Tuesday, 30 September 08
Today began with liquid nitrogen being applied to a pre-cancerous spot on my face. I had anticipated an incision, per last November, but this episode of skin cancer did not require such action. The day continued with the facilitation of the attainment of Austin's driver's license, in recognition of his 16th b'day. This consisted of (sorry for the long run-on sentence): a visit to the insurance agency, collecting a file of information and forms from a variety of sources, going to the driver's license office, returning home to get Austin's social security number, making the trek back to the driver's license office, where Austin failed the eye test, getting him to an optometrist, having glasses prepared and fitted, returning to the driver's license office and proclaiming victory with 30 minutes to spare.

Okay, so what does getting a driver's license with Austin have to do with a brain tumor story? Everything! It is great as a four year gbm survivor to be able to run all around town the whole day integrating these individual tasks into one ensemble of accomplishment on behalf of my son!

Saturday, 27 September 08
"Can I ask you; if you get up tight in anticipation of each MRI and hearing the results? How do you deal with it?" Certainly there is some anxiety associated with each MRI. How do I deal with it? I send emails to those who have been with me throughout this adventure - to the prayer teams at my church, at my work place, family and other survivors. The pending date of the MRI is noted in these emails, and I solicit prayers for a clean scan. I tell myself that there is no reason why the tumor must come back. This is up to God, not me. Worrying is not going to change the situation, at least not for the better. Worry can literally make a person sick, so I therefore try not to be consumed by the MRI results - easier said than done. I typically pray all during the MRI, while the scan is in progress. When I receive the film following the MRI, Kathy and I perform our own review, courtesy of the light shining through the windows in the lobby of the MRI facility. We are not formally trained in these matters, but we do know my brain, where the tumor was, where the recurrence was located, and we could spot any obvious major changes. We have a good idea what the report is going to say even before the report is published.

Saturday, 20 September 08
I met two good friends again for the first time north of Denton. John is a brother in Christ, and he is doing well in the total war against a brain tumor, by the grace of God.

Friday, 19 September 08
The Taurus' alternator is completely shot - incapable of sourcing power. I feel more than fortunate and grateful that the battery had enough juice clear Western Center, then exit off of I35W onto N Tarrant Parkway, away from traffic. Since the Taurus was in the shop today, I drove my Trans Am around town, running numerous errands, and retracing my steps.

Thursday, 18 September 08
When I left work today in my 1999 Ford Taurus, a vehicle heretofore not mentioned on this site, I noticed the radio flashing on and off, then on and back off again. "Great" I thought out loud; this new radio, less than a year old and now it seems to entering a state of disrepair. I proceeded East on I-820, and soon the tachometer went dead, next the speedometer, then the engine began to 'miss' at slow speeds. The "Check Engine" light remained ominously off, as if to suggest that there was nothing to do but brace for what was coming.

By now I was in the middle of the Western Center business district; heavy traffic this time of day, and I could just hear the traffic reports that would soon be broadcast: "There is a car stalled in the left North-bound lane of I-35W at Western Center." My immediate challenge was to get out of the way to avoid becoming a problem for the myriad of commuters behind me. "Clear a path, Lord" I repeated over and over, as the car continued to run rougher and rougher, especially in the stop-and-go situation I now found myself in. My metallic stead somehow limped past the Hwy 287 exit and coasted off of the Interstate at the North Tarrant Parkway exit. The remaining momentum was dispensed to position the car on the shoulder, and there I sat between two great lush pastures. A gentle breeze blew through the partially lowered windows. The angel had pushed my car to the first safe exit off of I-35W North of I-820. Here I would not present a hazard to my fellow drivers, or put myself in danger as I waited for the tow truck to arrive from Denton.

Monday, 15 September 08
The MRI from Friday has been reviewed as clean! My favorite part of the report from Touchstone's Radiologist reads: "...there is no evidence of abnormal enhancement, and overall, all imaging findings are stable to prior exam." In addition, CBC results are great, especially platelets, which at 202,000 cells per microliter, are at their highest level since September of last year. The peg test was accomplished in 20 seconds and 17 seconds for the left hand and right hand respectively.

Saturday, 13 September 08
I gathered MRI film, CDs and reports and visited my Radiologist for a quick, informal review of yesterday's charts. The official report from the Touchstone Radiologist will be available on Monday, but since this new Radiologist is not familiar with my scan history, I sought the opinion of my first Radiologist for his take on the scan from yesterday. His unofficial note is that I am clean. It will be interesting to compare reports on Monday.

Friday, 12 September 08
My MRI was accomplished today at the Touchstone Imaging facility in Lewisville. Their GE machine is rated at 1.5 tesla, and makes the obligatory metallic clanging and banging sounds during the scan. One sound was unprecedented and remarkable; something akin to a spitting, squirting noise as the device wound itself up for parts of the MRI. I just had to smile! I was quite pleased with the staff, the equipment, the procedure, the copay and basically the whole thing. Kathy and I reviewed the film and believe that I am still clean.

I then proceeded to an important meeting with Kay and Keith Zimmerman.

Thursday, 04 September 08
I'm 55 months post op now, by the grace of God for the glory of God, so what better way to celebrate than to schedule my next MRI? These scans are accomplished on a bi-monthly basis; I always call ISI a few days before the designated Friday when the procedure should be performed. But my routine phone call today was anything but routine.

I discovered that the ISI entity, the place where I have been getting these MRIs for four years, no longer exists. The building remains, the equipment remains, but the staff I know so well has left and the Radiologist who has been reading my film for four years left as well. So where did the Radiologist go? The new staff did not know. Why weren't patients like me notified?

There are a plethora of high quality MRI machines in the area, and there are numerous Radiologists who can perform brain scan studies. But the scanner at the former ISI is a 1.0 Tesla machine, other imaging companies typically use equipment with a much weaker or stronger field strength. And my Radiologist knows the minute details of my previous 31 MRIs. Maintaining continuity (same MRI machine, same Radiologist) from MRI to MRI is a major lesson learned.

I retrieved a report from my archives, located the cell phone number of my Radiologist and proceeded to rectify the situation. The Radiologist assured me that he would continue to read my film - a second opinion of sorts. He also suggested that it might be time to move on to another facility/Radiologist combination. This is a plan he had also recommended to Dr. Virginia Stark-Vance, my oncologist, earlier today.

For example, if Harris Methodist has suitable equipment, procedures and radiologists, I might be able to get the MRI at the Hospital, wait a short time, and then keep the doctor's appointment in one trip, since Dr. Stark-Vance's Ft. Worth office is at Harris Methodist. This would be a logistical simplification relative to the legacy plan, which has me getting an MRI on Friday in Denton County and traveling to Tarrant County the following Monday for the oncologist's appointment.

I anticipate an articulated path forward early next week. And in the interim, the first Radiologist will be available to review my film providing a bridge to the past as we move into the future.

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