Go See Doctor Specialist For That Doohickey!

Go See Doctor Specialist For That Doohickey

The Brain Bio & Update of Vincent Terrazas

(Skip to bottom if you know the story and just want the January 2012 update)

PROLOGUE

Every now and then a true story comes along and sounds so far fetched that it teeters on the edge of fiction, this Brain Bio is one of these stories. Within this diatribe I will attempt to explain the eccentric and demented mind of yours truly, Vincent M. Terrazas, as I step through the process of my brain surgery. Beyond these collections of letters grouped in to words, sentences and silly gibberish, the story continues and evolves with each days passing as I learn more about who I am and who I will be. 

My aim is to inform you of my condition, update you on the progress and bring awareness to the internal changes I experience. Also, depending on the hour of the night of which I am writing in, I will attempt to make you giggle once or twice with my distorted view of this humorous situation. Hey, I might even reach someone out there that has encountered something similar and provide a valuable tidbit of information about the Brain and Pituitary Tumors.

NARRATIVE

Throughout 2008, I noticed slight changes to my vision and began experiencing more intense migraines then I’ve had before. I’ve had migraines off and on for years as I have a rare form of Glaucoma in my left eye only, called Glaucomatocyclitic Crisis. A few migraines and vision changes are nothing new since I’ve been taking eye drops and a really nasty medicine called Diamox since I was in my early twenties for this. Slight changes in vision and a few headaches are par for the course in my life and unfortunately, I let these symptoms ride for some time before it really started to bother me.

By the time December rolled around, I was spending one night a week in a dark and soundless room trying to hide from the pain. These were some of the worse migraines I’ve ever had. Trust me, if you think you’ve had a bad headache to the point of wanting to drill a hole in your head or eye just to get some relief, then you might just begin to understand the “starting” level of pain in these migraines.

One day in January 2009, I pulled out of the driveway and was about to go on a short trip to somewhere-ville and noticed I couldn’t see fully out of my left eye. The entire left side of that eye was dim and faded into black. That was the moment this crazy ride started down the “Go See Doctor Specialist For That Doohickey” highway.

In order to keep this wordy adventure to under my 50K limit, let me quickly step you through the the next few months chronologically. (And all the readers rejoiced)

JANUARY- APRIL 2009

• January- Wrote down a reminder note to make an appointment to Go See Doctor Specialist For That Doohickey, my Glaucoma Eye Doctor and have this looked at.
• February- Lost reminder note to make an appointment to Go See Doctor Specialist For That Doohickey. Wrote another one.
• Later on in February- Made an appointment to Go See Doctor Specialist For That Doohickey. #WINNING
• March- Met with my Glaucoma Eye Doc and after an extensive evaluation, he says: “I see no problem whatsoever with your eye Vince. I think you may need to Go See Doctor Specialist For That Doohickey because you may have had some sort of Stroke or Aneurysm.” I was speechless.. umm, errr, umm...
• Later in the day - Called my Primary Care Physician and was able to get in since this was no minor common cold. She was a bit floored as to why I had not called in to be seen before.  I was speechless.. umm, errr, umm...  She said “Go See Doctor Specialist For That Doohickey”
• 24 hours later - I was stuck in an MRI tube, pumped up with some cool chemicals that make your brain glow in the dark (not really, it’s called contrast). After 2 hours of GRRRR BrMMMM GRR BrMUMMM, I was told to wake up and that I would have to Go See Doctor Specialist For That Doohickey to get the results. 
• Another 24 hours later - I became the proud father of a bouncing baby 2.3 centimeter tumor on my pituitary gland. After being told that, I was speechless again umm, errr, umm... That Doc said that I would have to Go See Doctor Specialist For That Doohickey” , a Neurosurgeon! 
• April- I met with the best Neurosurgeon around and we discussed the scenario. He looked over and over at the brain scans as he made muffled grumbly noises. A few more looks to be sure and then asked me to sit down... and stop staring over his shoulder. Then he said this “I wouldn’t make plans this summer. You’re in need of an escalated Brain Surgery. All your scans, the level of vision you have lost and the amount of discomfort you’re in, say that that puppy needs to come out soon or your going to go blind in that eye or both. (yes, I used “that that” in a sentence and it worked)

Apparently, the scans showed exactly why I was losing my vision and why my headaches became a full blown KISS concert in my head. The upper part of the mass was pushing up into my brain at the point that is called the Optic Chiasm; thus the headaches. This is also the area where your optic nerves crisscross and go into the brain. Part of this tumorous mass was also wrapped around the optic nerve connected to my left eye; thus, the vision loss. 

This non-cancerous benign tumor has been in my head for years and normally are very slow growing tumors. For some reason this one thought that this was to slow and began to speed things up a bit. I have my own non-medical reasons for this growth spurt but we’ll get into that later.

THE SURGERY

In early May 2009 I underwent a Transsphenoidal Adenomectomy. This is a type of brain surgery to remove an Adenoma (tumor) from the pituitary gland. I won’t go into the details on this type of surgery, since the method of how they reach the tumor is by making a 3 to 4 inch incision inside your mouth, right where your upper lip meets your upper gums. (The Superior Labial Frenulum) Then they lift up your face and…. umm, I said I wasn’t going to go into any details didn’t I? OK, moving on.

During this procedure, they found that I actually had 2 masses on my pituitary gland, one on top of the other. The tumor underneath had a fully functional blood vessel that could have easily ruptured if not protected by the other overlying tumor. This wasn’t a mere little coincidence and I firmly believe that the power of God's grace was flowing over me, within me and protecting me just as this tumor was protecting the other one underneath. It’s strange to know that something of such potential destruction was actually protecting my life at the same time another one was slowly destroying part of my pituitary gland.

Remember how I had my own opinion of why this tumor decided to grow rapidly over the past 16 months? Well maybe, just maybe our creator’s grace, power and abundant love used this overlying tumor to grow and therefore protect me from the other one that could have ruptured and things would have ended much differently. Who really knows, but maybe part of my life’s journey and path was going through this process. I have been givin the opportunity to learn from these times of trouble, learn to be positive and share what has kept me going - my Friends, my Family and my trust in the Creator above.

Since the Optic Chiasm is located at the bottom of the brain and immediately below that is the Hypothalamus and Pituitary gland, they only removed as much of the mass as they could to ease the pressure on the brain without causing any additional damage to the hypothalamus and pituitary gland. Additionally, full removal of the mass that was wrapped around my left optic nerve could not be 100% since doing so would cause complete blindness in my left eye. They did however loosen the tumors grip it had on the nerve. After putting the piece of my skull back where it belongs with a bit of Elmer's glue and wall spackling, they stitched me up and let me rest for 5 days at their fine establishment. :)

Am I getting to any type of point in all this gibberish? Yes, it’s coming soon, please be patient.

Needless to say (but here I am saying it anyway) the last couple of years have been a challenge as I encountered various side affects from the damage to the hypothalamus, to the pituitary gland and all the little things that the pituitary gland does for the rest of your body. My surgery wasn’t the typical removal of a pituitary tumor and I have been asked to Go See Doctor Specialist For That Doohickey tumor a few more times since I continue to have problems arise. 

A full understanding of this battle would be difficult to explain without you being in my shoes to fully comprehend what all transpires when your pituitary gland, the master gland of your entire endocrine system, doesn’t produce what your body needs daily.  I know that many of you can understand and relate to this, especially if you have or had health issues that limit your quality of life, but even I don’t fully understand everything that is happening to me right now. I just know that I’m blessed beyond what I can see in-front of me. Blessings are all around me and at every hour of the day, I’m reminded that this too shall pass. Others are worse off then I, others count far fewer blessings each day then I. I’m truly blessed by my friends, my family and my God. 

DAILY ROUTINE

Manual replacement of hormones that my pituitary gland no longer produces. This means thyroid hormones, testosterone, injections for diabetes (side affect from not getting the right hormones to the pancreas), amphetamine stimulants, polyneuropathy medications, more eye drops and the occasional pain meds. ugh!  Seriously, I’m not making all this up... there’s more to list here but that would be just silly and sad to list everything.  (The rest of this paragraph has been omitted to keep things upbeat and slightly humorous.)

Even with everything that has ensued from day one, I tend to be extremely positive and normally have a smile on my face 90% of the time. (maybe 80%) The remaining amount time is my Hulk Time. What is my Hulk Time you ask? Let’s just say you don’t want to experience my Hulk Time, you wouldn’t like being around me during my Hulk Time.

“Don't make me angry. You wouldn't like me when I'm angry.” ~ Dr. David Banner

Why am I so positive and upbeat? (on the outside) It's because I find that dwelling on the negatives of this entire situation will only make things worse, make me feel worse and bring others around me down. My life is one that wants to share a smile with everyone, not a frown. This is not to say I don't throw a small pity party every once in a while by myself...sorry, this party is by invitation only and you are not on the list. 

By the way, I have been told to Go See Doctor Specialist For That Doohickey for this as well and they also said "Go See Doctor Specialist For That Doohickey" so now I'm up to six specialists. 

TRANSITION 

For the most part, we’ve found a balance in the amount of hormones that I take as well as the amount of medications that keep the body functioning as normal as can be. The biggest issue I battle with is one that I don’t talk about much. I think I may have some silly hangups about what people will think or how I would be viewed as a technical thinker, artistic creator or even question my acquired capacity of intelligence. Oh well, I’ll get over it.

So the biggest issue that continues to bothers me is that my cognitive functions have changed after the partial removal of my tumor(s), and not for the better. It’s my thought process and my ability to multi-task that have severely diminished. I’ve gone from being extremely good at advanced technical processes, project management and theoretical analysis of problematic designs to merely attempting to reply to emails without it taking over hour to provide a simple one paragraph resolution plan. Yeah yeah, I’ve heard the replies to this statement of mine in the form of .. “but you can do things at a high level”.. or .. you can still do things I can’t” or I hear the reply of “your simply getting older Vince, things change”. 

Yes, things do change, I’m now 44, I age, I gain and lose wisdom, I need reading glasses and I know that I can function technically on some level, but not at the level I'm accustomed that I had before the surgery. This thought process change is not because of age. It was and is a dramatic change in how I now think, create, work and more. This was like a switch someone turned off in my brain that said... Section closed, no longer in use, please use the detour. It's just that they didn't leave a sign pointing the way over to the new detour for my neurons to follow. This lingering issue about how my brain processes thoughts and channels my creative abilities is the most frustrating for me. Before; I could manage multiple projects at one time and spread my minds resources to keep them all going in the required directions - After; all I can do is one at a time and focusing on that one is a challenge at times. (see memory issues below)

It’s not just this silly need to be technically minded and valued at work, it’s the simple things as well. 

The simple pleasures of playing music have changed for me. Playing the piano is a small example of these changes. Mind you, I’m not the greatest of players but I could at least work the keys to make some resemblance of a tune while using both hands. Now my brain seems to stutter when I attempt to use both hands. Songs that I've played for years elude me except if I play one hand at a time. Another example is I've tried to learn the guitar this past year and I could strum the rhythm and create the cords, but never could I use them together at the same time. The best way to describe this is that my brain stutters. Here again, I've been told... " well I can't do that either" , but I once could and now I can't. All in all, my creative thought processes are very hard to manage now and keeping them on track with my new brain drives me insane. :( 

WHAT'S NEXT or (What's left)

Besides the thought disorder, there are two remaining issues that have never been figured out.

• Memory loss.
• Constant ringing in my left ear.

The memory loss is a form of brain stuttering as well (I don’t know any other way to explain it), since some days I can remember the previous day, but then the following day brings no recollection of what transpired on that day. Three or four days later, I can remember what happened on that first day... but then it's gone again in 24 hours. I have also lost much of my memory from 2007 - 2011. What really makes me emotional about this is that those were the years when my daughter was in High School. I look back at pictures of Volleyball games or when I would assist the Lee's Summit North Marching Band with field drills and I build a small memory from the picture itself but have nothing to support that surrounding event or time. It's like my memories are stored in various databases in my brain and connections to them are not always connected. 

c:\ping brain.memory.vince.com

Pinging  brain.memory.vince.com with 32 bytes of data:

Request timed out.

Request timed out.

Request timed out.

Request timed out.

Ping statistics for brain.memory.vince.com

Packets: Sent = 4, Received = 0, Lost = 4 <100% loss>,

c:\

(LOL, I'm such a nerd) 

The ringing I hear in my left ear is terribly annoying at times, it's non stop 24 x 7, every hour I'm awake I can hear it. Right now they are calling it Nonpulsatile Tinnitus. I've had it every since the surgery, maybe even the year before when I had headaches, but over the last 9 months it has become more comparable to someone running a high powered Particle Accelerator in the left side of my brain. This high frequency tone will just not stop and if I cover my ear, it gets louder! The sound is not auditory to anyone else and it's not even in my ear. It's coming from inside my head. And yes, I've been told to Go See Doctor Specialist For That Doohickey for this as well. Been there, done that, have the primary results but I digress.

THE LONG AWAITED UPDATE (And all the readers rejoiced)

While under the care of my latest “Go See Doctor Specialist For That Doohickey”, we've worked together over the last 18 months to get a healthy baseline, find a hormonal balance for my body and make modifications to the other medicines I take to get the best possible mixture for my personal chemistry. With his guidance and the input from Dr. Specialist #3, #5 and and new #7, I began the next steps in figuring out why I think the way I think. (Or NOTthink for that matter)

Those steps started back on November 18, 2011. At that time, I had sent out an update to a small distribution list that described the following plan.

• Request some medical leave from my company to:
1. Gain some mental stability for what procedures I may need to have.
2. Prepare for potential surgery and/or radiation. (CyberKnife Stereotactic Radiosurgery)
3. Begin taking an additional medication that would make it difficult to maintain any sort of workload based on its side affects. Nov 18, 2011 to Jan 6, 2012
• Have my brain MRI'd and mapped for possible growth/shrinkage.(The tumor, not my brain- I know some of you were thinking it. LOL) Jan 9
• Allow the specialists to review the results and determine which path to take. Jan16   

Path #1- If the results show the tumor has become smaller, no growth or no additional pressure on the brain. I would have a few hormonal/medicine changes and begin to feel better, or shall I say I would begin to think better. (I said think, not type. My typing skills are no better than a highly trained monkey) It other words, no surgery required but the CyberKnife Stereotactic Radiosurgery could still be in order.

Path #2 -  If the results show tumor growth or new pressure on the brain or optic nerves, surgery or the CyberKnife Stereotactic Radiosurgery would be in play.

THE LONG AWAITED UPDATE (Seriously, I mean it this time)

GOOD NEWS! The tumor has not grown and in fact, it may have shrunk a tad. It's 1.3 centimeters which means there's no need for surgery or for any form of radiation. Good news? wait a minute... if this is good news then why are my thought processes, memory issues and that %^%$$#%$%@ ringing still around?

The reason this good news is that we, the Dr.'s and I, have been given and unexpected result that wasn't even on the table before. This unexpected result may come as a shock to some but then again, it may come in the form of one of those AH HA moments. For me, it was indeed an AH HA moment, as it was for my Doc as well. The findings are also good news because it give me an answer, and a real answer is more than I've had so far. So what's this new finding you say? I'm getting to it, keep your undies on.

The tumor, as it is right now, is not the cause of my current thought disorder, delirium, memory issues or ear ringing. The tumor may have been the root cause and still the current cause of my vision changes and headaches, but nothing that I don’t already know of. Yes, I still have a tumor that will eventually grow to the point where additional surgery/radiation will be required, but not for now. It’s a very slow growing tumor  and I will continue to have it monitored with yearly MRI’s yearly and my left eye evaluated every six months. The doc states that it may be 10 years or more before we need to visit that course of action. So for the care and maintenance of the tumor side of things, we're going to stay on the current course of action and give my body what it needs to function properly do to the partial functioning pituitary gland. 

THE FINDINGS

All I've gone through, all the tests, all the scans and all the little green alien probing that I've had, all point to one thing, a Stroke. I may have noticed changes to my thought process before and after the surgery for the tumor but the latest findings show this was not the only reason. The results showed that a loss of blood has occurred to that area of the brain (hypothalamus and above) at some point in time. This loss could have been from the blood vessel that was in the underlying tumor, it could have happened before the surgery or this could have happened shortly after surgery at some point. It's very hard to tell the timing of this since these are micro vessels and not something that can easily be pinned down. There is also a theory that my ear ringing could be a symptom of the micro vessel stroke, but I will need to Go See Doctor Specialist For That Doohickey to get more info on that. 

A stroke is simply a loss of blood to an area of the brain and it can happen rather quickly, as short as a few seconds can cause damage. That area of the brain dies and current technology can't bring it back. Just as in the game of golf, once you take a stroke, you can’t take it back. A stroke is a stroke, no medications, no surgery will bring that area back to life once a loss of blood has happened.  BUT!!  :)   The brain is a marvelous organ that can adapt and learn new ways of thinking and new ways to channel those thought processes. With the right training and learning, the brain can build a new synapse super highway to overcome these blocked areas. 

I PRESENT TO YOU - PATH #3

Working with my Endocrinologist and my Neurophysiologist, we're going to kick start my neurons and get them back to my 150 IQ or close to it. (I'll settle for 120) We're going to add HGH to the hormone mix because brain cells react to human growth hormone more that any other type of cell. (Other than fetal cells and I have no more of those) HGH may also provide healing to the hypothalamus as well. The benefit of this  being in my system as I work to re-train my brain is two fold since it will stimulate the brain cells and provide that extra boost for growth of new synapse super highways to ADAPT & OVERCOME! Sempre Fi! 

When you step back and look at the big picture, this is indeed good news. I look forward to 2012 and to my forth coming adventure with my Neurophysiologist. I start meeting with him on March 15th, and begin my HGH sometime near the end of February.
For now, I'm going back to work and will so my best to think technically and at a level to which IBM deserve's of me. I may complain here or there about my pay or my position level but IBM has been there for me during this entire process and I'm lucky to have a job with such a great company. Does this mean I won't complain about things anymore? .... No. :)

The bottom line is: 

• Prayer is always answered! 
• I still have a smile! (most of the time)
• Things could be worse.
• I love my friends, family and my lord &savior! 
• I'm still here, you can’t get rid of me!  :)

**Neurophysiologist: Is just a fancy way of saying Psychological Brain Acumen of the Theoretical Comprehensiveness of the Conscious Intelligence.

I provide the following for your viewing pleasure, as well as adding some extra content so that I can enter this blog post to Guinness Book Of World Records for longest blog post ever!
 (The video has no hidden reference to my brain's Jekyll & Hyde situation... yeah right) ;)