Tuesday, September 30, 2008

Liver Biopsy

Today was the day of my liver biopsy at Northwestern Memorial Hospital in Chicago. This was our fourth trip to the hospital in the past 2 weeks (2 doctor appointments and 2 procedures). Today's procedure was done in the Interventional Radiology department which is the same place where I had my portal vein embolization (PVE) done last week so I dealt with many of the same nurses and they were all wonderful (again).

I got prepped for the procedure and wheeled into the procedure room where an ultrasound was used to get a good view of my liver including the large hemangioma in the right lobe. The biopsy tissue was taken from the left lobe of the liver in order to avoid any contact with the hemangioma. One of the nurses shaved part of my right abdomen and they "painted" this area with a green antiseptic prior to the procedure. Soon after this I received my general anesthesia and the next thing that I knew I was waking up in recovery. I have a small bandage on my right abdomen where the needle had been inserted to get the biopsy tissue. The procedure took a little under an hour and I was in the recovery room for two hours following the procedure.

It sounds like the biopsy results will be available in a few days (hopefully by the end of this week). As I was wheeled into the procedure room I spoke with the doctor who had done the PVE last week and he indicated that based on the results of today's test the next test would likely be a Hepatic Angiogram (injection of dye into the liver's artery to see the location between the artery and my hemangioma). This test would also done in the same Interventional Radiology department if the test is required.

Friday, September 26, 2008

Wiped Out

Today was a rest day (I wasn't very sore today but extremely tired) and a day on the phone with the hospital about upcoming steps. We were told yesterday that we would be meeting with the doctors at Northwestern on Monday. Today there was a change of plans and I spoke with my surgeon about the unexpected results (high pressure in my portal vein) found during yesterday's liver procedure .

There are many different possible causes for the pressure and this needs to be understood better before I have the liver surgery. So next Tuesday I will have a liver biopsy to see if it shows any other problems with my liver (besides the benign tumor that I have). If the biopsy doesn't show anything then there is an additional test that will be done. I don't remember the name of this second possible test but I believe that it is a dye that will be injected into my tumor to see if it's location is causing the unexpected pressure.

My family bought tickets for a big concert tonight at our church but I wasn't up to going. My wife and older daughter went with one of her friends. The main act was Big Daddy Weave and the secondary group was Rush of Fools. I was excited about seeing Rush of Fools since I had seen them earlier this year with Newsboys and they put on a great show. I am sure that it was another good show tonight.

Thursday, September 25, 2008

Portal Vein Embolization (PVE)

Well today was the procedure to block the portal vein coming into the right lobe of my liver. (see earlier blog post for the reason for this procedure). My wife and I drove into Chicago before rush hour (4:50 to 6:00) and sat around until it was time for my check-in at 7:00 am.

After this I got prepped and eventually made it into the large room where the procedure was done. I don't remember a lot after this except for the following:

- There were a number of people in the room in addition to the doctor and staff that was doing the PVE procedure as it is a less-common procedure and others wanted to observe.

- I was laying on a table which had some imaging equipment above me and which had a large bank of video monitors. I guess this is how the doctor was able to see the veins coming into the right lobe of my liver and plug them up.

- Shortly after I was situated in the proper position (45% angle between laying on my back and laying on my left side) and I had been cleaned up, I was given IV medication to put me into a light sleep and to cover the pain.

- After this I was out for most of the procedure. However, as the medication was just for a light sleep (so that I could respond to commands about deep breaths and such), I did feel some pain near the end of the procedure.

- I remember trying to move when I felt the sharper pain and the staff helping me to stay still. Shortly after this I remember hearing, "last one and now we are done" or some similar words.

Later, after I had been in recovery for a few hours, I spoke with the doctor. I apologized for moving during the procedure when I had felt the pain. He indicated that it was all fine and that I had handled the entire procedure well.

It looks like the procedure went well though we learned of one complication from our discussion with the doctor. My portal vein had high pressure for some unknown reason. Because of this I will be needing another procedure to get some liver tissue for a biopsy. I guess if we had had any idea that this would be needed then it could have been consented by me in advance and the tissue could have been collected today. However, since the doctor did not have this consent he was not able to do this and I was drugged out and could not at that point give consent.

After 4 hours of recovery (of which I mostly slept through) I was released and my wife brought me home. I then went to sleep for another 3 hours. Hopefully I will sleep ok tonight.

I have another meeting with my liver specialist and liver surgeon on Monday next week and I am sure that we will discuss the portal vein hypertension as well as the needed biopsy. In the mean time, today's procedure should induce my left liver lobe to begin to grow prior to my surgery which will likely be early in November.

Tuesday, September 23, 2008

Book Review - "The Innocent Man" by John Grisham

I am a long time John Grisham fan. I have really enjoyed his legal fiction since his first book and I enjoyed his recent non-legal fiction, "Playing for Pizza", even though it wasn't critically acclaimed. I was very curious when I heard that Grisham had written a non-fiction book, "The Innocent Man", a couple of years ago but I was not in a reading phase at the time so I didn't get a chance to pick it up.

Recently I saw a reference to this book again and I read a brief description of the book online. It was at this point that I learned that the book centers on the town of Ada, Oklahoma and a real life crime in this town in the early 1980's and the incredible injustice that followed this crime. I lived and went to high-school outside a nearby town (Seminole) in the same general time frame of the initial events in the book so I really became interested in reading this book.

I purchased the book this past Friday and read it through the weekend and completed it this evening. It really is another great book by John Grisham. The writing and story telling are very compelling yet at the same time the story being told is sad and embarrassing to someone who lived very close to these events. I don't know if the book is 100% accurate but even if it is less then that, the events of the case are both unbelievable and the abuse of power is scary. The main story in the book is about two men, Ron Williamson and Dennis Fritz, who were wrongly convicted of a brutal crime in Ada and many years later were exonerated via DNA testing. The story also includes additional cases of wrongful convictions that overlapped with the main story.

I was very interested in the story as it was very compelling but I was also very interested as the locations and sometimes people were things that I knew about. I was away in college in Norman in 1982 when the actual crime was committed and I was living in Illinois when the trial took place so I did not remember much about the actual events but there was so much in the book that was familiar to me.

Ron Williamson, the primary character in the book, ended his high school baseball career playing for Asher in 1971. Nine years after this I was playing high school baseball and Asher was one of my high school's big rivals. There was also a reference in the book to another unsolved abduction that had occurred in Seminole prior to the crimes in this book. This reference was to a classmate of mine. Other references to places in Seminole, Ada, Norman and other places in Oklahoma all brought back many memories to my high school and college years.

The book is a great telling of a story that really needed to be told. I hope that in some way it may prevent this type of thing from happening again in some other small town. Reading the book was at times a bit surreal due to my familiarity with so much of the setting. I highly recommend the book (even if you are not from a small Oklahoma town).

Monday, September 22, 2008

Meeting the Surgeon

So my wife and I went back to Northwestern Memorial to meet the surgeon who will be doing my liver surgery. The meeting went very well. I will be having my portal vein embolization (PVE) this Thursday. We need to be at the hospital at 7 which means we will probably be leaving home before 5. (Today however we had an afternoon appointment and made it to the hospital in just over an hour. What a difference from the drive last week where it took over 2 hours.)

I will have another MRI in 4 weeks to confirm that my left liver lobe has grown sufficiently. My surgery will be 6 weeks from now which will be the first week in November. It sounds like my hemangioma is so close to the center of my liver that the surgery will actually be an "extended right lobectomy of the liver".

Sunday, September 21, 2008

Watching Grass Grow... (not)

I have heard some say that they would rather watch grass grow then watch golf on TV. Personally I enjoy watching big golf events and there are none bigger than the Ryder Cup (US vs Europe). I have been having a lot of fun watching this the past 3 days.

Golf is normally an individual sport but the Ryder Cup is all about the teams and it is a lot of fun to watch these teams. The pressure is incredible as these guys don't want to let their teams down and it is so impressive to see their response to this pressure (which is generally very good).

I am rooting for the US team but I love watching both teams and the great golf exhibition that they are putting on.

Friday, September 19, 2008

Health Update

Well it looks like I will be having liver surgery after all though it will likely be November or later. I talked to my doctor today and she confirmed the surgery though I need to first go through a procedure that will do something to the veins coming into my liver so that more of the blood goes to the left "lobe" which should cause the left lobe to grow.

I have a 6.8 cm hemangioma/tumor/growth in the upper part of the right lobe of my liver that has been causing me pain. Because of the location of this growth it is necessary to remove the entire right lobe in order to remove it. Normally the right lobe is 60% of the liver and it is ok to remove it as the remaining 40% will regenerate and the liver will return to its original size (or very close to it). However in my case there is an issue as my left lobe is smaller than normal and removing the right lobe will leave me with a smaller liver which may not be large enough to be safe following the surgery.

So the plan is to do this procedure which should send more blood to the left lobe and cause it to grow larger in the next 4 to 6 weeks. After this time I will be scanned again and if the increase is sufficient then the surgery will be scheduled to remove the right lobe.

I meet with the surgeon on Monday to discuss the procedure and the later surgery. I don't know much about the initial procedure but it sounds like it does not involve any cutting (the words of my doctor) so it isn't called a surgery. It sounds like they come up through the groin to get to the liver to do this. None of it sounds like much fun but the hope is that when it is all done that the pain will be gone.

Thursday, September 18, 2008

"A rose by any other name ..."

Today was a day when a number of people at my work location were "let go" due to the company needing to get smaller. Unfortunately this has happened too often in the last 15 years. It has almost gotten to the point where it has lost it's sting (unless you are one of the unfortunate people impacted).

Over the years my company has renamed this exercise of firing groups of people. Here are some of the terms that I can remember (I am sure I have forgotten others):

1) Layoffs - This is the first term that I can remember being used during one of these exercises. The term must have been too well known for it changed soon after this.

2) Downsizing - This term started the trend in getting more focused on the company and less on the impacted people

3) Rightsizing - It didn't take long for the HR people to decide that downsizing wasn't a good term so they changed to this alternative. The funny thing is that I never heard this term used during a round of hiring so it was pretty clear to everyone what "rightsizing" the company actually meant.

4) Force Management Program (FMP) - This term has been used quite a lot in my company and it didn't take long for it to yield the new verb "FMPed" which applies to anyone impacted by this exercise.

5) Reduction In Force (RIF) - This is the most recent term that I have heard for our layoffs. It is actually a much more honest term than the last couple and is easily understood.

Note that all of these are terms used on the US side of my company. A number of years ago I heard the term that was being used in the UK - "Made Redundant" which I have always found very interesting. The meaning is clear enough when you think about it but initially I had no idea what they were talking about. It almost sounds like a science fiction plot where someone secretly made a clone of you while you were sleeping and now you are without a job as you have been "made redundant"...

In the end, it really doesn't matter what you call the "layoffs". The news is bad when you lose your job. Every time we have a round of this at my company there are rumors flying around about how large it is going to be - "5%"? "10%"? "40%"? People in the company feel "good" when they hear that the number is smaller but the reality is that the number is really 0% (those retained) or 100% (those let go) for each person no matter what happens to everyone else. It isn't much consolation to someone who is let go to hear that they were one of a smaller number of people impacted.

Good luck to all the people who lost their jobs today. I will be praying that God opens new doors for you for even better opportunities and challenges in your life.

Wednesday, September 17, 2008

A Day in Chicago

There is a very good reason that I don't live in Chicago. 3 words - Crazy Taxi Drivers...

So I had an appointment today at Northwestern Memorial Hospital in Chicago with a liver doctor. My appointment was at 10:00 and I figured that 2 hours would be plenty of time to get there from the western suburbs. Bad planning. Traffic started bad when we (my wife and I) left the house and then it just got worse as we got into Chicago. At one point there was a stalled car sitting in the far left lane. Unfortunately we were in the same lane but we were able to go on the shoulder and squeeze between the car and the retaining wall. Traffic was stop and go for too long and around 9:30 we were thinking that we would likely be 30 minutes late to the appointment.

Finally something happened and traffic lightened up and we were able to drive the last 5 miles in pretty good time. We pulled into the hospital parking garage a couple minutes before 10:00. After squeezing into a parking spot on the 7th level of the garage we raced as quick as we could into the hospital and then up to the 14th floor (after changing elevators on the 13th floor) to my appointment. Thankfully it wasn't a big deal that we were a few minutes late. This was my first time to this hospital so there was quite a bit of paperwork to fill out. I had just sat down to start on this when I heard my name called and we were escorted to an examination room. The paperwork got filled out later as I waited for my doctor.

It looks like I will need liver surgery to remove the growth (hemangioma) that I have on my liver though the doctors are still discussing this and I will know something more definite early next week. I don't mind the surgery if it resolves the pain that I have been feeling lately.

Lessons learned today:
1) Northwestern Memorial Hospital has pretty good cafeteria food (though it was kind of pricey).
2) Taxi drivers in Chicago don't need an excuse to use their horns and the city could save money with the lane markers as the cabbies don't pay much attention to them either.
3) A validated parking ticket at the hospital means that they only charge you $10 for using their garage instead of requiring you to mortgage your house to pay the regular rates.
4) A number of cars were parked in 2 parking spots instead of one. This is either due to the spaces being very very narrow or is a way to make a statement about the parking rates.

Sunday, September 14, 2008

Eagle Sighting

Last month my family and I spent a week in Door County, Wisconsin for a nice relaxing vacation. Door County is near Green Bay and is the "thumb" of Wisconsin (if you think of the outline of Wisconsin as a mitten).

While there we did some swimming on both sides of the peninsula (Lake Michigan and Green Bay) and enjoyed some of the parks. One of these parks is the Peninsula State Park which is very scenic and located on the west side of the peninsula. While driving through this park we saw a lookout tower and decided to climb it for the scenic view.

Here are a couple of pictures of the tower and it's sign:





From the top of the tower we had a nice view of Green Bay but even more exciting was a pair of bald eagles that we saw on a nearby tree (thanks to the family that had already spotted them).



Later one of the eagles flew off but I was too slow with my camera to get much of a picture.

Friday, September 12, 2008

Game On - Audiosurf

One of my biggest hobbies is PC gaming. I have been enjoying it for 20 years since my first PC purchase (a 386 desktop that I got from AT&T with an employee discount back in the 80's). These days my gaming is mostly on my new laptop.

I have played all types of games over the years but my favorites have generally been strategy and adventure games. Lately however I have learned to really appreciate some "Casual" games. The first was Peggle which stole too many of my hours. Recently I have discovered Audiosurf (link). [Note that there really isn't anything "Casual" about either game as they are both giant time-sinks and great games.]

Audiosurf is a type of rhythm game though instead of keeping beat to a song you are moving your car in and out of lanes to hit/miss blocks. The track/obstacle course is constructed when you load a song which can be any music you have on your PC or some of the free tunes that come each week from the game. The enjoyment is playing to your favorite music and attempting to set high scores which are kept on Audiosurf's web server. My girls and I enjoy competing with each other to see who can put up the best score on the high score list.

One of the best parts of the game was the price. The game is normally listed as $10 from Steam (link) but a few weeks ago it was half-price so I got for $5. It has been a tremendous value and we are getting a lot of enjoyment out of a wonderful game.

A final bonus that I am enjoying is the "Achievements" that the game allows you to accomplish. These are a type of "medal" that you can get for completing certain tasks while playing. It adds another level of enjoyment to the game. Props go out to Dylan Fitterer the creator of Audiosurf for a great game. It is unusual these days to see games of this quality put out by individual developers. Well done Sir!!

Wednesday, September 10, 2008

Steven Curtis Chapman on CBS

I have been a Steven Curtis Chapman fan for the past 20 years. He was on the CBS early show this morning (link) and sang his "Cinderella" song. He talked about the healing that his family has been going through after the tragedy that claimed his youngest daughter Maria earlier this year. He discussed the hope that his family has through their faith even in their brokenness.

His oldest daughter Emily is getting married next month. She and Steven Curtis will be dancing to the Cinderalla song as his son Caleb sings it. I am sure that this song will always have a special place in the heart of their family and for his fans. It has become a memorial for Maria in addition to being a reminder of how precious the time is we have with our children.

My prayers continue to go out to the whole Chapman family during this time and especially to Emily and Tanner on their upcoming wedding.

Tuesday, September 9, 2008

Waiting...

I am very impatient on some things and the worst is waiting on phone calls from my doctor's office for test results. For various reasons I have had a number of medical tests in the past couple of years and I really dislike the waiting part. I had three MRIs where the technicians told me that I would have the results in a day or two. In all of the cases it was over a week before I heard anything. Thankfully the news was always good but the waiting kills me.

Last week I had a different test and was told that I would hear something "in a week". I am hoping that it is really just a week and that I hear good news soon.

My favorite OT scripture is Isaiah 40:31:

"but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint." (NIV)

I know that God is good and my hope is in him no matter how this test or any others come back.

Sept 12 Update:

I spoke with my doctor's office today and the news was good on my tests (biopsies of tissue taken from my esophagus during an upper endoscopy) from last week.

The testing is not done but at least the news has all been good up til now. Thank you God!

Monday, September 8, 2008

Greetings

As this is my first post to my blog it seems appropriate to say "Welcome" to my corner of the web. I am not sure yet how I will use this blog but I have some ideas. Hopefully I will have the time and interest to keep this going.

This probably belongs in my "about me" section (and may end up there eventually) but I would like to mention a few things that keep me busy and things that interest me. I am a software engineer in the telecommunications industry and have been doing this for too many years. When I am not working I stay busy with my family and various hobbies. These hobbies including computer gaming, web surfing, listening to contemporary Christian music and watching college football (go OU!).

One of my other passions is Oklahoma high school basketball though I live in Illinois. Thanks to some wonderful web sites (www.coachesaid.com and www.okrankings.com) I am able to follow high school basketball from my home state from 750 miles away. One of my guilty pleasures is making a road trip to OKC each March to watch the Oklahoma small school state basketball tournament. I have been doing this for the past 4 years and have no plans to stop. I am able to see 16 games in 3 days of the best small schools in the state. Hoops heaven for me, especially as I have been reading about these teams and players all season leading up to these state championships.

Again, welcome to my blog!