Chapter 2

Leaving work

Keep in mind that I have been in my current position for less than 90 days. It felt more than a little awkward informing my boss I need to go to the ER…and asking for a ride. Not only was one of my colleagues willing to chauffeur me, but intended to stay with me at the hospital. Welcome to the crazy train!

I decide to go to Beaumont in Royal Oak. It is the closest hospital to our home and Keith’s office.  (As you can see, I am focused on making this whole encounter less cumbersome for when I am released - as I surely will be later that day). 

I hate to admit that I decided to drop my car off at home before heading to the emergency room. It’s technically "on the way" and it eliminated the logistics of getting it home later. Clearly, I am still functioning under the delusion that I am going to the hospital simply as a precaution.  Unbeknown to me, my brother-in-law is conferring with colleagues about my symptoms and all are in agreement before I arrive at the hospital that the situation is dire; I am likely in serious trouble.

Arrival at Beaumont

Eventually, I am taken in back, seen by an ER physician and informed that I will be given a CAT scan now that my headache (which is definitely worse) is accompanied by vertigo.  The detail I am most interested in is the promise of some drugs other than the over-the-counter variety since they might finally address my headache. 

At this point, my CAT scan is not a priority because shockingly, I am still not presenting any symptoms of any kind that would indicate any immediate danger. At least that anyone at the hospital is observing. I recently found out from my co-worker that when we were walking to the café, I was beginning to weave and she had to steer  me back to a center forward walk.

The other complication is due to the fact that I have an extremely high tolerance for pain (how else could I walk around with a headache for 2 months?). For example, in 2001, I tore my trapezius muscle when moving Melissa (again) from one apartment to another. I waited until we finished settling in before heading to the emergency room. This time, my ability to ‘gut it out’ was working against me on a dangerous level.

Around 5 PM, my co-worker Jackie indicates she needs to head home (think mother of 3 young boys).  They come to take me for my CAT scan, so the timing seems perfect.  I assure her I have sent Keith a text message, so he will be present when I return to the ER.  Little do I know that none of my texts are going through and Keith is completely clueless. At this point, I am starting to get confused but I am unaware that I am beginning to lose touch with reality.

Another step complete

Team Studzinski was back at Karmanos at 5:45 a.m. for Peggy's gamma knife radiosurgery. In layman's terms, this procedure is a single dose of radiation focused on the tumor bed to destroy any remaining cancer cells invisible to the MRI. It is incredibly precise (within 0.1mm) and can be delivered in a single dose - both major advantages vs. traditional 'whole brain' radiation.

As you can imagine, gamma knife is highly complex and requires a team effort - in fact, the largest we've experienced thus far at one time - neurosurgeon, radiology oncologist, physicist (yes, physicist), and of course the fabulous cadre of nurses and support staff. (Learn more about gamma knife - http://bit.ly/nvk52K)

While it was a long day -- fortunately, everything went smoothly and we were home before 3pm! Peggy immediately went for a nap...Keith and Melissa have taken turns dozing off.

Completion of this procedure marks transition from treatment of brain tumor to ongoing monitoring (quarterly MRIs), a step in the right direction.

Next step: Back to Karmanos bright and early Thursday morning for biopsy of right lung.

Another Big Step Forward Towards KMA

We are heading down to Karmanos again today to meet with Dr. Mittal, my neurologist and Dr. Kim, my radiation oncologist to learn more about Gamma Knife radiosurgery treatment.  This is scheduled for next Tuesday morning.  Thankfully we live in a time where this is an option (versus having to receive whole head radiation).  This will spare me from experiencing any unnecessary brain damage by focusing the treatment on the bed of the brain tumor only.

Team Studzinski is ready and feels well equipped - especially with all the fabulous support being sent our way.  Here is one of our favorite cards - of which we actually received two: one from Barbara, one of Melissa's amazing teammates at CVS and the other from Jen , one of Peggy's OU girl friends.  We think it does an excellent job of conveying how everyone feels.

The Story...Chapter I

They say a picture is worth a thousand words.  As you can see, the cyst + the mass were the size of a tennis ball. 

When I look at the scans, the first words that come to mind are: " Ow!  Ow! Ow!"  and "No wonder my friggin' head hurt!" I can just imagine what Keith & Melissa said when the neuro people showed them my MRI the night before my surgery - probably something along the line of "Holy Shit!"  Let me know what goes through your mind after seeing this for the first time.

The odd part is that the discomfort I was experiencing was on the left side of my head.  It felt like I was wearing a hat or headband that was a little too tight - not a stabbing pain, just a consistent dull ache.  The explanation is that although the mass was in my front right temporal lobe, it was smashing my brain to the left across the mid-line as the cyst grew.  In some of the views, you can see how compressed my brain was and the difference in the right and left side is marked.

The doctors were in complete disbelief that I was not slurring my words or dragging my feet - much less not presenting any other symptoms of a neurological deficiency.  There should have been something that was "off" but I was able to perform on command: touch your nose, smile, push, pull, squeeze with your hands, etc. and answer questions.  The only symptom I had until the beginning of August was a headache I could not seem to find any relief for (whether I took Tylenol, Advil, Excedrin).

In hindsight, I now recognize a few other things were starting to happen that seemed "odd." Several of my co-workers have fans they run in their cubicles - while I sit wrapped in a blanket ;-).  I noticed that the air flow when it passed made my head hurt a little more when I was standing in their cubes.  Then the sound of the HVAC system at the office when it turned on sounded more like the whirring of a helicopter.  But by that point, my judgment was starting to be affected. and I discounted them as related to my headache.

The scary part is that the only reason I went to the emergency room on Wednesday was because my brother-in-law told me to.  He has a medical degree and moved to Michigan to open the medical school at Oakland University.  I had been conferring with him over several previous weeks about the lack of explanation for my headache.  As of that day, I was merely waiting for the appointment I had scheduled with a neurologist for Friday, August 5th.  I was referred to one when a doctor I saw at an out patient clinic on July 7th ruled out several other potential causes.  How ironic I ended up having having emergency surgery the same day to resect a metastasized brain tumor.

I sent Bob the following text from work on Wednesday morning. 

new symptom showed up sun late 

afternoon: vertigo. subsided quickly. 

came back mon afternoon.

had coworker drive me home. 

keith drove me to work on tues. 

I was fine all day. 

drove myself home tues & to work today. 

glad my neuro appt is fri. 

headache is worse than ever 

or else I am done being tolerant

& have lost all objectivity.  

r u & nancy available to come over 

4 dinner fri nite?

My phone rang immediately.  Bob told me to have someone drive me to a major medical trauma center right away.  Turned out to be a good idea.  Stay tuned for the rest of the story.

Credit to Everyone

As I emerge from the post craniotomy fog, I am in disbelief of everything that has happened since I went to the emergency room on August 3rd .  The more I learn, the more amazed I am at what has transpired.

Despite what I am sure was an an onslaught of questions, Keith and Melissa have dutifully waited for me to be brought up to speed on the events of the last 23 days to be sure I was comfortable with anything they disclosed.  The logical assumption would be to share details when people expressing their support were understandably also seeking some explanation.  After all. I am pretty forthcoming.  You could even say "a little too frank" but hey, that's me.

Kudos to my family for waiting to allow me to decide what to disclose - especially because it has become clear to them that I appeared to be comprehending more than I actually was.  Apparently, I am capable of bullshitting while under the influence of powerful narcotics!

All kidding aside, I would also like to give credit to everyone for allowing me to do what was crucial to my recovery: REST, REST, REST.  I would love to see people but I must continue to self-preserve because I have a hell of a fight on my hands.

We are constructing my battle armor.  You should see the array of weapons that the integrative medicine nutritionist we hired has outlined for me take.  Thankfully, I possess an excellent ability to swallow pills and intake tasteless liquid concoctions.  The big plus is that I already had a healthy diet to begin with, so I will not have to adjust to a complete food overhaul but I can't tell you how much I  am looking forward to having some kind of alcohol at some freaking point.   Wine in moderation is good for you, right?

Intro to Karmanos

Yesterday we ventured to Karmanos Cancer Center (KCC) for our consultation with Dr. Larry Flaherty, "THE" melanoma specialist. Check out how awesome Peggy looked.  The doctors and staff were all incredulous that the style maven in front of them had a craniotomy and a lung biopsy in the last 17 days.

Upon arrival, it was clear why KCC has such a stellar reputation. As for Dr. Flaherty, what an impressive guy. The insight he provided during our visit was immeasurable. In fact, Peggy has picked him to be her cancer quarterback.

Looking ahead, there are a variety of additional questions to be answered before Dr. Flaherty can establish the road-map for Peggy's ongoing treatment plan.

In the meantime, Peggy’s drafting her account of what has happened from start to finish. Stay tuned! (Finally, could this be the start to the book she’s been taunting us about for 30+ years?)

Feeling Incredibly Blessed

Mere words can not express my gratitude for the tidal wave of support we are experiencing.  I hardly feel equipped to convey how much it means to have been provided with such an over whelming amount of encouragement.  The universe feels full of good karma - so major thanks to the numerous people who have been storming the heavens with prayers for me. 

Of course the fact that I have such a rock star husband and a kick ass daughter only solidifies my complete conviction that melanoma has selected the wrong woman to mess with!

I am still slightly blown away by this unexpected "twist" but can't wait to demonstrate that is it not the end of the road - merely a wild bend in the crazy trip of my incredibly blessed life.

Fun with Fanmail

This is but a teeny sample of the tsunami of support & well wishes that have been arriving at the house. THANK YOU, THANK YOU, THANK YOU. It brightens our spirits and reminds us how lucky we are to have such an incredible network of family and friends.

The fanmail and care packages really came in handy as Peggy had a bit of a biopsy 'hangover' = heightened discomfort from Tuesday's procedure (she no longer had the benefit of the additional pain medication provided at the hospital). So Peggy had plenty to keep herself busy with distractions!

* Reread her dozens of cards!
* Swam in her tub (scented by her fantastic lavender bath salts!)

* Played with her Deluxe Mr. Potato Head set (thanks to her RI friends at Hasbro)

Back at Home!

Biopsy went smoothly this afternoon (sigh of relief).

The procedure took less than an hour and then Peggy went to recovery for 2 hours (need to confirm that her left lung was in tact before release home).

Peggy left the hospital this time with only a standard size Band-Aid and a prescription for more rest.

Back at home and all three of us will be taking a nap (followed by our nightly reading of fan mail)!

Staples are out!

All 24 staples came out lickety split. We have a "before" picture of them still "in"...for those that are brave enough I can email it to you!

Dr. Olson (neurosurgeon) said Peggy is healing remarkably well (as we would all expect). One more follow-up appointment with him in two weeks!

Big Week Ahead!

Two major milestones on Tuesday

• Staples will be removed (all 24 of them)
• Biopsy of the lungs (outpatient, thankfully)

Rest of the week will focus on recuperation and more rest! (Trashy magazines welcome...!)

Weekend update - feeling stronger every day!

Saturday - lots of quality time outside on the patio. So glad the rain held out until after dinner!

Sunday - Peggy took an hour-long walk with Melissa and returned the house back to the 'Peggy standard' of cleanliness and organization (so much for Keith & Melissa doing it their way).

Friday's email

Recap for those that may not have gotten Friday's email - the first week at home was a busy one!

• Rest & relaxation. Again, we appreciate everyone letting Peggy (mom) regain her strength (hard to believe it's only been a week since her surgery).
• Reading all Peggy's (mom's) fanmail. Thanks to all for your ongoing prayers, love & support.
• Peggy (mom) ventured out for the first time on Friday (just "had" to have a mani/pedi). 
• We're getting our team in place! Thanks to (Uncle) Bob Noiva, we have a consultation with Dr. Lawrence Flaherty @ Karmanos. He's the best of the best...exactly what we need!

Follow-ups in Action

Transition home was hard..we sure do miss all the nurses!  We are back on track and enjoying being home.  Peggy (mom) is following doctors orders and RESTING.

We have made some progress regarding next steps.  We have a few phone calls with some experts setup for later in the week and lung biopsy on Tuesday.

Please post comments and well wishes.  Help motivate Peggy (mom) to kick Melanoma's ass!!

Initial Diagnosis

The pathology report diagnosed the brain mass to be melanoma. Immediate next step is to partner with the doctors to formulate a comprehensive and aggressive treatment plan. While not final, it will likely involve a combination of the following: biopsy, radiation, surgery, chemotherapy and lots of rest.

We will continue to finalize the treatment plan with her team of doctors over the coming days and will give an update as soon as we are able.