Surgery, Staged Radiation, Embolization, or Nothing. We’ve made our decision. Here’s the plan.

We have finally made a decision as to how to approach this bad boy in my brain.  For the past month or so I have been sharing in this blog what has been on my mind…literally and figuratively. 

If nothing else I thought it would be a good way for me to have a permanent journal of my thoughts and feelings as my family (because of me) took an unexpected turn down an unfamiliar road that has “frowning Providence” written all over it.  Smiling Providences are those obviously good things in our lives for which we happily give God the glory.  Frowning Providences are the actions of God that often make us frown, hurt, confuse us… the kinds of things that we would never choose given a choice…but which nevertheless serve God’s larger purposes of being glorified.  

I believe with every fiber of my being that God is comprehensively sovereign over every molecule of this universe.  Were there even one rogue atom or quark then God would be limited…just like us. Ever since October 23, 2008 when a seizure graciously revealed the peach sized AVM in my left frontal lobe we have been seeking God and consulting with experts in the fields of neurology and neurosurgery.  We have heard lots of new words, done quite a bit of research, and been earnestly inquiring of God as to what we should do with the knowledge before us.

Before I tell you what we have decided let me just say that modern technologies present difficult decisions that wouldn’t have been possible 30 years ago.  Before MRI’s and CT’s people who had seizures because of AVM’s never would have known a thing about it.  Surgery or radiation or embolization would not have been possible for it was not possible even to know they were present.  Not so today.

What follows are the courses of action we have ruled out, the one we have chosen, and why:

1. Nothing.  I could do nothing and live with the ethereal “61% probability” of having a cerebral hemmorhage at some point in my life and the ensuing brain damage (or possibly death) that would result.  Because of my age none of the doctors we have consulted seem to think this is the best course of action.  As one ages the blood vessels weaken thus increasing the possibility of a bleed.  This AVM acted up for some reason now.  Makes me think it probably will again.  Because of other decent options doing nothing is not an option we think is best for us.

2. Staged Radiation.  The gamma knife procedure is a non-invasive treatment over time where radioactive cobalt is directed at one part of the AVM during one treatment and another part of the AVM on another treatment.  The gamma knife is the method of choice for small AVM’s without question.  But for larger ones it is not so effective.  This “staged radiation” procedure is still very new and largely untested.  I’m not interested in advancing scientific knowledge with a procedure that is largely untested…especially when preliminary results are not very promising.  It would take roughly four years or so to even know if it was working and it has about a 40% chance of completely obliterating the AVM.  It is  a safe method, with only a 5% likelihood of a long term neurological problem from the procedure.  But, it also weakens the blood vessels, thus increasing the probability of a brain bleed during those years one is waiting to see if it has worked.  No thanks.

3. Embolization.  This is where an angiogram is performed and a catheter is inserted through the femural artery up into the brain and glues or plastics are stuffed into the bogus arteries in the AVM to stop the blood flowing through them.  This by itself is sufficient for effectively treating small AVM’s and has the least amount of risk.  I would love to do this alone. Unfortunately, there’s no way embolization would work on this big boy.  Too many arteries and vessels.

4. Surgery.  The crainiotomy is where a portion of the skull is removed and the surgeon physically removes the AVM.  In my case he would be removing a mass the size of a peach.  It is a surgery that normally takes 5-6 hours, with a couple of days in intensive care, and another five days in the hospital.  The successful surgical removal of an AVM makes  a bunch of people happy.  The mostly successful surgical removal of an AVM decreases the collective happiness…on down the line.  As I have written earlier this procedure carries with it a 15% probability of debilitating life long neurological deficits or worse.  It’s definitely not a no-brainer.

However, after much prayer…by us and by hundreds and thousands of you, we have have made our decision to proceed with the full surgery.  We have discussed it as a family, particularly with our 14 and 16 year old sons.  We have talked openly about all the possible outcomes that we can imagine and have decided together to move ahead.  If my sons had not been comfortable with this course of action I would not be proceeding.  That’s how important it is to me that we are in this together.  We made the decision together, and we will live with the outcome together, entrusting ourselves into the hands of Almighty God.  We don’t ultimately trust in statistics, probability charts, or even the most skilled hands on the planet.  Our trust is in the name of the Lord our God.  Psalm 20:7 says “Some trust in chariots and some in horses, but we trust in the name of the LORD our God.”  This does not guarantee the outcome we desire, for God is not beholden to any man.  But it does mean that we are willing to accept whatever outcome ensues.

It’s weird territory to have to be making such decisions…decisions I couldn’t have even imagined 50 days ago.  But such is life in a fallen world.

Here’s the plan as it now stands:  We are scheduled to be in Rochester beginning the week of February 9th.  Monday the ninth I would undergo a physical.  Tuesday or Wednesday I would undergo an embolization treatment to block off some of the larger arteries and vessels in the AVM and reduce the risk of surgery.  Then, on Thursday Feb. 12th Dr. Meyer would perform the surgery.   I normally take Fridays off so this is a good time for the surgery.  I should be good for the weekend [a joke for the humor impaired].  

If all goes well I should be able to come home by about February 19th and work on doing whatever is necessary to get life going on as it was before.   It would great to get back to work in March sometime and also resume preaching by the end of March.  Goals are good!

Well, that’s all for now my friends.  Thought you would be interested in knowing our plans.  Thank you for your continued prayers.  Karla thinks I’m going to chicken out!

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20 thoughts on “Surgery, Staged Radiation, Embolization, or Nothing. We’ve made our decision. Here’s the plan.”

  1. Mike,
    Wow, it has been alot of information for you to take in and to truely make a decision. My prayers for you were that God would give you the wisdom and peace about the decision. He definitely has done that for you and your family. Praise God. We will continue to keep you in our prayers. Have a blessed Christmas. Kathy

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  2. Mike, Karla and kids,
    We have been praying for all of you for God’s direciton and insight into how to handle this decision. We are so glad you have made a decision and are moving forward in that direction. We really enjoy your daily blogs, keep it up and stay strong through these coming months. Have a blessed Christmas and if there is anything we can do, please let us know. We will continue to keep you in our prayers. We love you all! The Ropp’s

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  3. Mike,
    We haven’t spoken in some time and I was just made aware of the situation you and your family are facing. For as much comfort as it can provide, please know you are in my and my family’s prayers daily and our thoughts constantly.
    God does have big plans for you. We will wait and see whether those are here or at his side. For all of us here on earth, I pray you remain with your family for years to come.
    Take care my friend and know you are loved and card for (by many you may not have even considered).

    God Bless,

    An “old” football buddy
    Brad Versteegh
    Austin, TX

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  4. Hey Mike,
    Danny and I got word a while back from Bev. We will continue to pray and trust God with you.
    In prayer,

    Danny and Connie Hodges

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  5. Hey, Mike~

    I’m saddened to hear about your troubles as of late. For what it’s Worth, St. Paul’s Episcopal Church in Marinette, Wisconsin knows of your plight and you are in our prayers. Big people stuff, eh?? Quite a long sight from our days together on the football field.

    I hope you are well, my friend. As you may know, my path to God has been circuitous and about 25 years later in the coming than yours. My relationship with Him is certainly more tenuous than is yours, but if He IS listening, then He knows that I am praying for you and your family. At the very least, know that an old friend is hoping for the very best of outcomes.

    Peace and grace,

    Eric Craver

    Marinette, Wisconsin

    (Many thanks old friend! It seems I remember a deal we made one fall day during chemistry class in our sophomore year that we would play a game of tennis together after we had turned 100. Game on! Mike E.)

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  6. Mike,
    I want you to know that my family,church, and I are praying for you and your family through this time. I know He will be with you and He has great things planned for you. If anyone can face this challenge, it is you!
    Peace and love,
    Jenny Currant Hamand
    Stevensville, Michigan

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  7. Mike, Sam and I will be praying for you as will others at St Luke. It sure is funny how different the whole world looks when you see it through a different lens all at once. I know God is blessing you and those you love. Karen Clark

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  8. Hi Mike,
    Sorry to hear you are going through this, Mike. I will be keeping you and your family in my prayers along with Valley Church. The song “He Will Carry You” comes to mind.

    There is no problem to big, God cannot solve it.
    There is no mountain to tall, He cannot move it.
    There is no storm to dark, He cannot calm it.
    There is no sorrow to deep, He cannot soothe it.

    If he carried the weight of the world upon his shoulders. I know my brother that he will carry you.

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  9. Mike,
    Thanks to Facebook, I have this information. Even as you and your family are grieving such an abrupt change in life, be assured that many, many are praying for you, and that we have seen God do greater things than this! You, your family, and certainly your surgeons are in the prayers of Living Word Lutheran Church in Buda, Texas, and of this pastor.

    Peace++
    Lori Ruge-Jones
    (NHS ’84, cheerleader)

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  10. Mike-

    God Bless you nad your family! What ever is ahead of you, your failth will carry you through. Mike can do all things through Christ who strengthens him!

    We will pray for you and yours.

    Joe

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  11. Hey, Mike~

    YOU REMEMBERED! I’m impressed. The tennis match IS on. However… you have to promise – PROMISE me that you will show up. If I am going to haul my carcass out of my rest home and my Jeopardy re-runs to meet you for tennis at 100 years old, you had best be there…

    Eric

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  12. Mike,

    You and your wonderful family are in my prayers.

    One of my favorite quotes comes from Columbus…”You can never cross the ocean unless you have courage to lose sight of the shore.”

    God Bless You!

    Tina (Mulbrook) Dube, Class of ’83 NHS
    San Antonio, TX

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  13. Mike –

    Saddened to hear of your challenege – but gladdened (yes – I do make my own worrds up) to see such an out pouring of care.
    My daughter, wife and I will make sure and include you and your family in our prayers.
    Now – go get the NHS 83 yearbook and figure out who all these people are!

    God Bless

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  14. Mike,
    Brad V. forwarded me your blog link. It’s been years since we’ve connected, so I hope you remember me from high chool. I am sorry to to hear about your diagnosis. My heart goes out to you and your family. I hope I can be of a little help or at least provide some comfort as I work at Mayo Clinic and have been here for 10 years now.
    I’m not on the medical side but int Public Affairs. Through my work in public relations and sharing patient stories, I’ve have had the great fortune to work closely with Mayo’s Neurology and Neurosurgery depatments.

    In particularly, I have worked with Dr. Fredric Meyer, your neurosurgeon. I can, with all confidence, say that Dr. Meyer is one of the best (likely the best) neurosurgeons in the country! He is the Chair of the neurosurgery department and has successfully done many of this type of surgeries. You can have a great deal of confidence in his abilities. He is highly skilled and will do everything in his power to make your surgery successful.

    I know coming to Mayo can be an overwhelming experience as I’m sure you have already exprienced with all your testing. It’s hard enough to face such a crisis in your own community let alone having to travel miles away from family for a seroius surgery. If you need any help knowing where your family should stay, how to locate things, how to get around town or just want someone to offer reassurance please feel free to contact me. Mayo also has a wonderful chaplain program that I am sure you and your family will find comforting.

    I wish there was more than reassurance I could offer, but I hope you find some encouragement from my words. The Mayo Clinic is truely an amazing place and miracles happen here everyday. It is the only place I have worked were everyone from the gardeners to the top surgeons know their mission. “The needs of the patient come first”

    My work email is lammers.carol@mayo.edu. Drop me a note and I will send you my phone number.

    God Bless and please let me know how I can help.
    carol

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  15. Mike, You are still in Neil’s and my prayers and also our retirement center church’s prayers. He is with you and your family and all things are good with God at your side.

    Jan and Neil
    Alamo, Texas
    6 months of the year

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  16. Mike,

    You’ve been on the top of our prayer list every day since Karla alerted us to your situation several weeks ago. Our cell group and church here in Bangkok will also be lifting you up regularly when I share your decision with them this week.

    You know, it’s a awesome thing to see a Godly man go through a trial. Of course we’re sad to see you and your family having to deal with this, but what a testimony to the power and sufficiency of our great God and Savior, Jesus Christ. You’re a great preacher (and writer, as we all now know), but nothing compares to seeing faith in action. My family and I are so blessed by you!

    The comment above from your old high school classmate (Carol Lammers on Dec 11 above) brought me to tears. How strategic is the Lord! We so often underestimate Him, to our shame. But what a great reminder about Who is in charge around here!

    Blessings, friend, and tell Karla I’m betting on you.

    Scott Harpe for Michelle, Nathan, Lydia, and Abigail Harpe

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  17. Dear Mike,

    I just heard about your diagnosis and just read parts of your blog. I am so sorry that you are facing this ordeal, but am heartened by your faith and spirit through it. As you said, it is a blessing that you discovered this through a seizure and not a more complicated way. Please keep typing and keeping us updated.

    And I guess we have a common thread….we attend an E Free church in Boulder (do you know Pastor Tom Shirk?)

    Grace, mercy and peace to you,
    Lora

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  18. Mike,

    I recently wrote a song called “Blessings” – in it, the chorus goes like this…

    May the Spirit of the Lord shine upon you as you go from this place.
    May the Spirit light a path before you ever filled with his grace.
    May the Spirit of the Lord always guide you as you go on your way.
    May the Spirit send you blessing, each and every day.

    As you prepare in the weeks ahead to face the surgery and allow God to watch over you and your family – I will pray that God will send blessings every day to you, Karla and your wonderful kids –

    God will see you through this – I am confident of that – your faith is admirable!

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  19. Dear Mike,
    You don’t know me but I read your blog from a HEED email. I receive many HEED emails and normally delete many before even reading them as time does not allow me to read them all.
    God laid it upon my heart to read the one about you and go to your blog. I am a nurse and so have some understanding of medical terms but never heard of AVM. I also happen to work weekend package on North 3 at Methodist(one of the 2 heart floors).
    I am just amazed at your wonderful attitude and your willingness to submit to God in this most difficult situation. You are such a remarkable living testimony to how glorious our God really is!
    I will pray for you and I will ask our church (Cumming Community Church, E-free) to hold you up in prayer. I can see God’s peace is already upon you and I pray that you and your family continue to stay close to our Father through this. I also pray that God will make your surgery successful and your healing rapid and without complications.
    Philipians 4:4 says “Rejoice in the Lord always, I will say it again, rejoice, the Lord is near. Let your gentlness be evident to all. In all things through prayer and petition and with thanksgiving present your requests to God. Then the peace of God which transcends all understanding will guard your hearts and minds in Christ Jesus”
    May God bless you for your faithful heart to serve Him joyfully even in this time of trial.
    In His name, Lisa Abbott

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