, but even the most well-made plans can go pear-shaped quickly. It simply isn’t possible to pre-think and pre-plan everything for every eventuality. So there’s only so much you can do. But much that is listed above could be considered “good practice” for any adult anyway, even if you aren’t in the same situation I’m in.

Plans for this blog post

So what are the plans for this blog post? Well, I plan to keep this post updated with my progress for those who are interested. This will be the only blog post where I mention Gary the prick. Basically it will be a self-contained blog post about a topic I never expected to be living, let alone writing about! And as with my web performance blog posts, I’ll try to keep them as ‘living documents’ that are constantly updated as things change. I will continue to use the ‘Post changelog’ below in exactly the same way.

Thanks

So I have a huge number of folks to thank who have been amazing over the past few weeks:

  • My wife, who has been so incredibly brave throughout this. Immediately looking for information and support that is out there (both emotional and practical). She amazes me every day.
  • My parents, sister, brother-in-law and immediate both sides of the family who have rallied around to help us in whatever way they can. At the moment COVID restrictions make this hard, but this should become easier in the UK very soon. I can’t thank them enough.
  • Line managers from GDS, both past and present, who have helped ease my mind when it comes to the logistics of work in the future.
  • The Frontend community at GDS. I feel so lucky to be able to head up and work with such an amazing group of talented and dedicated individuals. They inspire me every day.
  • A certain ex-GDS colleague who shall remain nameless. They have been a fountain of knowledge in so many different areas that, in all honesty, I didn’t even realise existed 3 weeks ago!
  • And last, but certainly not least, the wonderful paramedics, doctors, nurses, and all workers of the National Health Service. The quality of care I’ve received so far has been truly outstanding. It’s all the more impressive considering the huge strain COVID is placing on the whole system at the moment. They really are heros!

And finally, thank you reader for taking the time to read the post. It wasn’t at all easy to write, but I feel so much better for actually taking the time to do it. Hopefully some of you find it useful. If helps even just a single person get through such a monumental, life changing event such as this, then it was totally worth my time writing it.

Updates

Another seizure - Monday 10th May

On Monday night I had a really ‘fuzzy’ head. That’s the best way I can describe it. It was almost like I’d taken some sort of sleeping tablet. I also had a ‘prickly’ head and scalp, quite sensitive to touch. I went to bed early but woke up at 2:30am with the same OBE I’d experienced before. I think I had another seizure in my sleep. I can’t be 100% sure as I fell to sleep again right after it. I just remember waking up to the same feeling.

On speaking to the team of specialists they said it’s most likely from lack of sleep, my body adjusting to the drugs and general stress with everything going on at the moment. They aren’t too concerned and my medication will be staying at the same level for the moment. If it gets worse in the coming weeks they will look to up the amount of anti-seizure medication.

I just need to work out what the triggers are, and the warning signs of one occurring. It’s a whole new world for me, so I don’t recognise the signs yet. You can live 39 years in a body, and still have no idea what is going on with it…

Messages of support - Thursday 13th May

I’ve been absolutely blown away by the huge number of messages of support I’ve had since writing this post. I posted it on Twitter and on LinkedIn and have received literally hundreds of messages. I’ve tried to respond to as many as I can, but I may not have seen them all. So sorry if I haven’t replied! Just to say thank you to everyone who has reached out. I really do appreciate the support. It’s all been quite overwhelming, and will admit to welling up a few times from the sheer number of them. What a crazy couple of days.

Neurosurgery pre-assessment clinic - Saturday 15th May

On the 20th May I have another appointment at the hospital. This is the pre-assessment for the surgery. I’m not 100% sure what is involved, but I’m going there with a list of questions I’m hoping to get answered. On speaking to a senior member of the team during the week the timeline for surgery has been revised down from 3 months to 4-6 weeks (assuming other higher priority cases don’t bump me down the list). This is good news, but also makes me a little anxious! I was mentally preparing myself for having 3 months to get used to the idea of awake open-head surgery. 4-6 weeks seems way too soon! But it is what it is. I’ll get used to it, it’s not like I really have much of an option…

Yet another seizure - Wednesday 19th May

A short update. I had a very short ‘mini’ seizure in the morning just after waking up, around 6:10am. I was feeling perfectly fine, then suddenly my face felt quite warm. I could feel something was about to happen. I had the feeling of losing control of my face again (drooping), then started rocking gently backwards and forwards in my seat as has happened before. I was fully aware and conscious during this time. Around 10 seconds later I was back in control. It was nowhere near as intense as some of the other seizures I’ve had, but it’s still a seizure. So it’s important to keep the specialists informed. I believe we may look into upping the dosage of the Keppra drug I am on in the coming days.

Pre-operative assessment appointment - Thursday 20th May

So today was an interesting day. I learnt a lot about the upcoming treatment and the weeks ahead. The more information I have at the better, as planning anything is virtually impossible at the moment! I had a 2.5 hour meeting with a friendly senior nurse on the team looking after me. She answered all my questions and gave me a rundown of the coming weeks, months, and years. I’ve tried to break what was said down into sections following a chronological order of future events. Ultimately the reason for the consultation was to prepare me for surgery in the future, which is a good thing. Although I’m still very nervous about the thought of a whole team poking around in my head, the information given to me today has really helped me understand it all.

Future seizures

I need to start logging any previous and future seizures, this is very important. Ultimately the plan is to achieve a sustained period where I don’t have any seizures, while keeping me on the minimal amount of drugs possible (due to drug side effects). There’s a fine balance to achieve this, and we aren’t there yet. I seem to be getting one seizure a week at the moment. I’d say my drugs will be increased in the coming days. I’ve also been asked to try to speak the next time a seizure occurs. The team has questions like: “Am I able to talk at all?”, “Does it cause slurred speech?”, “Are the words I want to say totally different to what comes out of my mouth?”. The team are interested to know how a seizure affects my speech, since this can give an insight into the parts of the brain being affected by the tumor. So that’s on my to-do list for next time!

Neuropsychology assessment

I’m scheduled to have a neuropsychology assessment in the coming weeks. I didn’t realise how important this actually was until today. It’s going to be a long process, possibly a 3 hour+ meeting where members of the team will conduct many memory and cognitive tests on me. Ultimately, this testing will be used as to set a ‘baseline’ for various aspects of my current brain function. This baseline will then be used both during and after the surgery.

It was explained to me that during surgery they will be constantly asking me questions and asking me to move parts of my body. While this is happening they will be manipulating and testing neurons in my brain to see what effect it has on my cognitive ability. Only once the surgeon is 100% happy that said part of the brain is safe to remove, will it actually be removed. As you can imagine this is going to be a long process with a tumor the size of mine! The baseline will also be used to compare brain and memory function during the recovery period. Without this baseline it would be extremely difficult, if not impossible, to measure the effect the surgery has had on me.

Only after this baseline has been established will my surgery be scheduled. That’s how important this assessment is!

Pre-surgery preparation

I’ve been given a set of items to use the night before surgery.

  • Antibacterial body wash
  • Antibacterial cream (for my nose to combat MRSA)
  • Antibacterial mouthwash

Basically I need to be as germ free as possible before having surgery. I will be using all three of these the day before and on the morning of the surgery. Body wash all over, leave for 1 minute then rinse. Rub the cream up my nose 3 times throughout the day and in the morning. Mouthwash 3 times the day before, and again in the morning of surgery. Doesn’t sound pleasant, but if it means there’s more chance of success I’m more than happy to do it!

The surgery

Now this is where it all starts to get very interesting, as the process was explained to me in detail so that I know what to expect on the day. I will likely be told on a random Tuesday in the future that I’ve been scheduled for surgery on the following Friday. So I’ll only get 3 days notice! That’s going to be an interesting week! I’ll have a COVID test 2 days before, then on the Thursday I will go into the ward and prepare for surgery the following day.

I will have another MRI scan and a brain mapping scan. The brain mapping scan is used to map the coordinates and direction of travel which the surgeon and team will enter my skull. All this is planned to the smallest detail. Nothing like Dr. Nick off The Simpsons (thankfully!).

The surgery is likely to last 5 hours, 3 of those with me being awake. They will put me to sleep for the first hour to prepare me since it sounds a little unpleasant. I will be attached to a metal frame via a set of small screws that are drilled into my skull. I will then be woken up and won’t be able to move my head. My head will already be open. Upon waking I will be surrounded by a team of people and won’t be able to see or feel anything that is happening behind me. The team will continue to ask me questions and to do things while they operate and slowly remove the tumor (using the methodology mentioned earlier). Once they are happy, they will again put me to sleep for an hour, patch me back up and I will be sent to recovery. It all sounds so simple doesn’t it!

Recovery

Assuming the surgery goes well I will be admitted to the recovery ward for around 24 hours. I’ll have a tube coming from my head to allow fluid from the wound to drain safely away, as well as various other pipes attached to my body. The aim is to get me up and mobile (at least a little) within the first 24 hours. This is to reduce the chance of blood clots, as there’s a raised chance these can happen for up to 3 weeks after surgery. If all goes well and I don’t show signs of seizures, I will be sent home. How crazy is that, major brain surgery to home within 24 hours! If it is that there are complications, I’m unable to move etc, I will be kept in for longer. It’s all a complete unknown at the moment.

Once Gary the prick has been extracted, he will be tested to see what exactly he is (or was), and this data will be used to inform my ongoing treatment plan. Genetic marker testing (e.g for the 1p/19q Codeleted gene) will also be conducted, and this data will also be used to plan the best treatment moving forwards. The ‘default’ treatment for this type of tumor is surgery, so it’s likely I will have more head screwing fun in the future! Radiotherapy can be used once, and chemotherapy can be used multiple times to clear Gary’s leftovers should it be needed. We shall only know more after the messy uninvited squatter has been forcibly removed.

Back to ‘normal’ and work

I’m likely to need a minimum of 6-8 weeks off work. In this time I will likely exhibit changes in mood, behavior, concentration, and personality. This is all perfectly normal due to the fact that my brain will be adjusting both physically and chemically to the tumor not being there anymore. If I require further surgery and/or treatment like chemotherapy/radiotherapy, I may need a little longer to recover. Again this won’t be known until after surgery.

The key is to take this slowly. I already know this is going to be an incredibly frustrating time for me. I know myself. I’m not one for sitting around doing very little. I’m always on the go and doing something. But I’m going to have to live with it for a few months. Maybe I can start watching all of the box sets & movies I’ve always wanted to watch! Or start tackling the tonne of books I’ve never read over the years. I mean after all, it sounds better than the alternative!

A bumpy weekend - Saturday 22th - Sunday 23rd May

So it was a bit of a bumpy weekend in terms of how I’ve been feeling. I’m now on anti-seizure medication that I will be taking for the foreseeable future, maybe even forever depending on how surgery goes.

Saturday

Day went well until about 10:30am, suddenly I felt extremely tired, sat on the sofa and promptly fell to sleep. Woke up 10 mins later to find my 4 year old son had covered me in cushions and was laughing his little head off as I woke up. I was completely and utterly confused as to what had happened. The medication I’m on mentions drowsiness / tiredness, so I put it down to that. I didn’t feel 100% all day, generally quite weak. I had the same feeling around 6:30pm where I could barely lift my arms and just wanted to sleep (this is not at all like me, as I generally hardly sleep!). This feeling passed after an hour or so, after a little food.

Sunday

Went to the park with my wife and children, no issues at all. Around 1pm I had a sudden feeling of weakness. Went to the living room, sat on the sofa, promptly fell to sleep. My 4 year old son is very opportunistic, again covered me in cushions, again in hysterics when I woke up 20 mins later. He’s going to be a fun teenager…

Seizure in the kitchen - Monday 24th May

Due to everything that happened over the weekend, which we assumed were the side effects of the drugs I contacted the team of specialists looking after me early in the morning via email. I knew because of this they would be in contact with me later in the day.

Around 7:30am I was standing in the kitchen having just prepped the kids breakfast. I suddenly had what I can only describe as an emotionally driven feeling that something was about to happen. I could feel something building. I immediately recognised something wasn’t right and sat down next to my wife at the kitchen table. She could see something wasn’t right either, so stood up next to me and so as to shield me from the children. I suddenly couldn’t really control my movements and started gently rocking backwards and forwards. I was conscious and remembered that I’d been asked to speak the next time this happened. I said out loud “Can you hear me?” to my wife. It sounded perfectly clear in my head, but to my wife it sounded slightly slurred. She could still make out what I was trying to say though. Apparently while this was happening my eyes were very wide, but that could really have just been panic on my part. It all passed so quickly as they always seem to do.

Going back to the emotion I felt. I’m not sure if this was something triggered by my subconscious, as in “bubbling up” to tell me “stuff is going on here, get ready for it”, or if it was me thinking about a seizure and then this triggered it because I thought of it. I’m thinking the former to be honest.

On speaking to the specialist nurse she seemed to think that the episodes that occurred over the weekend weren’t side effects of the drugs. These were actually a different type of seizure that were happening over a longer period of time. Well at least now I know! Because of this my anti-seizure medication has been increased, and will be increased again in a week. The aim is to have a long period of time between each, or even stop them completely before surgery. So we shall see over the next week if this increase actually works.

Obtained my full scan data - Tuesday 25th May

When in one of my follow-up meetings (20th May) with a senior nurse I happened to ask the question if I could have a copy of the original photos from the scan. All I had at the time was a screenshot from a video call that was shown to me off the neurosurgeons smartphone (what a crazy sentence, isn’t modern technology amazing!). I was told to visit the hospitals radiology department, fill out a form at reception and it could all be arranged. On the form the interesting part for me was the following section:

Section of the image scan application form where you get to choose how they send the data to you.

The top section allows you to choose how they send you the data. For a patient it was either as an online link or as an encrypted CD. It shows you how old the form is, no mention of USB sticks, or even DVD media! I chose the option where an online link is sent to me via email.

It’s also worth noting the sentence below this box:

The patient is entitled to a copy of all the Radiology imaging we retain at this trust. However if specific episodes are required, please specify below.

So depending on your local NHS trust, you should be able to do this yourself (should you be interested).

I received an automated email saying this could take up to 28 days, but 2 days later I had an email from a member of the team saying that my scans were scheduled for the overnight upload and I’d receive the link the following day. Upon receiving the link they sent me a one time password (OTP) via my mobile number that allowed me to login. The web performance of the system was shocking. Took around 20 seconds to load on a 50 Mbit connection and a modern browser! Thank you JavaScript…

Once I clicked on the download button I realised this wasn’t just a set of high resolution images, as it was a zip file for 1.3 GB of data! Intriguing! It took me a number of attempts to actually download the data, and I had close friends try too. Their server connection was slow and unreliable, and it also doesn’t seem to support HTTP range requests, so it wasn’t possible to resume a download after already managing to grab 880 MB of it! Best thing to do I found was to wait until later in the evening. I managed to get a download speed of around 2.7 MB per second, so it only took around 15 minutes in the end.

The reason the zip file is so huge is because it is sent in a standardized format for use in specialist tools that can interpret the data. Here’s me thinking it would be just a few images… nope! It’s literally all the images from all scans completed so far! Hence the box on the form stating which scans you require.

Image of lots of thumbnails of my head. All the images captured in the scans!

I believe there are around 4,000-5,000 images in total from 1 CT and 1 MRI scan! Thankfully there are tools that you can use to view these images. And not just view them, they allow you to navigate through all the scans. Each image is essentially a “slice” of the brain. The tools allow you to move through all 3 axis in near real time, with each of the corresponding panels changing depending on the input from the others.

Image of the three navigation axis from my MRI scan.

In the above image you can see my MRI scan. It’s essentially an orthogonal view of my head, with each of the panels represents a different axis:

  • Left panel: Top of my head (Axial view)
  • Top right: Front to back of my head (Coronal view)
  • Bottom left: Side of my head (Sagittal view)

The solid blue line you see in the views is the current plane I have selected to see. As you move this plane, all three images change accordingly. Notice how the blue line on the axial view (left panel) matches that of the coronal view (top right) in terms of position. The resulting image in the sagittal view (bottom left) is the image that corresponds with this selection I have made.

It’s so incredibly clever and absolutely fascinating (to me at least)! I spent the best part of 2-3 hours looking at my own brain scans. I wish I knew what it all meant, but I plan on quizzing the experts when I get the chance. I’d like to write a blog post all about it in the future. So, watch this space!

For those interested in doing the same the tools I used are:

Horos takes it a step further, as it allows you to view your scan in 3D, and even export an animation to show all your friends at the next soirée you attend! So yes, if you ever fancy looking at your own insides in detail, remember you can request your CT and MRI scan data!

Cloudy head seizures - Friday 28th May

So I think I’ve started to recognise the signs of having a seizure. But this isn’t an obvious type of seizure that started this whole saga off 5 weeks ago. This looks to be a different type that I touched on in a previous update. In my ‘Seizure spreadsheet log’ I’ve written:

Weakness in arms, “cloudy” thinking. Feel it around my face, tingling in forehead, almost throbbing sensation. Sleepy. Hard to keep my eyes open. Muscles changing in my face (odd tightening up from the middle). Feeling coming on for a number of hours. Feels like it is building up to a seizure. Brain feels “heavy”. Went to sleep for 40 mins, felt like something ‘lifted’, may have had another seizure in my sleep. Had the same out of body experience while sleeping.

It’s hard to say, but I think I may have had another more obvious seizure while resting. I remember it happening so I did try to move my arms and they seemed fine. So who knows! Urghhh! But after my ‘sleep’ for 40 minutes or so I felt a whole lot better.

Also, I’ve noticed my left foot (heel) has started to hurt, which is one of my initial symptoms that I was blaming on sciatica. So I’m going to be mentioning that at my next catchup with the team.

Date for the memory test - Tuesday 1st June

So I’ve now been given a date for the baseline memory test. This is happening on the 29th June, a whole month away. Not ideal, and I’m a little torn with the date. In some ways I want it sooner to “get it out the way”, but in other ways I want it later. At least when it’s later it gives me more time to ‘prepare’. I still feel I have so much general life administration left to complete before the ‘big day’.

The symptoms with my left foot still persist but tend to vary day to day. Because of this I may need to be given different drugs and / or have additional scans to see what Gary is up to. I’d like to think he hasn’t gotten even bigger in the last month, but it wouldn’t surprise me!

So now I have the date. I’m guessing the operation date will be 1-2 weeks after this. So around mid-July… or in other words around the time of the F1 at Silverstone… Damn you Gary!

Back on the steroids - Thursday 3rd June

Unfortunately over the past 2-3 days the symptoms in my legs and feet have returned. I was hoping that the anti-seizure drugs were the ones keeping these at bay, but it turns out it must have been the steroids which I came off a number of weeks ago. The team have decided to put me back on a short dose so as to improve my mobility (which I’m very grateful for!). I’ll be halving the dosage in a week, then likely coming off them again the week after. Since it takes a while for them to leave your system I’m hoping that takes me up very close to a surgery date, at which point the root cause of the issue can be ejected from one’s skull!

Reduced seizures and steroid side effects - Monday 7th June

So the good news, the seizures seem to have reduced a lot over the past few days. I’ve had very little to write in my seizure log for the team. I like this direction of travel. Unfortunately as happened before the steroids have decimated my sleeping pattern. I’m currently writing this update at 00:40 and don’t feel tired at all. And yesterday I went to bed / sleep at around 3am, then woke up at 6:50am. Apparently under 4 hours of sleep a night isn’t the ideal amount you should be having! Oh well, at least I’m getting lots more stuff done!

Neurologist appointment - Thursday 10th June

Due to the seizures I’ve been having I was referred to the Neurologist who is part of the multidisciplinary team who are looking after me. It was a somewhat confusing meeting, but also very interesting that lasted around 40 minutes.

From previous conversations I’ve had with doctors, I was under the impression that the tumor was likely causing the issues I’d seen with walking in October (left back, leg, foot pain etc). But upon talking to the Neurologist and describing my symptoms, they seem to think that isn’t the case and it’s all purely coincidental. Confusing! I’d prefer it to be the tumor causing it to be honest. Having 1 major brain operation and solving 2 problems, sounds like a good deal! But alas, we shall see when Gary finally buggers off into the hospital incinerator. Only then shall we know for sure!

What was interesting for me was the conversation around classifying my seizures. I’ve been keeping a seizure log (yet another fun Google spreadsheet!). All fairly standard columns:

  • Date
  • Time
  • What was I doing
  • (Copious) Notes

Now I’d already started to notice this myself: not all my seizures are alike, and since taking the anti-seizure medication I’d started having different symptoms. The Neurologist confirmed this today. So I’ve now added another column:

  • Is it a seizure involving the ‘core features’

A convoluted column title I know, but I’ll explain what It means. The ‘core features’ are effectively the most obvious (and serious symptoms). For me I’ve identified them as:

  • The feeling of being ‘outside my own head’
  • The emotionally driven feeling of everything being bigger than my own self (existentialism)
  • Any loss of motion and control over my body
  • Loss of consciousness (not happened as of yet thankfully!)

Basically if I have a seizure that displays these core features, then it is logged as one. The other seizures I’m having are still logged in detail, but not listed as a ‘core feature’ seizure.

So why is this important? Well, without this classification every little seizure suddenly contributes to what looks like an escalating number of seizures. If this is the case then getting the balance for medication is difficult. I want to be on enough to stop the ‘core feature’ seizures, but not so much that I have other side effects. This classification allows me to pull out the really important ones and therefore allow the team looking after me to see if they indeed are escalating, or if they are being managed.

So there we go, top tip if you have a brain tumor. Keep a seizure log and look for patterns in what happens when they occur!

A ‘core feature’ seizure - Friday 11th June

After the call yesterday it was all going so well. Nothing I would class as a ‘core feature’ seizure for the best part of 2 weeks. Unfortunately, one happened this evening at about 10 past 9pm. Watching the TV sitting on the floor, my wife just paused the TV to get something from the kitchen then I felt it. Again like an emotional response. Something was about to happen. I could feel it coming on. I tried to turn around and ‘shake myself’ out of it and convince myself I could stop it from happening. But within 5 seconds I’d lost control of my upper body and was shaking gently back and forth, unable to stop it.

As I’ve been told to see if my speech was affected I made sure my wife could hear me this time. She had walked in the room and not noticed what was happening so played the TV. I just started saying “Pause it”, “Pause it” “Pause it” over and over again, then eventually I said “I’m having a seizure”. Now I could have stopped myself from speaking, but I wanted to make sure we knew what the effect of it was on my speech, so I continued talking. It turns out she could hear me fine, no slurred speech. Said I sounded quite normal. I guess that’s a good thing? In total from the feeling to the end I’d guess it lasted about 30-40 seconds. Even 2 hours after it I still feel weak across the back of my shoulder blades and upper arms.

I’m hoping it was due to it being a long and busy week, maybe just tired. Or the fact that I’m now weaning myself off the steroids on the request of the Neurologist. I’m not sure! But to be honest, if I only get them once every 2 weeks, I’ll take that at the moment!

A sleepy seizure - Thursday 17th June

All has been quite quiet on the seizure front for the past few days. I’ve been gradually feeling weaker as the steroids pass through my system and my body takes over producing whatever it needs to produce… (can you tell I’m an expert in this doctor stuff!)

I’ve been getting very tired, very quickly. One moment I’m fine, 5 mins later I can hardly keep my eyes open. This happened around 5pm, just after having dinner with the kids. So I needed to go sit down in the living room. Within a few minutes I’d fallen asleep. While sleeping I’m 99% sure I had a seizure. Unfortunately due to the fact that I was asleep I’m struggling to classify it, as I’m unsure if I lost control of my arms etc, since I wasn’t moving.

The reason I believe I had one was because I remember coming too, and it felt like my brain split in two. Suddenly a pressure was released and my head felt ‘open’. I didn’t even realise I had that pressure there; it was only once it had been released I noticed the difference. I woke up a few minutes later and felt so much better, so maybe that’s how it works? The ‘pressure’ builds in my head and I don’t feel better until it is released. I’m not sure, I’m still getting used to the whole having seizures, and what triggers them.

An epiphany - Friday 18th June

It’s hard to stop yourself thinking about everything that is going on. It’s one of the reasons I enjoy continuing to work. I get to escape from thinking about the current situation and feel ‘normal’ for a short period of time. Well, at least until I remember what is happening again…

So on Friday I had an epiphany about the whole situation. I came to the realisation that I’m dying. Now I know what you’re thinking… “Damn, that got dark very quickly!” I came to the conclusion via a little thought experiment.

Imagine the wonders of modern medicine didn’t exist. No drugs, no ability to operate and remove Gary. What would be happening to me in this situation? The reason I know about any of this at all is because the tumor has got to a sufficient size to cause the seizures, so it must have crossed some tipping point recently. The tumor would be getting bigger, the number of seizures I’d be having would be ever increasing. I believe the tumor would just be getting bigger and bigger, putting more and more pressure on my brain until it eventually caused so many issues that I passed away. I’m actually on a path in my life where this would be happening to me, but thankfully I have options to try to change this path.

I like to think of all this as water slowly filling a bucket. If the bucket overflows, bad things happen. At the moment the drugs have created a hole in the bucket to help stop it overflowing, but eventually the bucket will overflow, even with the hole. The only way to stop it from overflowing is to stop the water, and that basically means removing Gary. So thank goodness for modern medicine, else there’d be overflowing buckets all over the place!

Well that was an uplifting read wasn’t it? Thanks for reading, have a great rest of the day! :)

A very good roast dinner - Sunday 20th June

Due to covid I’d not been to see my sisters new house. Not so new anymore since she moved in in February 2020! With restrictions gradually lifting and testing readily available we’d decided to go visit and have a Sunday dinner. The kids loved the adventure, investigating the house and going to visit a new park just 5 mins away.

We ate around midday. It had been a while since having roast dinner, especially since it was beef, so I may have eaten a little too much too quickly. About 5 minutes after finishing while just chatting at the table I suddenly felt incredibly tired. I simply couldn’t keep my eyes open. My arms felt heavy and I found I couldn’t concentrate on the flow of the conversation. There was no immediate seizure, but it felt like something was happening. Thankfully my sister had a spare room with a bed so I decided to go lie down to try to sleep it off.

I woke up around 1.5 hours later feeling much better. As I’ve mentioned a couple of times before, I may have had a seizure in my sleep. The ‘pressure’ in my head seemed to lift it one point while sleeping, I remember it happening. It isn’t really ‘pressure’ as such, but it’s hard to describe. Something ‘lifted’ and I suddenly felt much better.

So there you have it. My sister now has quite a claim to fame. Her roast dinners are so good they gave her brother a seizure!

The baseline memory test - Tuesday 29th June

At the beginning of the month I was told a date of the 29th of June for my memory test, so the whole month we’ve been waiting for this day. I wouldn’t say I’d been nervous. Really just anxious to get it ‘out the way’. I had no idea what was involved. All I knew was it was quite intensive and it would last a few hours. Thankfully you can’t revise for a memory test, as it did feel like being back at school waiting for an exam. The testing involved a chat with the neuropsychologist for 1 hour and then some intensive testing that lasted 2 hours.

The first part was easy. I enjoyed chatting about the situation to test myself and see what I could remember. And also to verbalise my understanding of the situation. Now I’m pretty sure the doctor had read all my medical notes, but there were points in the chat where I felt she was feigning ignorance about certain details. I’m guessing this is a tactic used to try to get me to explain my thoughts and feelings so they gather a greater understanding of my current mood and attitude to the whole situation. Not that I mind at all, it’s good to talk about all this. I often find I don’t know how I’m feeling until I try to explain it to another person.

The actual testing was really interesting. I was given around 12-14 different tests over a 2 hour period. Some were more difficult than others. There were tests that involved pronouncing words, and also remembering words. The tests always started very easy, then gradually got harder. So you’d start off thinking how smart you were, then by the end think the complete opposite! But I guess that’s the point when trying to look for a baseline result, each and every person doing the tests will find some more difficult than others.

I personally found one set of tests quite difficult. It involved thinking of as many words starting with a particular letter in 60 seconds. The only rules were they couldn’t be a person’s name or places. Any other word in the english language starting with that letter. There are that many surely it can’t be that hard! Well apparently not. For some reason my brain was insistent on thinking of swear words starting with whatever letter I was given. So each and every time I’d think to myself, “No I can’t say that word, it’s rude…”. Once you get into that little game with your brain (“say that, it would be funny!”), It’s hard to stop! Thanks brain! I think I could only think of between 10-15 words in 60 seconds. Not many at all so I’d say I’m below average for that test!

The easiest tests I found were the ones involving patterns. Look at this sequence of colours and shapes then pick the next one in the sequence from a list. I think I did okay in those tests, but who knows! Maybe I’m below average for those too.

The testing was intentionally hard as this is to try to gauge where you’re at and set that baseline. After surgery they can then repeat the test and look at the difference between the two sets of results. I guess since there were lots of different types of tests, if they see a drop in the results for one type of test, it suggests a change in a certain area of the brain. It’s all very clever!

Now with this date out the way, it’s just waiting on a date for surgery. All I know is that it is likely to be at some point in July. So July is going to be an interesting month!

Shielding - Sunday 4th July

Unfortunately there’s been a number of positive covid cases at my children’s school. Year 2 and year 5 have been isolating at home for 10 days. We’ve been testing every day, and have been for a drive-through PCR test. Thankfully they all came back negative!

With both children back at school, and covid literally so close (there are a number of schools in Bicester having similar issues), my wife and I decided that it would be best if I were to shield. It’s pretty crappy to have to avoid your own children, but having waited 2.5 months for a surgery date I really don’t want to lose it because I catch covid. That would be bad!

So I’m now staying with my parents. It’s the first time I’ve lived with them in 21 years! I’m still working and plan to do so, up until I get a surgery date. This will happen on a Tuesday at some point in July. Every Tuesday they triage the patient list and make plans for the week. So I’ll receive a phone call saying surgery will be on Friday! You don’t get much notice, only a couple of days. Although that’s probably a good thing. I don’t want to be dwelling on the fact that they are going to be removing part of my brain in a couple of days for too long!

When folks have asked me how I’m feeling about it all, It’s hard to describe. In some ways I want the surgery to happen right away to at least “get it out the way”. But in others I don’t want it to happen at all, as it really is a watershed moment in my life. There’s always going to be a ‘pre-surgery’ and ‘post-surgery’ me from beyond that point. Fingers crossed those two versions of me don’t change much!

I’m siding on the fact that I actually want it done now. My family and I have been in limbo for a few months now, so it would be good to be able to move forwards and start to actually plan things! I’ve gained so much respect for people who are on transplant lists for years. Waiting for hearts, kidneys, livers etc. I’ve only been waiting 2.5 months and it has felt like an eternity! I can’t even imagine living your life waiting years for surgery. Not being able to properly plan anything because “what if we get the call?”.

My next update will likely be when I have an actual surgery date. Not too long I hope!

No news - Tuesday 6th July

So having waited around all day for a call from the hospital, it unfortunately never came, so no surgery this week. Annoying but at least it gives me a little more time to get a few more things done! Let’s see what next Tuesday brings!

In other news, there’s been a few more reports of covid in schools in Bicester so I still feel sheilding was the right thing to do!

Still no news - Tuesday 13th July

Mid-way through July now and still no news about surgery. I was hoping to have it at the start of the month so I could at least start the recovery process and maybe have the latter end of the summer to do something “normal”, (whatever that means in 2021!).

Being on the waiting list for hospital appointments is pretty stressful at the moment as covid cases are surging, I really feel for the folks working in the NHS at the moment. It must feel like a never-ending tsunami of stress and unpredictability.

Well at least I’ve been given a date of “July”, that’s a lot more than some people have! I’ve a sneaking feeling it will be right at the end. Fingers crossed the next few weeks go quickly. Although, saying that, these past few months have been the longest of my life!

Between Life and Death - Thursday 15th July

Earlier in the week I discovered there’d been a short series on Channel 4 here in the UK called “Brain Surgeons: Between Life and Death”. Reading the synopsis it all sounds very interesting. I thought it would give me some insight into what to expect on the day. Unfortunately I wasn’t mentally prepared to watch it. I made about 5 mins into the program and had to stop. It hadn’t even got to any of the surgery yet and was just talking about the people and their families. I think that brought it all home how serious this all is, not just for me but for everyone around me. What finished me off was seeing the guy lie down on the operating table and realising in only a few weeks time I’m going to be doing exactly the same. It’s not a pleasant position to be in.

I mean let’s be honest here, the clue is in the title: “Between Life and Death”. It probably isn’t the best thing to be watching weeks before major brain surgery! Saying that, I do plan on watching it post-surgery. I’ll have a very unique perspective of what it’s like from ‘inside’ the process. I can then compare notes from ‘outside’ the process too.

Close but no brain surgery - Friday 23rd July

So this week has been quite a rollercoaster. For the past 3 weeks I’ve been mentally preparing for a date of the 30th July for surgery. Now, I realise none of this is set in stone, but as that’s the only date you’re given it tends to be the one you focus on. Unfortunately I had an update at the start of the week stating that the date was going to have to be pushed back. It sounds like I was actually quite close, but a few emergency cases came in that took priority. So I’m back to the 2 week holding pattern (which really sucks!).

Saying that, I was given some interesting information during the conversations I’ve had with the team. Another MRI scan has been requested as I’m coming up to the 3 month point since diagnosis. But this isn’t your usual MRI scan. It’s actually being pitched as the pre-surgery scan. The neurosurgeon (and team) would like to understand what Gary has been upto over the past 3 months. From what I understand, this will be a more detailed scan that can be used for surgery planning. I don’t know if this means it will take longer, or if they just conduct more scans / more detailed analysis(?) I guess a question for the test operator when I meet them soon.

I was also given information that the operation is likely going to take longer than expected. The team usually conducts 2 operations on the Friday of each week. But the neurosurgeon is now considering only operating on me on the day, due to the size of Gary. I’ve yet to decide if this is a good or bad thing? Good in the fact that they can take their time to extract “the prick”, but bad in the fact that it is needed (and I’ll be awake for most of it!).

Fingers crossed the 6th August materialises. Folks have said to me that the waiting is the worst part. I’ve no way of knowing that at the moment, but I’m happy to agree. It is pretty bad! Let’s see what next week brings I guess!

Pre-surgery MRI scan - Monday 26th July

Today I had my pre-surgery MRI scan. Now that suggests that I have a date for surgery, but alas no, not yet. I’m supposed to have an updated scan every 3 months to look at what Gary has been up to, so instead of having 2 scans in a short period of time, the standard scan has been upgraded to a pre-surgery scan. This means that the scan takes a little longer than usual (around 40 mins). They take more detailed scans and I assume maybe a few more types? This means there’s no ‘blocker’ for surgery now. When I get a slot, I’m not waiting on an MRI scan. This is good news!

The scan itself was fairly easy. There was a slight miscommunication so I was waiting around 30 mins longer than needed, but compared to how long I’ve been waiting for surgery it’s nothing. At least it is done! 40 minutes stuck in a cold, confined tube that screams at you like a ZX Spectrum isn’t the most relaxing experience. At 35 mins in they came in and injected the contrast into my arm via the cannula (I hate cannulas, so uncomfortable!). It was cold as it ran up my arm. A few seconds later I could swear I had a mini-seizure. I had the ‘emotional’ response I’m getting used to, but since my head was tightly strapped to the MRI table and I was lying down in a confined tube, I’m not sure if it affected my movement. I’m going to raise this with the next doctor I speak to. Maybe it’s a known side effect?

As another Tuesday rolls around, here’s hoping I get any news on a date for surgery. The wait is really starting to get me down.

One confusing week! - Sunday 1st August

The last week has all been a little crazy. On Monday I had my 3 month MRI scan, which was also the pre-surgery MRI scan too. I’ve mostly been on annual leave from work as there’s just so much going on it’s hard to concentrate on anything else.

On Tuesday I was back to work for the day, but something unusual happened. I was in a meeting with my incredibly supportive line manager, but 30 mins into our 45 minute video call I had to stop quite abruptly. I completely lost my train of thought and felt like I was on the cusp of having a seizure. Thankfully I can now recognise the telltale signs of this happening. This is a worrying sign as work has been a haven for me over the past 3 months. I’ve been able to zone out of “real life” for a few hours and concentrate on work, completely oblivious to the fact that Gary even exists. For a few hours at least! It now seems that even this little haven is eroding.

On Wednesday I had a call from the hospital with the results of my Monday scan. It’s a bit of a mixed bag. The good news is that the tumor hasn’t grown in the past 3 months. The less good news is that there’s still no date for surgery. The bad news is that some swelling can be seen around the tumor, also known as cerebral edema. I think this explains the symptoms I saw on Tuesday.

Thursday and Friday were a bit of a writeoff to be honest. All day I wasn’t feeling 100%. Incredibly sleepy, dizzy and at times quite confused. It’s strange, and it comes on so quickly. One minute you feel fine, next minute it all changes for no apparent reason. Thursday evening was particularly bad, where I could barely keep my eyes open or even really speak to my wife. I was completely disconnected from reality and didn’t have the energy to even try to re-engage.

On Friday evening it got so bad that my wife decided to ask for advice from the 111 team (non-medical emergency number). We went through the triage process and eventually the very nice on-call GP was sent out to see me. She was satisfied I didn’t need to go to hospital but did want to phone the specialists in the oncology and neurology departments. On speaking to the on-call neurology consultant who looked at my scans they recommended that I should be back on steroids to reduce the swelling in my brain.

Now here’s the difficult part. The team I’ve been under the care of for the past 3 months have been very keen to take me off steroids when I’ve been on them, since they are quite strong and have some nasty side effects. Steroids take around 2 weeks to leave your system once you take them. So I’ve been stuck between a rock and a hard place. Take the steroids and I could potentially compromise a future surgery date. Don’t take them and my symptoms could get worse.

Weighing up these options, it was 100% my decision NOT to take the steroids until I’ve been given the all-clear from the team looking after me at the hospital. There’s no way I want to lose the opportunity of surgery because I took a drug that is now in my system for weeks. So due to the fact that I was having unpredictable symptoms from the swelling, I’ve moved back with my parents for a few days. At least they can easily keep an eye on me without having to keep two young children entertained.

So there you have it, quite an eventful week! I’m seriously hoping that the upcoming week is the one where I’m given a surgery date. I don’t think I can cope with much more waiting around “treading water”. Roll on Tuesday. Fingers crossed the phone call!

The brain fog has lifted! - Friday 6th August

Yet another crazy week with quite a few highs and lows. I’ve been using some of my annual leave to get a few things sorted before the surgery. If I’m honest, I haven’t managed to do much for the past few weeks which is very frustrating. Being so tired and dizzy makes it hard to concentrate. I’ve been sleeping a lot and very rarely left the house.

Tuesday came and went with no real updates about a surgery date which was very disappointing. I did hear back from the team at the hospital about the steroids, so from Wednesday morning I started on them again (to reduce the swelling around the tumour). Wednesday and Thursday there was some improvement like they were beginning to make a difference. I had much more energy and I could finally walk properly again (as the issue with my foot has returned).

But it was today (Friday) where I’ve really felt better. The best I have felt in weeks to be honest. I realised while having a shower this morning that I was actually thinking and planning out my whole day ahead of time. Multiple streams of thoughts about everything I wanted to get done. I’d not had this ability for a few weeks. It has literally been quite ‘single threaded’ (there’s a web developer term for you). Basically I’ve only been able to focus on the single task at hand, nothing more. I must admit I didn’t notice this change, it was only once I ‘reverted back’ to feeling normal again I realised it had happened. So yes, I went into overdrive with work today because I could finally do things again! I worked until 7:30pm (naughty I know) getting tonnes of stuff sorted, and started making plans for the department’s stance on legacy browsers (cough… IE11), which should come into effect in March to June in 2022. So planning almost 10 months ahead of time. I simply couldn’t have done that even 3 days ago.

Next week is going to be interesting. I have a couple of meetings with the hospital to go over symptoms and then speak to the neurosurgeon again. I have lots more questions for the team. So let’s see what next week brings! Maybe some clarity on a date, like I’ve had from the steroids over the past few days. That would be nice!

Another mixed few days - Sunday 8th August

Well it has been an odd weekend symptoms wise. Friday was a very good day. The best one I’d had in a while actually. I could finally think clearly again. Unfortunately I think I went a little bit overboard!

Saturday

I really paid the price on Saturday. As Friday had gone so well, we decided to head out to an open day event for a charity. We were under the impression it wouldn’t be particularly busy, but unfortunately not. It seemed like everyone had turned up. This isn’t a bad thing in terms of covid as it was all outdoors and we all kept our distance. It was just the sheer number of people, sounds, noise, interactions… the general busyness of it all that broke my brain.

I lasted about an hour then had to admit defeat and go back to the car to sleep with some quiet music on for 2 hours. I believe this was a mixture of the tumour, swelling, and having just started taking steroids. Apparently steroids can heighten your senses, making sounds louder, colours brighter etc. I think it was a combination of it all that my brain just needed to get out of the situation.

Thankfully after a couple of hours of rest and getting home I felt much better, and ended up doing virtually very little for the rest of the day.

Sunday

After a great Friday and poor Saturday we decided that I best not risk doing much, so I mainly pottered around the house looking for little bits to keep me occupied. I’ve certainly noticed that I’m much more comfortable and settled while at home. I’d assumed it was all a part of the past 18 months and the pandemic, but I’m beginning to think it is all interrelated. I think (unknowingly) to me this tumour has been developing and growing and it has been changing how my brain works and thinks. Although I don’t feel anxious about leaving home, there’s always something in the back of my head where I can only fully relax once I’m back.

Now, day to day you don’t notice this, why would you after all? Such small changes. It’s just like watching your children (or pets) grow up. Day to day you see no change, but looking back everything has changed. So when these subtle differences are compounded over months (and even years), then you see the huge change staring you in the face. The more I think about it, the more it makes sense. My brain is actively looking for a place with the least cognitive load. Familiar surroundings and people with complete predictability. This equates to a brain that doesn’t need to do much (which is good when you have a brain tumour!).

Annoyingly on the flip side, the steroids seem to give me enough energy to put me on edge (almost twitchy), but then I don’t have the energy or brain capacity to do anything particularly useful with it. Stuck between a rock and a hard place really. So the day was mainly resting and mentally preparing myself for another week of uncertainty.

The week that will never end! - Wednesday 11th August

Well, the title says it all really. This feels like it has been a very long week. I’ve had 2 important meetings at the start of the week, and after those it’s hard to believe there are still more days left to go!

Monday

Since starting back on the steroids last week to reduce the swelling on my brain the team has wanted to keep a close eye on me. If there’s one takeaway from the past 3 months it’s that they don’t want me on them! That’s fine with me, I’m happy to listen to the experts!

So I had a general catchup with the nursing team going over my symptoms since I started back on them again. I explained the highs and lows of the weekend and it all sounds like classic steroid side effects. One day you feel on the top of the world, the next day you are back in the depths. When you couple it together with the tumour, swelling, and the fact that steroids obliterate my sleeping pattern (3-4 hours a night when on them), it all makes sense really. I’m on mild sleeping tablets to combat the issue, but they don’t work too well.

The rest of the call was mainly to prepare me for the Tuesday call with the neurosurgeon. I’d already started making a list of questions, but off the back of the conversation I now had a few more. The more information you can get from the person who will actually be operating on you the better really!

Tuesday

I worked in the morning as the call wasn’t until the afternoon. For some reason I was very nervous about the whole thing, so I was glad to have the distraction. I’m not quite sure why I was so nervous, but it’s always in the back of my head: “maybe they made a mistake, and the 2nd scan will show a much worse prognosis”. Unlikely I know, as I’m sure they would have mentioned it, but it’s hard to stop thinking about it!

But overall the 45 minute conversation went really well! There’s been no growth in the tumour size over the past 3 months which is amazing news. The tumour still looks to be of the type oligodendroglioma. The fact it hasn’t grown point towards it still being grade II and not anaplastic oligodendriogliomas (grade III). We still won’t know this for sure until 10 days after surgery, as that’s how long it takes to get biopsy results back.

The swelling around the tumour isn’t as bad as thought. Only slight swelling really. But this then points to the fact that the symptoms I’ve been getting (dizziness, ‘fuzzy head’, loss of concentration, disconnection with the world etc) all relate to the tumour itself. I’m not sure which I prefer it to be, the tumour or the swelling!

I got to ask lots of great questions and get most of the answers I needed. One of the fundamental takeaways is that I “must not get covid”, (direct quote from the neurosurgeon). I’m more than happy to keep to that! Having been double jabbed and not really going out, I’d hope the chance is pretty slim anyway.

The main discussion was around a date for surgery, and this came up almost right away. The team were very apologetic that it had taken so long, but the pressures on the whole system at the moment are large. Now as I seem to have a grade II tumour that is large (but not aggressive) this drops me down the priority list somewhat. There are some types of brain tumour like the glioblastoma that are really really aggressive and can’t be cured. The neurosurgeon explained that in these cases sometimes you only have a matter of days / weeks where you can make any difference to a patient’s life expectancy! So at the moment I’m now top of the list, barring any emergency cases coming in. So in theory I should hopefully be operated on in the next two weeks(!). Off the back of the meeting we are looking at a date of “August”. If this is the case, it fits well with the children going back to school in September, as I can see the risk of getting covid in this period increasing once they are back. And what with my instructions “not to get covid”, these two worlds don’t fit together!

I asked about how big he thought my tumour was. I’ve already exported a 3D animation of Gary which you can see here, but I wasn’t sure actually how big ‘he’ is in terms of numbers. The neurosurgeon estimates that ‘he’ is taking up around 10-15% of my brain. That’s pretty impressive! So I only have the capacity to use 85-90% of my brain anyway. I also asked the question if this is the type of tumour I could have had since birth, and I’ve just grown up with it? The answer to that was a blunt “no”, so that’s the end of that conversation then!

I found out a more about the operation itself and recovery period:

Operation

It is likely to take 6-9 hours, with me being awake for approximately 6 of those hours. That sounds like a hell of a long time to me, but the neurosurgeon assures me it will go quickly. He said I’d be surprised how quickly it passes, so watch this space. I’ll let you know after the event! A successful operation is where he manages to remove around 80% of the tumour, leaving the rest to be removed via other means (radiotherapy / chemotherapy / additional surgery).

Recovery

Now because the tumour is so large and deep into my brain, it comes with a few risks (as I’ve mentioned before in the original post). One of the main risks is the fact that the tumour is wrapped around my motor cortex, which is the part of the brain that controls limb movement. As Gary is sitting in my right frontal lobe, any issues will occur on my left hand side (since the brain is reversed in this respect).

The neurosurgeon explained that there is something like a ‘switch’ that can effectively turn on and off if the brain is damaged (or changed). During the operation there’s no warning that this will occur. One moment I could have full control over my left arm / hand, the next moment nothing. Quite a scary thought really! Thankfully in most cases this is only temporary and lasts 10-14 days. It’s very rare that it is permanent. Over time, as the brain re-adjusts to being without the tumour, it relearns how to process limb movement and the ‘switch’ is turned back on. If this were to happen, my seemingly ridiculously short 24-48 hour stay in hospital will turn into a couple of weeks in rehabilitation. So there’s just another unknown to throw into the mix!

So that was mainly what I learned from the first two days of the week! Quite a lot to take in, and there are still 3 days left to go! I plan to take it a little easy to process it all and start mentally preparing myself for the next two weeks, where there’s a lot that can happen very quickly indeed. I feel I’m about to reach a watershed moment in my life. There’s forever going to be a pre-surgery me, and post-surgery me on the horizon.

Tune back in soon for more on the eviction of Gary ‘the prick’ Glia!

Houston, we have a date! - Tuesday 17th August

So it’s been over three months since I was first diagnosed, and I must admit I’ve no idea where the time has gone! In some ways it feels like it has gone quickly, but in others it feels like it has been the longest three months of my life! Living your life in weekly chunks isn’t much fun. Waiting for every Tuesday to come around for a surgery date is quite stressful. The day comes and goes with a whole range of emotions. A mixture of anxiety, excitement, all the way through to disappointment and sadness, then rinse and repeat for another week.

Thankfully the waiting now seems to be coming to an end as I’ve finally been given a date for the operation: Friday 27th August, or G-Day as I’m calling it. G-Day stands for “Gary get the f*ck out of my head”-Day. The plan is for me to go into hospital the day before and stay overnight, with the operation happening on the Friday morning. It should last approximately 8-9 hours. Beyond that is a big unknown, so we’ll have to see how it goes!

Unfortunately, there is always a chance that it could be cancelled at the last minute, or the hospital doesn’t have a bed for me. If this happens there are multiple options. The nurse explained: “Plan A is the aim, but plans B-E also exist too”. We will only know the plan I’m sticking to on Thursday. It will be a relief to get a hospital bed, as that’s the final step before surgery!

In other news: I also found out that during recovery I’m going to need to wear deep vein thrombosis (DVT) stockings for 1 month(!) after surgery. Night and day, 24/7! Apparently the risk of blood clots post-brain tumor surgery is high, so to reduce the risk the stockings are required. Now as a person who doesn’t even like to wear socks to bed, this sounds horrendous! But if it means I don’t get blood clots, well I guess it’s a thing I’m going to need to get used to. I think the next few months are going to be very difficult. A character building experience some might say…

Last day at work - Friday 20th August

Today has been a strange day. It was my final day “in the office”, as I’m stopping work to prepare for my operation next week. I have to admit I’m feeling a little sad about it. Work has been a real safetynet over the past few months. When I needed a distraction from all this, and an “injection” of normality I could always fall back on work. The work isn’t easy. In fact it is incredibly frustrating at times. But that’s part of the distraction. Being able to make plans for the department in the coming years is time consuming and slow, but ultimately very rewarding. I’ve handed over as much as I can and tried to remove myself as “a blocker” from as many areas as I can, but it could be that certain areas stall until I get back to finally drive them forwards. Here’s hoping for a quick recovery and staggered return to “normality”, whatever the hell that is in 2020/2021!

Houston, we have a seizure! - Friday 20th August

Just when Friday wasn’t strange and emotional enough, Gary steps in and makes things worse. 6:30pm rolls around and I’m making a cup of tea in the kitchen. I suddenly feel something “isn’t right”. I’m standing and realise I need to sit down quickly before it happens. I start to walk the few meters across the kitchen to the nearest chair but don’t make it in time. My body goes into a focal (partial) seizure.

As I’m walking I say to my wife: “I need to sit down”, but the words came out slurred (they sounded fine to me). Luckily I manage to lean on the kitchen worktop when it happens, so as not to fall over. I gently start to rock back and forwards, this is out of my control. At that point Claire told me to keep speaking, as it’s good to know what effect the seizure is having on my speech. At that moment I actually struggled to speak. That isn’t through lack of ability, it was through lack of “being bothered”, would be the best way to describe it. There seemed like a real disconnect between myself and reality which I didn’t have the energy or inclination to break down at the time.

The seizure seemed to pass quite quickly. Probably 20-30 seconds in total. I managed to sit down and take in what had just happened. Annoyingly I didn’t feel any ‘release’ of pressure in my head which I’ve had in the past sometimes. I actually didn’t feel any difference at all.

So this was the first clear ‘core function’ seizure I’ve had since the 11th June. There are two intriguing similarities between them: they both happened on a Friday after work, and both happened while coming off steroids. Now this may be a complete coincidence? I have no idea. Maybe I’ll ask the team next week. Next Friday can’t come soon enough!

Time slows down - Sunday 22nd August

I knew this would happen. As soon as I had a date everything would shift. Suddenly time slows down as I’m no longer living each day waiting for a phone call, I’m living each day with a future date on ‘x number of days’ away. It certainly doesn’t help that sleeping is difficult. Only sleeping 3-4 hours a night makes for very long days! I think this may be the longest week of my life. I need to find a distraction (that isn’t work) to keep me occupied. Roll on next weekend and the Belgian Grand Prix. I will never be so happy as to be able to watch a Grand Prix knowing surgery is over!

Cancelled surgery #1 - Tuesday 24th August

So today was a bit of a roller coaster. I woke up very early (I’m still not sleeping too well), as I needed to complete my PCR test at 7am. This works out as 3 days before surgery on Friday. Once completed I went for a little walk to post it in a priority post box. I saw absolutely nobody at that time of the morning, which was handy for COVID. I just so happened to walk past my old secondary school too, which was a trip down memory lane. Not much looked to have changed apart from some of the dilapidated classrooms have been knocked down and replaced with sports courts. I remember them being bad in 1998, I hate to think what they would have looked like 23 years later!

Unfortunately the positive start to the day wasn’t to last. A few hours later I received an email from the hospital stating that my operation on Friday had been cancelled due to a staffing issue with the team. I do wonder if this is all related to COVID, as it seems very strange that an operation planned 1.5 weeks in advance suddenly doesn’t have an important member of the team available. This is disappointing, but in all honesty I’d much prefer they are 100% happy with the team and everyone is available, rather than a ‘settling’ for a team just to get the operation ‘done’. So for the sake of another few weeks (after waiting 4 months), that’s fine by me!

Note that I’ve called this update ‘Cancelled surgery #1’. I’m hoping that there won’t be a #2!

The end of a long week - Friday 27th August

Today was supposed to be the day of my surgery. Unfortunately it was cancelled on Tuesday. In some ways I’m glad it was cancelled so early into the week, as that has given me time to get used to it all. If it had been cancelled the day before, that would have been even worse.

I’ve now been signed off work by my GP until my surgery date. I’ve managed to work for over 3 months, but the combination of the drugs and tumour are starting to take its toll. I can have dizzy spells and get tired very easily. One minute I feel fine, 5 minutes later I’ll feel totally different, almost drugged / drunk (I don’t drink). This all has had an impact on my concentration and work. This is especially true now that I’m off the steroids. They gave a little boost that enabled me to power through, but without them it’s difficult.

So all in all, a very long week. I’ve started making plans for the coming weeks as I’ve been given a very loose date of the 10th September for surgery. It’s not guaranteed, but it’s the only date we have to work towards at the moment, so it will have to do. With the children going back to school on the 2nd September I can see this being an interesting few weeks ahead!

A promising end to the week - Saturday 4th September

It has been a very busy week, lots going on! In preparation for recovery we’ve had a third of the garage converted into an office. This frees up a room that can be used as a spare bedroom. This will be really useful if I need friends and family to stay and help during this period. Because of this, I’ve been gradually cleaning up and making sure we can find things. I can’t explain how frustrating it is not to be able to find tools in the garage. A 5 minute job takes 20-30 minutes just because I can’t find the tools! Saying this, it’s all looking great, not 100% yet, but I’ll be able to potter about during recovery and finish it all off.

My kids are now back at school so I’m self-isolating at my parents. The risk of me getting COVID has jumped since we can no longer control or monitor who the kids are interacting with. Since it takes around 48 hours for COVID to become detectable using a lateral flow test, I could easily catch it and not know about it for a few days. This would be bad in terms of the operation. It puts me at risk, as well as the whole 12-14 people team who will be involved in the operation.

I had some really positive news on Friday when the neurosurgeon who will be forcefully ejecting Gary, phoned me. He phoned for 3 reasons:

To apologise for the cancellation on the 27th. To check on how my seizures are at the moment. To see if I would be interested in taking part in a new feasibility study related to more detailed brain imaging.

In relation to point 1, although this was disappointing, I really appreciate the fact that he made the difficult decision to cancel surgery. It was made because a critical team member wasn’t available. I’d much prefer to go into a long operation with the correct team, than a team pulled together just to ‘get the job done’. This makes me feel more comfortable about the surgery, both from the fact that I know the best team is involved, and also that the neurosurgeon has the team he wants around him. This must be a confidence boost for him too. Not that I expected (or even needed) an apology, it’s nice to be given it. The NHS are doing a fantastic job considering the tidal wave of craziness they have been under for the past 18 months!

Point 2 is an interesting one. It’s been a few weeks since I’ve had a ‘core feature’ seizure, but that doesn’t mean my brain hasn’t tried! There are certain days where I feel quite ‘detached’ from the world. If not ‘detached’, then I can be quite fuzzy headed where concentration is hard. I’m no expert, but this seems to me as though my brain is trying to have a seizure, but the drugs I’m on are stopping it. I keep a detailed seizure log and have been keeping the hospital team constantly updated with how I’m feeling day to day.

There have been discussions this week about upping my drugs, or even putting me on a second drug to try to combat these episodes during the operation. If I were to have one during the operation it could be bad! Although now it sounds like the decision has been made not to change my medication. I’m personally not concerned either way. I’m happy to follow the team’s advice. They are the experts afterall! According to the neurosurgeon it could be that the operation is adjusted to account for these ‘almost’ seizures, this could mean I’ll be awake for less time, which is safer if I do have a seizure. But it also means they won’t be able to take out as much of the tumour because they won’t know if they are inadvertently taking out ‘good’ parts of my brain. Ultimately it’s the neurosurgeon’s decision, and he will be making it on the day. I just need to keep the team informed as to how this week goes. That’s all I can do!

Point 3 is super exciting. I’ve been offered the chance to take part in a new feasibility study related to Fluorodopa PET Imaging in Glioma. I’ll be administered intravenously with a mildly radioactive drug, called fluorodopa. The PET scanner then detects the radiation within the tumour. This imaging should give the team a lot more information about the internals of the tumour that a MRI & CT scan can’t show. So for example, the more aggressive parts of the tumour will show up on the scan, allowing the neurosurgeon to focus on those areas and make sure they are removed as a priority. In this instance the more data the team has the better, so I’ll be consenting to taking part in the study. It’s great to think that these scans could help with diagnosis of tumours in other people in the future. I’m also keeping my fingers crossed that I will also have access to these more detailed scans when I request them all post-surgery.

All in all a very busy week! Next week could be G-day week! We shall see, I expect to hear more on Tuesday, so watch this space. Gary, your days could be well and truly numbered. 6 days and counting (hopefully!).

 

MRI & PAT scan day - Wednesday 8th September

So it’s G-day + 2, and all is still looking good for Friday! I had to sign a lot of forms today related to the feasibility study and the actual operation. It was mainly going over the risks associated with surgery and what to expect. I’ve now been put on a 2nd type of seizure medication to try and head off the last of the seizure symptoms I’m having (pun intended!). My first PCR test came back clear, and I had another PCR test today. I will most likely have another 2 this week. My poor nose!

The MRI scan went well today. It lasted around 40 minutes. Thankfully I didn’t have a reaction when they injected the ‘contrast’ this time which is great. It was loud but tolerable. The doctors and staff at the hospitals (I went to 2 today) were all fantastic. I couldn’t wish for a better team. I feel very fortunate to live in Oxfordshire.

The PAT test unfortunately wasn’t as pleasant. It was nothing to do with the fluorodopa, it was the fact that CT scanners really aren’t built for comfort. The scan lasted a whole hour, and honestly it felt like a lot longer as I had no reference point for the time! I was strapped to a machine with my head restricted and my feet were cold. The worst part was that there didn’t feel like there was enough padding behind my head. After 10 minutes the back of my head started to hurt, and once you notice it, it’s hard to stop focusing on it. Especially when there’s nothing else to do! Try it some time, it takes a surprising amount of energy to lie perfectly still for 1 hour while staring at the ceiling. I’m very glad it is now done though. Apparently the scans came out really well and they got all the data they needed for Friday’s operation!

I also found out a little about the surgery itself. I’ll be lying on my left side for the operation with some sharp points tightly pushed against my skin to stop my head moving. I’ll have a cannula in my right arm, as they want me to be able to move my left arm when I’m asked too. Since there’s a risk of partial paralysis on my left side, they will be testing for this throughout the operation. It sounds like this could be quite uncomfortable on my neck which is a worry, but I’m hoping I’m drugged up enough to really know about it!

So anyway, this is likely to be my last update for a little while, as I should be heading into the hospital around midday tomorrow. Fingers crossed Friday all goes well and I’ll be able to post updates soon. This should include the PET scan imaging as well as a before / after image of my brain, minus Gary!

No matter what happens, thanks everyone for all your support, kind messages & visits over the past 4 months. They have been very much appreciated. Here’s hoping the rest of 2021 / 2022 improve!


Post changelog:

  • 21/04/21: Tumor first diagnosed.
  • 12/05/21: Initial post published.
  • 15/05/21: Posted 3 new updates from the week. Next appointment on the 20th May.
  • 19/05/21: Added information about another seizure.
  • 21/05/21: Added information about the pre-operative assessment appointment.
  • 25/05/21: Added update about the weekend and another seizure I’ve had.
  • 29/05/21: Added information about obtaining my scan data and a different type of seizure.
  • 03/06/21: Added update on date for memory test and overall symptoms.
  • 07/06/21: Added steroid and reduced seizures update.
  • 10/06/21: Added update from latest Neurologist meeting.
  • 11/06/21: Update on first ‘core feature’ seizure I’ve had in 2 weeks.
  • 19/06/21: Added an update about the sleepy seizure and an epiphany.
  • 18/07/21: Added an updates about the month of July and “Between Life and Death”.
  • 23/07/21: Update on the latest timings and the surgery info I’ve been given.
  • 26/07/21: Pre-surgery MRI scan update.
  • 01/08/21: Scan results and swelling symptoms update.
  • 06/08/21: Back on the ‘roids and finally a productive day!
  • 12/08/21: The highs and lows of steroids and finally some information on an operation date!
  • 23/08/21: Added info about a surgery date and the fact I had another seizure.
  • 27/08/21: Surgery cancelled, and an update on the very long week.
  • 04/09/21: New surgery date is looking promising update, fingers crossed it will be next week!
  • 08/09/21: Added update on the scans today and my final post for a little while.
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