Second Opinion

[This is a post I started and was going to edit - but what the hell, I may as well post it now, even at this late date. Then I'll bring you all up to date in the next post.]

March 25th - Back from UCSF, second opinion and consultation. Very good news.

I will avoid all the details ( partly because I don't exactly understand them myself ) so as to not confuse anyone and/or bore you. Let me just say that after discussing my condition with the doctor at UCSF and looking at my MRIs and medical records it was advised that I not participate in the Clinical Trial. The reason for this is that my condition is such that regular radiation and the regular chemo should do for me all that is expected. In other words, things look very promising and according to the doctor I will, his exact words, "Be around for at least another two years" then who knows, I could be around for another twenty. Of course there is always the rare chance that I could be gone in a matter of months, but in all likelihood, I will be here for at least two years and probably many more.

Why? It seems that my surgeon did a very good job and got most if not all of the tumor out of the brain. Of course, this type of tumor sends out little microscopic tentacles with cancer seeds that could start to grow anywhere and at any time, but from the films taken of my brain there are no signs of this and everything looks just great. So, the experimental drug that was part of the clinical trial would create more risks than obvious benefits. For instance, the drug basically cuts down on the production of capillaries which feed the growth of a new tumor. However, in the process capillaries are also shut down in all parts of my body so what happens is that my same blood flow will occur but through fewer blood vessels meaning that most likely my blood pressure would increase. I would have to be vigilant in keeping an eye on it, but, should I begin to hemorrhage somewhere, well then, I would most likely die. There would be little they could do for me. The doctor said he could see no reason why, even though it is a rather low risk event, that I should expose myself to that risk. Also, because the tumor needs a blood source to grow, and it will create such a source, there is no evidence of any abnormal blood vessels in the pictures. So, why should I take a drug that would prevent the production of such a source, when one is not evident, yet could cause the production of a tumor to grow in some other fashion. This type of tumor is known for its ability to rapidly change course, to develop in a new direction and all because I actually took the drug. Finally, there is the fact that UCSF wouldn't, themselves, engage in such a blind placebo clinical trial. They have an ethical problem with that concept. Something we also had problems with and caused us a bit of concern.

I know I did a terrible job explaining the process, but the overall meeting was very encouraging. He was very optimistic about my being around for the next two years. I could always ask for the "Avastin" should the MRIs show that such blood vessels have developed; He agreed to review my MRIs on a regular basis (at a cost - but a minimal one) for such a development;

And, this is for you Tony, the doctor made it clear that there would be no reason why I wouldn't be able to climb Mt. Kilimanjaro in the future. That gave me a lot of hope. I like this guy.

It has been about a month since the accident. I have been trying to piece together all that occurred. All my visitors, when they came, what hospital I was in, pre-surgery, post-surgery, what I had said, what I had felt and the more I try, the more I realize just how fucked up I was.So, I know that no one is expecting anything of or from me, but nevertheless, I want to take this time to apologize to everyone for my conduct. I remember some of it, but it was as if I had watched it in a movie. Not exactly in a fog, but very real and I felt as if I were very much in control, knew what I was doing, understood everything and communicated quite well. I remember being in extreme pain. My back and shoulder, especially. I remember being told I had a tumor, a glioblastoma and that I had a year to live. What I don't remember is where everyone went when they were not in the movie. Was the cast just sitting around waiting for their next scene. Of course not, but that is how it seemed to me. I can't place the scenes in order and I can't remember what was said at any given moment. This part reminds me of the bygone days of old when I would perhaps drink a bit too much and the next day I'd try to remember who I had dissed and whether should I be embarrassed. And, embarrassed for what?

I've been told that I was very emotional. One minute I'd be crying, the next I'd be screaming in pain. I remember this, but only in the context of coming out of it. I remember short and fragmentary moments where I would feel as though I was just getting a grip on controlling my emotions, but as quick as I grasped hold, it slipped, as if I hadn't the ability to get a foothold in reality so that I might actually address myself and my situation and deal with it. The moment I thought I had that fingerhold, I would immediately let it slip and I'd fade into either another movie scene, sleep or find a place where I could let myself just cry. I don't know the reasons for all the emotional exhibition, nor am I trying to apologize for that bit of the show. I'm sure there are many reasons, some because of the drugs and some because of the physical effects caused by the tumor and the accident. Most important to me, however, is the confrontation with mortality. I may not have been in the best frame of mind when told of my fate, but I have and I will for a long time to come look at my life in a very different light. I have to review the meaning of it; I have to take the time, make the time, set aside the time, create the time just to make sure I have the time to enjoy the time and to contemplate the concept of mortality. I'm thankful already that I was given 'a bit of extra time" for such an opportunity. I drove by the accident scene (well, I rode by) and I saw that I could easily have died at that scene. I didn't (obviously) but more important is that I could have but didn't hurt anyone else, either.

Anyway, I started out with an apology and that's what I want to do here. I apologize for not getting back to everyone who has shown me so much love and care. I will. I promise, but it may be some time, yet. I want to apologize to those who pulled me from the wrecked vehicle. The two, one CHP Officer and one civilian I'm told, who decided to risk their lives for mine and pulled me from my vehicle even though power lines were everywhere and posed a real danger of electrocution. To you I owe a great deal of thanks, but also an apology for placing you in such danger. And to everyone in my movie, I apologize for not really being there, but I'm getting there. I'm sorry if I embarrassed anyone, I'm sure I should feel some myself, but I haven't the time. Let it go at that. I WILL SURVIVE THIS BASTARD THING CALLED CANCER. Lenny