Dr Sunshine Weds #2

The brain is mystery organ. Having a bit of trouble on what year it is. But quite unexpectedly in walks Rebecca Spencer, MD PhD, anesthesia resident, who is Kathy’s niece, and a delightful detailed conversation ensues! Upon reflection I guess relationships developed earlier in our history than did numbers, time and dates .. maybe back with tree shrews … but it does seem to this engineer like those things would have more complex neural representation!

In other news, they repositioned Kristine & I got a good look at the hair situation. Let’s put it this way, it’s less like the Palouse highway and more like I90 through Bellevue. But only visible from the back, so I’m thinking jaunty beret would be the way to go!

One of the neuro team just came by, and I’d say the muscle-strength part was unremarkable. So, even if the year continues to be elusive, I predict no problem with downward dog.

Dr Sunshine Weds #1

Dr Sunshine passed out in a hotel bad and awoke to a beautiful Boston October morning. Yesterday we were overrlooking the Charles River and for a brief moment the thought occurred to me that maybe rowing would be pleasant. That passed.

Kristine continues to have the mother of all headaches and is well-medicated. Probably the next milestone would be to get beyond the nausea and start eating.

Before I arrived Kristine was visited by my 2nd grad school roommate who is a pediatrician here. He and his wife used o sit in the pew in front of me at the Harvard Sq UCC church and in fact was the one who suggested I get to know the seminarian. Probably would not be unreasonable for our kids o drop him a thank you note.

I got a peek at Kristine’s incision. There is just like a 1 inch strip running north-south. On the outside everything is glued shut, no bandages all.

21st century The icu room looks like it should be in the Starship Enterprise. Kristine happily ate a lemon ice which is not as good as cannoli but feels good after 8 hours of intubation. Did I mention she still has most of her hair?

Dr Sunshine update #2

MGH1

Just to add a visual, Kristine’s OR is in silvery building on the left. The last I time did any work here, the white building to the right was the main building, the red+silver are newer. Some famous Boston names attached to these.

Literally everyone we have dealt with, from surgeon to orderly have been super nice and calm-inducing.

When we were here 3 weeks ago, Kristine and I visited the Ether Dome, the 19th c surgical theater where surgery under general anesthesia was first demonstrated. It should come as no surprise that I’m the kind of guy that reads every little plaque and picture on the wall, and one caught my eye, which leads to this.

In Stephanie J. Snow’s book, Blessed Days of Anaesthesia: How Anaesthetics Changed the World (Oxford, 2008) the author asserts “In Christian theology, pain entered the world after Eve’s disobedience in the Garden of Eden and remained central to humanity”. In a Christian framework, suffering during childbirth was considered to be a necessary and permanent reminder of Eve’s sin. The biblical quote “in sorrow shalt thou bring forth children” (Gen. 3:16) was commonly enjoined as an argument to disallow the use of ether or chloroform in childbirth. Christian beliefs that to avoid pain was against God’s will were common, especially in rural America in the middle of the nineteenth century, and this too impeded the acceptance of anesthesia. Snow goes on to demonstrate that it was to a large extent women—requesting ether and chloroform during delivery—that facilitated a change in the interpretation of these biblical ideas and religious mores, ushering in an acceptance by not only society in general but the medical profession of this humane discovery.” (http://ecti.english.illinois.edu/reviews/52/vannatta-snow.html)

What is is with religion and uppity women !!??

Prior to anesthesia, surgery was a last-ditch affair, in the same realm as torture, so there was something like only one per month at MGH. I cannot adequately describe the huge surgical machine that is here now .. the logistics, the staff, the supplies, the communications … it’s going to take a while to me to really get a sense of the whole thing and digest it .. but hey, I’ve got time this week!

Mostly Set to Go

Ah, Boston.  The land where Rs either don’t exist on the end of words, or they are added when they actually aren’t there (example:  “pizzar”).  The land where you pay your toll to the Sumner Tunnel and the guy calls Jonathan “Pal.”   The land where Jonathan is kind of a folk hero because he can describe what it was like to be there during the blizzard of  ’78.  The place where, even though we lived here for many years, the antics of drivers can still surprise us.

It’s been a long day of appointments, but we are mostly ready to go now. Turns out that spending an hour+ sitting in the Chief of Neurosurgery’s waiting room is a really good way to end up feeling that you have no problems at all in the world. Today it was packed with people with shaved heads, mobility and mental challenges, and lots of stories. Just listening in made me realize that, if you ever want to be around a lot of courage, you should just go hang out in the neurosurgery waiting area. Particularly emotional for me was the young woman who has 2 stents in her brain because she was born with hydrocephalus and also shrapnel in a number of areas of her skull because she and her family survived attacks when they lived in Sarajevo. Hearing her telling her story, all the time with a face of bravery and  a  type of humor I’ve come to understand is critical to making it through these moments, put many things in my own life in perspective.

We met with Dr. Eskandar to confirm the details of the surgery. And then there was the great moment when he gave me a wink and said “See you tomorrow, shall we?” That’s a moment — when your neurosurgeon winks at you!

I was felt like a star in pre-op because it turns out that doing a lot of yoga and Nia keep your blood pressure and the rest of your body very healthy — all of those tests and numbers looked good. I have a delightful anesthesiologist (Standford Grad — Go Cardinal!) who was telling Jonathan where he could watch the youtube video on putting in a central line (I’m going to pass on that this evening).  Heard the general description of the gizmo they screw my head into so that it remains perfectly still while they do the surgery. It’s a lot to take in, and I am happy that I will not be awake for most of it.

Kind people seem to be everywhere.  Even the woman doing my blood work and my EKG told me, when we finished that she would be praying for me (and go by her church and light a candle for me).  I can’t imagine feeling more surrounded by love than I do right now.  And I love you, right back!

What is it Like to Have a Seizure?

Little Kristine at camp

Little Kristine at camp

One of the things I wanted to get down, before I have surgery, are the answers to some of the questions that I’m often asked by doctors. One of them has to do with describing “the first seizure you remember.”

The reality is that most people that have the type of epilepsy I have (temporal lobe epilepsy) don’t talk a lot about their seizures, because the seizures are subtle, confusing, and they make us feel like we are crazy. My seizures begin in a very specific part of my brain.  This manifests as an intense “thought,” accompanied by a strong sense of deja vu. It was only a few months ago, when I did an extended monitoring EEG in a hospital, that I came to understand that this unique “thought” and “feeling” were indeed, an aura. An aura is a small, initial seizure.  In my case, after the aura, I have about 30 seconds  before I have a full, grand mal seizure.  I learned this because, in the hospital, I had to push a button every time I thought I might be having a seizure, and this “button pushing” exercise confirmed that I was right — every time.

Why didn’t I figure the seizure business out sooner? Because I’ve had the experience of the strange “thought” and “feeling” for as long as I can remember. Like many people with epilepsy, I never had a grand mal seizure until I hit puberty, but the “little” ones have always been a part of the way my brain works. So I never talked about it because I knew, on the one hand, that something strange was going on, and yet, this “strange thought” was also totally “normal” to me.  How do you know something is a seizure when it’s something your brain has always done?  It would be like getting a fish to understand that it is wet — how would it know anything else?

The first really memorable moment I had that was, most likely, a larger seizure, occurred when I was at a summer camp I regularly attended as a child. Camp Easterseal (later renamed Camp Roger Larson)  was on Lake Coeur d’Alene and was a camp for kids with special needs as well as kids without (back then, we thought I was one without special needs). Every year, we would go on an overnight and sleep outside under the stars. The year I’m remembering was one where I had befriended a girl in my cabin named Peggy. Peggy was hearing impaired, had seizures, and had brain damage that resulted in her having little ability to perceive physical pain. This meant that others of us would stick close by her, because she often got hurt. This particular evening, I was sleeping beside Peggy, watching over her (in my little sleeping bag with the cowboy flannel lining!). She was very scared of being out doors, and so we were snuggled up close.

All of a sudden, I remember having this strange sense, actually, a sense of absolute sureness, that everything was, is, and always will be connected to everything else.  There in my little cowboy sleeping bag, I knew, in that moment, that there was no difference between me and Peggy, no matter how “different” we seemed on the outside.  I remember feeling connected not only to  all the other sleeping campers, but the sand on the beach, the dark trees, the vast number of stars in the sky, the moonlight on the water, the endless waves.  And what was strange was that it wasn’t like having a “thought” about this, but it was an actual, physical feeling, deep down in my bones, that this was real — as real as feeling my breath moving in and out of my body.   There was a sensation of the “terrible beauty” of that knowledge — it seemed “too big” to think about for a little girl.  I also remember the strong feeling that I now know is called deja vu (but had no name for back then).  It was as if I not only knew this truth in that moment, but that I had known it  for a very long time before that moment.  I later wrote in the little hot pink vinyl diary I kept back then that it felt like “forever knowledge,” something I’d known before I had a sense of being me.

Later on, I would have that same sensation on a fairly regular basis. Years later, when I finally had my first grand mal seizure,  I finally came “out of the closet” with this strong sensation to my mother, describing to her that I was having this  thought/feeling that was a “theory about how to do anything better” . . . which had to do with knowing about the deep connectedness of things.  I now try to imagine what it must have been like for my wonderful mom trying to figure out what the heck that was about!  Back then, there was little understanding of epilepsy, and it took years for me to be diagnosed as having epilepsy (I was 18 when it was first suggested).

It turns out that what I am describing — the deep sense of universality, the strong emotion, including terrifying fear, the sense of deja vu, are all classic symptoms of temporal lobe epileptic seizures. You can break it down into some of the unique features of the temporal lobe, including the amygdala — it’s a busy area of the brain that processes language, memory, emotion, a sense of time and place, and, to some extent, a sense of connection.  It is probably also understandable why many of us who have this type of epilepsy seem to have a strong spiritual bent — I believe that spirituality and a sense of connection to that profoundly beyond ourselves, gets hard-wired into us, not as an idea, a theoretical belief, or a wish, but as a sense of something known as deeply and surely as any other experience.

I think, for many of us, it is a relief when we finally share these stories of seizures with others — others with epilepsy and/or neurologists — and they say “Oh yes, we recognize that and we’ve heard that before.” (Code: “You’re not that special!”). It’s a relief to know that others have had this same type of experience. And yet, it’s also part of the reason why Hippocrates first named epilepsy “the sacred disease.”

I have no doubt that these experiences have shaped me into the minister and yoga/Nia teacher I am today. That sense of the embodied Sacred is one I’ve always been trying to explore, explain, understand, and live out of the secret place it so often dwells and into the light of every lived day.

I hope that others who have epilepsy will take time to write about their experiences of seizures. It is so helpful to others who go through the same thing, often feeling very alone.

Game On!

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I added this picture because I like the idea of a bunch of monks saying “WHEEEE!” as they take a plunge into the unknown.  I can relate.

An update for everyone:

Jonathan and I heard back from a member of the team of doctors who have been making decisions about my surgery, and they have decided to go ahead with surgery on Tuesday, October 8th, as 12:15, as planned. Jonathan describes this surgery as “minimally invasive brain surgery,” in which they are taking out the lesion in my left temporal lobe which they believe is responsible as a starting site for the seizures. What they have decided not to do, at this point, is the more invasive surgery in which they take out larger portions of the temporal lobe and left hippocampus. The doctors are hoping that this surgery that takes “less real estate” (as they often refer to the brain) will stop or at least greatly diminish the seizures. If not, I might be facing a second surgery. However, the more invasive surgery came with more risk of significantly impacting my language and memory, and so I think we all feel good about trying this and hoping that it works (there’s a good thing to keep in your prayers!).

We are getting everything ready to head out of town shortly. Thank you to everyone who has been helping, in so many large and small ways along the way — they all feel huge. Thank you for supporting Jake and Leda (who will be here in Pullman during this upcoming week). Thanks to Chip and Trina at church, and the talented group at Aloft Yoga and Nia who have come together to teach for me and keep things going while I am away. Thanks to members of the CCUCC and UCC communities, the yoga/Nia community, the Muslim community, the St. Gertrude’s prayer chain, several LDS communities, the Hindu community, my friends who describe themselves as the “atheist well-wishers,” the Buddhist community, Native American friends, and many, many others who have let me know they will be holding me, Jonathan, Leda, and Jake close this week . . . It means a lot to us. We feel surrounded by God’s grace, your care, and the beautiful mystery that facing challenge in the midst of love brings front and center.

I have spent this past week doing some things for Jake and Leda, talking to my mom, catching up on some concerns with members of the church, planning and teaching Nia and yoga, and today I began working on an idea for my first sermon back at the church and some creative worship for Advent. I told Chip that it’s good to know that, even in the midst of a week like this, when I know something will be dramatically different inside of me next week, I still wanted to spend this week doing all of the same things I always do, because I truly love the many things I do that make up my life. I go into what lies ahead knowing that I journey with that incredible gift of feeling fully alive, and having the privilege of a life that is interwoven with so many wonderful people.