I had my second PVE procedure yesterday at Northwestern. I have documented the reason for the second PVE in previous blog entries. The highlights are that the first PVE was done very conversatively since the doctor did not know if my liver surgery would proceed based on the unexpected high pressure found in my portal vein. Now that the high pressure is well understood and the surgery is back on schedule the second PVE was done to more thoroughly block the blood supply to the right side of my liver. An MRI last week had shown that the growth in the left side of the liver had not been as much as the doctor's wanted to see. With yesterday's procedure it is hoped that the left side will grow sufficiently within the next 3-4 weeks before the next MRI.
Yesterday's procedure went well though I was pretty wiped out when it was done (as well as today). The procedure started at 8:30 am and was completed at 11:10. I was in recovery until 1:10. One difference between yesterday's procedure and my previous PVE is that I was awake for more of the procedure yesterday. The doctor asked me a few times to hold my breath near the end of the procedure. I assume that this was so that they could take some images of my liver and the blood flow after they had completed much of the embolization. Later after the procedure was completed we spoke with Dr. Lewandowski and he indicated that everything had gone well. He described how they used additional metal coils for the embolization to back up the particles that were put in first for blocking the veins. He was confident that the veins were very well blocked on the right side.
As far as we know the next trip into Chicago should be in 3-4 weeks for the next MRI.
Saturday, October 25, 2008
Tuesday, October 21, 2008
Switchfoot - We Are One Tonight
Ok, I put up a link for Relient K the other day. Today I have to give some love to one of my other favorite groups, Switchfoot. I have many favorite songs from Switchfoot. But for their videos I think that I have a single favorite (based on the clever editing done in the video). Enjoy!
Monday, October 20, 2008
MRA Results
Well, I am bummed. I got a call today from the nurse at Northwestern and it looks like the MRA test from last week shows that my previous portal vein embolization (PVE) did not result in sufficient growth in my left liver lobe so I will be needing an additional PVE. This means that my liver surgery will likely be pushed out 4 weeks from the beginning of November to some time near the end of November.
When I had the original PVE the doctor told us that he had found the unexpected pressure in my portal vein and because of this he was not overly-aggressive in the plugging of the portal vein. This is because the pressure could have been due to liver disease which would have meant that the surgery would not happen. If that had been the cause of the pressure then they would not have wanted the coils added by the PVE to be permanent or to cause too much atrophy to the right side of the liver.
Now that we know that the pressure was not caused by liver disease but was instead caused by the fistula within my tumor it means that the PVE can be very aggressive to stimulate the growth of the left liver lobe. So I guess the PVE this Friday will be much more aggressive (i.e. more branches of the portal vein will be blocked) then the previous procedure.
I don't care about the PVE but I am disappointed as I really wanted the surgery to be completed before the holidays. It looks like it will now be at the earliest right before Thanksgiving and the recovery will be much of December. In the worse case it could extend even longer. I am disappointed but I am still very thankful for the excellent care I am getting from Northwestern Memorial and that so many of the potential issues that have come up with my liver have not been real problems. I just need to be patient now and wait for the process to play out.
When I had the original PVE the doctor told us that he had found the unexpected pressure in my portal vein and because of this he was not overly-aggressive in the plugging of the portal vein. This is because the pressure could have been due to liver disease which would have meant that the surgery would not happen. If that had been the cause of the pressure then they would not have wanted the coils added by the PVE to be permanent or to cause too much atrophy to the right side of the liver.
Now that we know that the pressure was not caused by liver disease but was instead caused by the fistula within my tumor it means that the PVE can be very aggressive to stimulate the growth of the left liver lobe. So I guess the PVE this Friday will be much more aggressive (i.e. more branches of the portal vein will be blocked) then the previous procedure.
I don't care about the PVE but I am disappointed as I really wanted the surgery to be completed before the holidays. It looks like it will now be at the earliest right before Thanksgiving and the recovery will be much of December. In the worse case it could extend even longer. I am disappointed but I am still very thankful for the excellent care I am getting from Northwestern Memorial and that so many of the potential issues that have come up with my liver have not been real problems. I just need to be patient now and wait for the process to play out.
Saturday, October 18, 2008
Relient K - Sloop John B
I have a number of "favorite" music groups but Relient K is probably at the very top. I own just about everything that they have published (I think that I am missing 1 or 2 EPs). One of my favorite treats was the DVD recordings that came with the "Five Score and Seven Years Ago" CD. This DVD was some studio recordings from Capitol A Studios and included acoustic versions of some of their music along with a recording of the song "Sloop John B" (made famous by the Beach Boys).
Some time ago while perusing YouTube I found that someone had uploaded this recording. It is really good stuff so I thought that I would throw up a link to it. Enjoy!
Some time ago while perusing YouTube I found that someone had uploaded this recording. It is really good stuff so I thought that I would throw up a link to it. Enjoy!
Thursday, October 16, 2008
Helicopters
Today was an early morning with a trip into Chicago for my MRA. Thursday's are also our garbage/recycleables day (put it all out on the curb before going to work). As this is Fall we also fill up leaf bags and put them on the curb. Altogether I had about 10 items to move to the curb this morning.
So this morning I got out around 6:00 (still dark outside) and started moving things to the curb. The first thing that I noticed is that I heard some helicopters in the sky. This isn't too unusual but what was different was the number of them. There were 5 helicopters hovering not far north of where we live. Quite a bit of noise.
My neighbors were out also putting out their garbage and pretty soon we were all discussing the helicopters and what they were doing. As I said sometimes there may be 1 or 2 if there is an accident on the highway but this is normally farther away from our neighborhood. No one knew the reason at that time.
30 minutes later we dropped our girls off at a friend's house so that they could get a ride to school and we learned from their mom that there had been a medical helicopter crash about 3 miles from our house last night. [They had closed off the road that we normally travel on so it was really good to learn this.] Unfortunately the crash was a fatal crash for all 4 occupants (including an infant) and was national news today. link
This explained all of the other helicopters that were in the sky that were from various news stations covering the story. I wish that the answer to the mystery had been better news. :(
So this morning I got out around 6:00 (still dark outside) and started moving things to the curb. The first thing that I noticed is that I heard some helicopters in the sky. This isn't too unusual but what was different was the number of them. There were 5 helicopters hovering not far north of where we live. Quite a bit of noise.
My neighbors were out also putting out their garbage and pretty soon we were all discussing the helicopters and what they were doing. As I said sometimes there may be 1 or 2 if there is an accident on the highway but this is normally farther away from our neighborhood. No one knew the reason at that time.
30 minutes later we dropped our girls off at a friend's house so that they could get a ride to school and we learned from their mom that there had been a medical helicopter crash about 3 miles from our house last night. [They had closed off the road that we normally travel on so it was really good to learn this.] Unfortunately the crash was a fatal crash for all 4 occupants (including an infant) and was national news today. link
This explained all of the other helicopters that were in the sky that were from various news stations covering the story. I wish that the answer to the mystery had been better news. :(
Tuesday, October 14, 2008
Angio-Seal
Last Wednesday my procedure included the insertion of a catheter into my artery in my right groin area to get access to the artery coming into my liver. When the procedure was completed the doctor closed the hole in my artery using a device known as an Angio-Seal.
This device is kind of like an anchor that you might insert into a hole in the wall when the hole is too large for a nail or a regular screw. In the case of the Angio-Seal there is an anchor that is inserted inside the artery and there is a suture that connects to the anchor which puts tension on it to close the hole. There is also a third component which is collagen which is outside the artery at the point where the suture and anchor are connected. This helps seal the hole as well.
The purpose of the device is to allow quick recovery (a couple of hours) following the procedure as compared the the traditional method of applying pressure on the artery for some time and then 6 or 7 hours of recovery to prevent the artery from bleeding again. One interesting aspect of the Angio-Seal is that all 3 components are made from a "biomaterial" which is absorbed by your body within 60-90 days.
I assume that it is all working well but this area has been sore since last week with a nice big bruise. The bruise is starting to fade a little and I am sure that the soreness is due to the procedure with the catheter in the artery as compared to the Angio-Seal applied at the end (mostly since the soreness extends higher than just the area of where the artery was sealed).
My next test is an MRI/MRA (magnetic resonance angiography) which will get a good view of my liver and the blood vessels in it to confirm that it has grown enough for the surgery. This test will be this Thursday (10/16/08) at another Northwestern Memorial location in Chicago. If the results from this are good then the surgery will be scheduled in the near future. It sounds like there will be one more trip to Northwestern before the surgery to get the pre-surgery blood tests completed once it is known exactly when the surgery will be.
10/15 Update:
I was sitting at work today and all of a sudden I had an epiphany about this Angio-Seal business. Yesterday I compared it to an anchor behind a big hole in the wall. Well this is an ok comparison but it lacks the plugging up the hole which the Angio-Seal does. The better comparison is an aluminum rivet:
A rivet is plugged into a hole with a "rivet gun" which pushes the rivet into the hole and then it pulls on the aluminum stick part (the bottom of the rivets in these pictures). This causes the top of the rivet to bulge out and between that bulge and the middle section above the hole is plugged up on both sides. The rivet gun then breaks off the "stick" part as it is no longer needed once the hole is plugged.
So in the case of the Angio-Seal it is exactly the same kind of thing happening. The only difference is that the "stick" is the suture which pulls on the anchor on the inside of the artery and the collagen covers up the other side of the hole. Like the rivet stick, the suture is cut at skin level once the Angio-Seal is in place and it pulls back below the skin level (where it is later absorbed by the body along with the other parts).
So I now have a much better understanding of why my leg is sore. I just imagine someone using a rivet gun and placing a rivet in my body. It all makes sense now... :)
This device is kind of like an anchor that you might insert into a hole in the wall when the hole is too large for a nail or a regular screw. In the case of the Angio-Seal there is an anchor that is inserted inside the artery and there is a suture that connects to the anchor which puts tension on it to close the hole. There is also a third component which is collagen which is outside the artery at the point where the suture and anchor are connected. This helps seal the hole as well.
The purpose of the device is to allow quick recovery (a couple of hours) following the procedure as compared the the traditional method of applying pressure on the artery for some time and then 6 or 7 hours of recovery to prevent the artery from bleeding again. One interesting aspect of the Angio-Seal is that all 3 components are made from a "biomaterial" which is absorbed by your body within 60-90 days.
I assume that it is all working well but this area has been sore since last week with a nice big bruise. The bruise is starting to fade a little and I am sure that the soreness is due to the procedure with the catheter in the artery as compared to the Angio-Seal applied at the end (mostly since the soreness extends higher than just the area of where the artery was sealed).
My next test is an MRI/MRA (magnetic resonance angiography) which will get a good view of my liver and the blood vessels in it to confirm that it has grown enough for the surgery. This test will be this Thursday (10/16/08) at another Northwestern Memorial location in Chicago. If the results from this are good then the surgery will be scheduled in the near future. It sounds like there will be one more trip to Northwestern before the surgery to get the pre-surgery blood tests completed once it is known exactly when the surgery will be.
10/15 Update:
I was sitting at work today and all of a sudden I had an epiphany about this Angio-Seal business. Yesterday I compared it to an anchor behind a big hole in the wall. Well this is an ok comparison but it lacks the plugging up the hole which the Angio-Seal does. The better comparison is an aluminum rivet:
A rivet is plugged into a hole with a "rivet gun" which pushes the rivet into the hole and then it pulls on the aluminum stick part (the bottom of the rivets in these pictures). This causes the top of the rivet to bulge out and between that bulge and the middle section above the hole is plugged up on both sides. The rivet gun then breaks off the "stick" part as it is no longer needed once the hole is plugged.
So in the case of the Angio-Seal it is exactly the same kind of thing happening. The only difference is that the "stick" is the suture which pulls on the anchor on the inside of the artery and the collagen covers up the other side of the hole. Like the rivet stick, the suture is cut at skin level once the Angio-Seal is in place and it pulls back below the skin level (where it is later absorbed by the body along with the other parts).
So I now have a much better understanding of why my leg is sore. I just imagine someone using a rivet gun and placing a rivet in my body. It all makes sense now... :)
Sunday, October 12, 2008
Loss of a Friend
I attended a very small high school (Varnum High School located outside the town of Seminole, Oklahoma) and I am on a mailing list from the alumni association. I graduated in 1982 and I was very surprised when I received an email yesterday entitled "1982 Grad Dies". Even before I read the email I knew that I had lost a friend as there were only 20 people in my graduating class and I consider all of them friends.
I was very sad to read that Shari Osborn (now Shari Patzell) had passed away in North Dakota. I hadn't seen Shari since 1985 or 1986 when I ran into her on the campus of OU. I learned in her obituary that Shari had been a nurse for the past 15 years. This doesn't surprise me as Shari always had a very kind and caring personality. I am very sad for Shari's family and I will be praying that God grants them his peace and love during this time of their great loss.
I was very sad to read that Shari Osborn (now Shari Patzell) had passed away in North Dakota. I hadn't seen Shari since 1985 or 1986 when I ran into her on the campus of OU. I learned in her obituary that Shari had been a nurse for the past 15 years. This doesn't surprise me as Shari always had a very kind and caring personality. I am very sad for Shari's family and I will be praying that God grants them his peace and love during this time of their great loss.
Thursday, October 9, 2008
Hepatic Angiogram - Good News
Yesterday was another trip to Northwestern Memorial Hospital in Chicago and another liver procedure for me in the Interventional Radiology (IR) department. The primary purpose of yesterday's procedure was to try to find the cause of the high pressure that was seen in my liver and in the portal vein that feeds into the liver. The main procedure that was planned was a Hepatic Angiogram which is the insertion of dye into the liver (via a catheter which is inserted into the hepatic artery) and the subsequent taking of x-rays of the liver to get a good mapping of the blood vessels in the liver. However, additional testing was also planned to measure the pressure of the blood that leaves the liver and comes into the heart to see if the problem was not in the liver but actually a heart issue.
My wife and I got to the hospital around 9:40 for my 10:00 appointment with the actual procedure planned for 11:00. As I was filling out my paperwork at around 9:50 the nurse came out and got us so that I could begin to get prepped for the procedures. We went back and I finished the paperwork, got changed and got onto my gurney. The nurse checked my vitals and started the IV and then we waited. This was a little after 10 and we assumed that the procedure would start close to 11 as my previous ones had all been either on time or a little early. Luckily my wife and I both had some reading material. Around 10:50 the nurse came back with the news that my procedure room (the "best" one in the IR department according to my doctor) was still in use and my procedure would likely be delayed until 12:30. This was fine but a little different compared to the previous visits. Between 11 and 12:30 we were able to talk to my primary IR doctor (Dr. Lewandowski, who had done my previous PVE procedure) and one of the fellows (Dr. Scanlon) who would be assisting in today's procedure. At 12:30 I was wheeled back to the procedure room.
The procedure room for this procedure was the same one I had been in for the PVE. It contained a large imaging machine above me as well as a large bank of video displays for the doctor to see the images. Once I was on the table I was prepped for the procedure. As the doctors were planning to look at both the veins above my liver and the artery coming into the bottom of my liver it was necessary to prepare 2 locations for entry. The first part of the procedure would be coming into a small incision in my neck which they would feed the catheter into the veins leaving my liver (hepatic vein). The second part of the procedure (the actual Angiogram) would be coming into a small incision in my groin which they would feed the catheter into the hepatic artery coming into my liver. So both entry points (right side of my neck and right side of my groin) were shaved and heavily painted with antiseptic.
Soon after this I was sedated and I slept through the first hour of the procedure (the work through my neck to check the pressure in the veins leaving my liver). Unlike my previous procedures, however, I was awake for most of the remainder of this procedure. At some point I started hearing the doctor talking to me and telling me that I needed to hold my breath for a short period of time. I assume that this was part of the angiogram so that they could get clear x-ray images after the dye had been inserted. I am not clear on the duration of this part of the procedure but overall everything took around 2 hours (from 12:45 to 2:45). I was feeling some pain in the groin area when I was waking up during the procedure and I mentioned this to a nurse. They must have given me more of the pain medication as this did not seem to continue to be a problem.
As an aside, one thing that I have learned through the 3 procedures that I have had is that there are 3 elements to the medication that I am given. The first part is for the pain relief, the second part is to relax me (this usually puts me to sleep) and a third part is to make me forget the experience. I guess I could have guessed the first 2 but I didn't realize until now about this third part which must help people after the procedure who wouldn't want to remember any of the pain if they were not asleep through the whole thing.
Around 2:45 I was wheeled back into recovery and I was there until 4:45 when we were able to leave the hospital. During this time we spoke again with Dr. Scanlon and Dr. Lewandowski and we learned that everything had gone very well. The first good news was that the pressure in the veins above the liver were all normal so this means that there is no issue with my heart. The pressure problem had to be in the liver. The second good news was that they did find an issue within my tumor where a vein and an artery were cross-wired. This fistula appears to be the cause of the high pressure in my portal vein as the pressure in the arteries is much higher than in the veins and the fistula was causing this pressure to enter my venous system. The reason that this news was "good" is that it removed the mystery of why I had this high pressure and it concluded that I have a single liver issue (my tumor) and not multiple issues (as was possible when they found the high pressure during the PVE procedure).
Dr Lewandowski discussed the findings with my liver surgeon (Dr. Baker) and liver specialist (Dr. Kulik) and they decided that it was safe to leave things alone and to go back to the initial plan of having surgery to remove the tumor. It was possible that if they had found some other malformation in my liver yesterday that they would have tried to repair it (embolize/blocking it up with coils) but as the issue was in the tumor which will be removed this was not necessary.
The left side of my liver should be growing at this time (it has now been 2 weeks since my PVE) and I will have a CT Scan or MRI within the next couple of weeks to confirm that it is large enough to proceed with the surgery. The surgery will be scheduled as soon as this is done.
Thanks again to all of the nurses, technicians and doctors at Northwestern. I have now been in the Interventional Radiology department 3 times in the last 2 weeks and the people working there have all been wonderful (though they are curious why I keep coming back). :)
My wife and I got to the hospital around 9:40 for my 10:00 appointment with the actual procedure planned for 11:00. As I was filling out my paperwork at around 9:50 the nurse came out and got us so that I could begin to get prepped for the procedures. We went back and I finished the paperwork, got changed and got onto my gurney. The nurse checked my vitals and started the IV and then we waited. This was a little after 10 and we assumed that the procedure would start close to 11 as my previous ones had all been either on time or a little early. Luckily my wife and I both had some reading material. Around 10:50 the nurse came back with the news that my procedure room (the "best" one in the IR department according to my doctor) was still in use and my procedure would likely be delayed until 12:30. This was fine but a little different compared to the previous visits. Between 11 and 12:30 we were able to talk to my primary IR doctor (Dr. Lewandowski, who had done my previous PVE procedure) and one of the fellows (Dr. Scanlon) who would be assisting in today's procedure. At 12:30 I was wheeled back to the procedure room.
The procedure room for this procedure was the same one I had been in for the PVE. It contained a large imaging machine above me as well as a large bank of video displays for the doctor to see the images. Once I was on the table I was prepped for the procedure. As the doctors were planning to look at both the veins above my liver and the artery coming into the bottom of my liver it was necessary to prepare 2 locations for entry. The first part of the procedure would be coming into a small incision in my neck which they would feed the catheter into the veins leaving my liver (hepatic vein). The second part of the procedure (the actual Angiogram) would be coming into a small incision in my groin which they would feed the catheter into the hepatic artery coming into my liver. So both entry points (right side of my neck and right side of my groin) were shaved and heavily painted with antiseptic.
Soon after this I was sedated and I slept through the first hour of the procedure (the work through my neck to check the pressure in the veins leaving my liver). Unlike my previous procedures, however, I was awake for most of the remainder of this procedure. At some point I started hearing the doctor talking to me and telling me that I needed to hold my breath for a short period of time. I assume that this was part of the angiogram so that they could get clear x-ray images after the dye had been inserted. I am not clear on the duration of this part of the procedure but overall everything took around 2 hours (from 12:45 to 2:45). I was feeling some pain in the groin area when I was waking up during the procedure and I mentioned this to a nurse. They must have given me more of the pain medication as this did not seem to continue to be a problem.
As an aside, one thing that I have learned through the 3 procedures that I have had is that there are 3 elements to the medication that I am given. The first part is for the pain relief, the second part is to relax me (this usually puts me to sleep) and a third part is to make me forget the experience. I guess I could have guessed the first 2 but I didn't realize until now about this third part which must help people after the procedure who wouldn't want to remember any of the pain if they were not asleep through the whole thing.
Around 2:45 I was wheeled back into recovery and I was there until 4:45 when we were able to leave the hospital. During this time we spoke again with Dr. Scanlon and Dr. Lewandowski and we learned that everything had gone very well. The first good news was that the pressure in the veins above the liver were all normal so this means that there is no issue with my heart. The pressure problem had to be in the liver. The second good news was that they did find an issue within my tumor where a vein and an artery were cross-wired. This fistula appears to be the cause of the high pressure in my portal vein as the pressure in the arteries is much higher than in the veins and the fistula was causing this pressure to enter my venous system. The reason that this news was "good" is that it removed the mystery of why I had this high pressure and it concluded that I have a single liver issue (my tumor) and not multiple issues (as was possible when they found the high pressure during the PVE procedure).
Dr Lewandowski discussed the findings with my liver surgeon (Dr. Baker) and liver specialist (Dr. Kulik) and they decided that it was safe to leave things alone and to go back to the initial plan of having surgery to remove the tumor. It was possible that if they had found some other malformation in my liver yesterday that they would have tried to repair it (embolize/blocking it up with coils) but as the issue was in the tumor which will be removed this was not necessary.
The left side of my liver should be growing at this time (it has now been 2 weeks since my PVE) and I will have a CT Scan or MRI within the next couple of weeks to confirm that it is large enough to proceed with the surgery. The surgery will be scheduled as soon as this is done.
Thanks again to all of the nurses, technicians and doctors at Northwestern. I have now been in the Interventional Radiology department 3 times in the last 2 weeks and the people working there have all been wonderful (though they are curious why I keep coming back). :)
Saturday, October 4, 2008
Lady Whippets
The Lady Whippets basketball team from my high school (Varnum) made it to "State" for the first time in the history of our school this past year (2007-2008). Before the 2008-2009 season gets under way I wanted to say "Congratulations" to the team and also include a video from one of the OKC TV stations that was taken prior to their state tournament appearance this past spring. Unfortunately the team lost their first game at state but the team should be very good this coming year.
Update:
I originally posted this blog entry in 2008 after the Varnum Lady Whippets had made their first trip to "state". I mentioned in this blog entry that the team should be pretty good the following year. They in fact were very good and in 2008/2009 won the school's first basketball state championship. Varnum had 2 All-State players on this team, Kodi Morrison and Kelsi Vass.
Update:
I originally posted this blog entry in 2008 after the Varnum Lady Whippets had made their first trip to "state". I mentioned in this blog entry that the team should be pretty good the following year. They in fact were very good and in 2008/2009 won the school's first basketball state championship. Varnum had 2 All-State players on this team, Kodi Morrison and Kelsi Vass.
Small Town Oklahoma High School Basketball
One of my favorite hobbies is following high school basketball from my home state of Oklahoma. As I live in Illinois it is difficult for me to see many of these games but I am able to follow the results and details of games via many web resources. I am especially interested in the smallest classes of schools (Class A and Class B) as I graduated and played basketball at one of these small schools.
Oklahoma has many many small schools as the state has not done near as much consolidation of small high schools as many other states have done. There are 483 high schools listed in the OSSAA (Oklahoma Secondary School Activities Association) handbook for 2008-2009. The smallest 131 schools are in Class B. These schools range in size from 24 to 4 students per high school grade. The next larger 96 schools make up Class A. These schools range in size from 40 to 24 students per high school grade.
Following basketball from small towns all across the state of Oklahoma is a way for me to stay connected to the state as the 227 smallest schools span the 4 corners of the state as well as every county in between. This also allows me to stay connected to a sport that I love at the small high school level where it really is played for the love of the game.
Practice for the 2008-2009 high school basketball season for these small schools started this week (Oct 1). The season will culminate with the Class A and Class B State Championships in Oklahoma City on March 5-7, 2009. I have been fortunate to go to the State tournament 3 of the last 4 years (one year I went a couple weeks early and saw some earlier games in this tournament due to some family needs) and I am planning to attend this coming spring.
The funny thing is that the title of this blog is "Small Town ..." yet many of these smallest schools are rural school districts that are not even big enough to be considered a town. They are often just school districts that exist outside of towns that may have a larger school. However, this doesn't in any way take away the appeal of these hundreds of small schools competing in basketball. In many ways basketball is what puts some of these schools on the map.
Oklahoma has many many small schools as the state has not done near as much consolidation of small high schools as many other states have done. There are 483 high schools listed in the OSSAA (Oklahoma Secondary School Activities Association) handbook for 2008-2009. The smallest 131 schools are in Class B. These schools range in size from 24 to 4 students per high school grade. The next larger 96 schools make up Class A. These schools range in size from 40 to 24 students per high school grade.
Following basketball from small towns all across the state of Oklahoma is a way for me to stay connected to the state as the 227 smallest schools span the 4 corners of the state as well as every county in between. This also allows me to stay connected to a sport that I love at the small high school level where it really is played for the love of the game.
Practice for the 2008-2009 high school basketball season for these small schools started this week (Oct 1). The season will culminate with the Class A and Class B State Championships in Oklahoma City on March 5-7, 2009. I have been fortunate to go to the State tournament 3 of the last 4 years (one year I went a couple weeks early and saw some earlier games in this tournament due to some family needs) and I am planning to attend this coming spring.
The funny thing is that the title of this blog is "Small Town ..." yet many of these smallest schools are rural school districts that are not even big enough to be considered a town. They are often just school districts that exist outside of towns that may have a larger school. However, this doesn't in any way take away the appeal of these hundreds of small schools competing in basketball. In many ways basketball is what puts some of these schools on the map.
Thursday, October 2, 2008
Good News
I was hoping to get news today regarding the liver biopsy and I was not disappointed. I received a call around noon from a nurse in the Interventional Radiology department at Northwestern Memorial and she gave me the good news that the biopsy did not show any problems in my liver. I will be having a Hepatic Angiogram next Wednesday to inject dye into the liver to get a good view of the blood vessels and the location of my hemangioma. Hopefully this will provide some answers on why the portal veins coming into my liver have more pressure than expected.
There are still lots of questions about my liver but I am very happy that the biopsy removed a lot of possible causes from the list. I was most worried that my liver had been damaged by a autoimmune disease and that this was the cause of the portal hypertension. I was concerned when I had read of this possible cause as I do have a different autoimmune issue going on in my system which has been causing severe hives for the past 21 months. I am very thankful that this was not the case with my liver as it would have indicated a long term issue with my liver.
I apologize to anyone reading this blog that it has become so "health" focused. When I started the blog it really wasn't my plan but it does reflect my life the past few weeks. As some of the issues have come up I have tried to research them on the internet. Often I find medical papers on different procedures but what I am often interested in is anecdotal stories about people who have already gone through the procedure and any information that they can share including how they tolerated the procedure. I am not always able to find these types of stories but I am thankful when I do as it makes the procedure more real. At some point I decided that I would like to use my blog to share my medical experiences so that it may be a resource for someone else going through these procedures in the future. It is this reason that I have at times included very specific medical terms so that future google searches may hit this. Hopefully anyone that reads these entries in the future will be encouraged as I have been by reading the stories of others.
My hope is that the liver story will have a happy ending sometime in the not too distant future and I can again write about more fun things. (This is not a promise that it will be any more interesting however.) :)
There are still lots of questions about my liver but I am very happy that the biopsy removed a lot of possible causes from the list. I was most worried that my liver had been damaged by a autoimmune disease and that this was the cause of the portal hypertension. I was concerned when I had read of this possible cause as I do have a different autoimmune issue going on in my system which has been causing severe hives for the past 21 months. I am very thankful that this was not the case with my liver as it would have indicated a long term issue with my liver.
I apologize to anyone reading this blog that it has become so "health" focused. When I started the blog it really wasn't my plan but it does reflect my life the past few weeks. As some of the issues have come up I have tried to research them on the internet. Often I find medical papers on different procedures but what I am often interested in is anecdotal stories about people who have already gone through the procedure and any information that they can share including how they tolerated the procedure. I am not always able to find these types of stories but I am thankful when I do as it makes the procedure more real. At some point I decided that I would like to use my blog to share my medical experiences so that it may be a resource for someone else going through these procedures in the future. It is this reason that I have at times included very specific medical terms so that future google searches may hit this. Hopefully anyone that reads these entries in the future will be encouraged as I have been by reading the stories of others.
My hope is that the liver story will have a happy ending sometime in the not too distant future and I can again write about more fun things. (This is not a promise that it will be any more interesting however.) :)
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