CSTAR

So much to update!
1. The appointments:

Dr. Pelzer continues the positive news about my treatment. Its hard to quantify my prognosis, but he is very optimistic about my future. One thing is for sure, enucleation(eye removal) has been the key to victory. No regrets whatsoever. Most importantly, Dr. Pelzer is certain none of the patients in previous studies had the level of surgeons that I am fortunate to employ. He says that Dr. Chandler was able to remove more tissue than he (Pelzer) could alone because of his neurosurgery expertise. Specifically, he was able to remove bone from the socket, and resect the optic nerve all the way back to where it connects to the other optic nerve, behind the eye socket. Dr. Pelzer is “wildly enthusiastic” that I will continue to be cancer free.

Dr. Mittal (Radiology oncologist – in charge of my radiation treatment) also saw me on Wednesday. We did the mapping process of the area to be radiated. The pictures below are of the mask they made of my head, neck, and shoulders. The mask is made of plastic mesh melted on to my face, and is used to immobolize me during treatment. Movement during radiation would be “bad”. They use a CT scan to map the area to receive radiation (and more importantly the areas to not receive radiation). Radiation treatment (IMRT) will begin in three weeks (14March). The side effects of radiation that we are worried about are: nauseau, fatigue, damage to the good eye, radiation to my brain, and radiation induced cancer. The first two are fairly certain. Radiation damage to my other eye or brain have “extremely low probablilty”. The chance of a radiation induced tumor from this type of treatment (IMRT) is .07%. Dr. Mittal says I would have to be extremely unlucky to develop cancer from the radiation treatment. I laughed and told him I have one of the most rare cancers recorded, so what the hell is .07% to me? Ha Ha. Cancer joke.

Dr. Fine saw me on Thursday and is happy with the progress of the tissue/skin graft. There is one little spot that is taking its sweet time to heal, but it should be “fine” by the time radiation starts. If not, radiation may have to be delayed until the graft heals.

2. The Joy of Joy Cooking is in full effect at 15th and Halsted. We’ve got meatloafs. We’ve got soups. We’ve got blueberry muffins, stewed carrots, and more. More food is coming on Sunday from Mom and the Round Lake chapter of the Schranks.

3. Heart of a Marine is an organization dedicated to providing financial assistance to military personnel with unmet needs. Nancy Diduca (SSgt Diduca’s mom) is a member, and has sent a Visa check card to cover expenses we have incurred from treatment. Dealing with this for the last three months, a lot of relatively small costs quickly add up (i.e. $9 – $20 a day for parking X 6 weeks of radiation, etc). They have also left the door open for any other expenses in the future. Their generosity is humbling. It is even more humbling to consider the vital support they have provided to Marines whose needs far outweigh ours. Thanks SSgt and Jeanette Diduca for introducing us to this organization. The link is: www.heartofamarine.org

4. NOW FOR THE BIG NEWS: Dr. Pelzer and I had to work our butts off to donate my eye. Cancer is normally disqualifying for organ donation. It was a big deal to me to be able to donate, however, and Dr. Pelzer worked with the director of the Illinois Eye Bank to ensure my eye could be donated, since the cancer was not actually in the eye itself. Here is the result (click to enlarge):

I can’t exlain how much this means. It’s such a big deal that someone could benefit. We are pinning this cloud and beating a silver lining out of it when one is not apparent. One more reason that surgery was the right decision. We know now that radiation would not have been enough to cure. My eye would have ended up being removed after radiation failed, and the radiation damage (a sure thing for the left eye) would have prevented organ donation. Fortune smiles on us.

Sorry I haven’t posted much lately…I’ve been busy as you can see from the picture! This is Bosco and I feverishly working on recovery.

Big Thanks to Joy and my Mom for all the food! We have been supplied with homemade goodness a couple of times already, and I am expecting another round of fridge resupply this weekend. Its made life so much easier here to have stuff to eat and not worry about cooking or grocery shopping. Go Team!

From the latest round of appointments:

1. Dr. Fine (who needs a nickname when you are a plastic surgeon named “Dr. Fine”?) is overall pleased with the progress of the tissue graft in my left eye socket. It changes color once a day to keep me guessing as to how its healing. Last week it, was actually a nice pink color, only to change to a series of greens and yellows this week. Dr. Fine says this is normal and expected however. We are concerned about the inner corner of the graft, which has yet to fully take. The worst case scenario is that it will take a little longer to heal. Dr. Fine thinks the window to worry about the skin/tissue graft failing has passed, and that it is now only a matter of time. He removed most of my stitches, and will remove the rest this Thursday.

2. Dr. Chandler continues to deny my demands and tell me that my activity level needs to remain at approximately zero (I am allowed to walk – yay). Since I am not getting the answers I want, I’m calling Dr. Pelzer today to see if he’ll give me a different answer. If mom says no, go ask dad!

3. I am becoming a professional napper…Bosco and I have several nap-offs daily…especially since its really the only thing that I can do to speed up this recovery. Trust me, I’d much rather be out doing something…damn doctors.

4. The only pain I have now is a little bit in my left shoulder, and these random wild headaches. They are pretty crazy…basically debilitating head pain that disappears as fast as it starts. I almost laugh when its over because it is the wildest thing I have ever felt. Feels like someone is banging pots and pans in a megaphone inside my skull (especially since my hearing goes out during these attacks), and then its gone! Thats the only time I am medicated, which is a nice improvement over the high-all-the-time days. Overall, I feel great. I actually feel totally recovered, I just need my skull to catch up with my spirit.

5. Just to tidy this up – Mom won the Dr. Symanski nickname contest: Dr. Stacy “Commendable Occulo-Mass Eradicator” Symanski. Congratulations!

As it turns out, the information previously posted about my optimistic commissioning outlook was premature. My future in the Marine Corps is once again in jeopardy. There is no doubt that I will attack this issue with unbridled enthusiasm and tenacity, but the prognosis is uncertain to be sure. I’ll post more details on this when appropriate. We are planning for all eventualities, but its not an issue to be handled at this moment. First comes the healing.

Overall, the situation is fantastic. I have come to the conclusion that I am glad the second surgery was “unsuccessful”. My situation if the second surgery had worked would be to have a left eye of questionable ability, but also close to a 20% chance of recurrence of cancer. It is quite possible that radiation would have further damaged vision in that left eye. Given that my current chance of recurrence is near zero, I like where I’m at now. The recovery is the easy part. I am focused on getting better, and the relief of not worrying as much about cancer now or in the future (knock on wood, cross fingers, etc) is worth losing my eye.

I swear I have yet to feel sorry for myself. I think I am Very Lucky. There aren’t many people who get this intimate with cancer, who get this close to the worst imaginable prognosis, and then get to walk away. I have been blessed with great support and superb medical care, and I am thankful. I am fortunate to have 24 hour medical care at home, and that has made this so much easier. Given the dire circumstances, I couldn’t be in a better situation than I am right now. Thanks!

Next post will be after my thursday appointments…

Here’s the latest:

1. Dr. Pelzer (otolaryngolical surgeon) relayed the final pathology report from the craniotomy surgery today. He couldn’t be more pleased with the results. He doesn’t think there is any cancer left, even on a microscopic level. We are going ahead with radiation therapy on principle alone.

2. The pathology report indicates that the cancer had started on some of the nerves in the eye socket. This could have been very serious. We’ll never know how seriously my life was in danger, but this information alone completely validates our decision to remove everything.

3. We also saw Dr. Chandler (neurosurgeon) today. He is very pleased with my recovery from the craniotomy. He thinks I shouldn’t do much for a while, but we’ll see if Dr. Pelzer will override that next week.

4. We saw Dr. Fine (plastic surgeon) earlier this week. He is also very happy with the way my head and face are healing. He removed the covering of the stitches on my head, and also removed the padding on my “eye”. I still have a gauze dressing on my “eye” that has to be changed every other day until next week. He will remove the stitches next thursday.

5. I talked to Dr. Pelzer about the long term characteristics of my treatment. Basically, we will do another CT/MRI a few months after radiation to determine whether I am officially cancer free. Dr. Pelzer has agreed to stay on as my doctor for the “long haul”. He has affirmed that no matter where in the world I am, he will obtain my CT/MRI scans electronically or physically and interpret them to ensure I am continuing to be without cancer. He didnt seem to be concerned whether Tricare would support this or not. Dr. Pelzer has been our biggest asset in this whole process and continues to pay dividends.

I feel really good right now. Physically, its a long recovery. Mentally and emotionally, though, I am in a great place. I think the worst is over until radiation therapy. Most of the shoulder pain is now gone, and every day I wake up feeling better than the day before. The recovery part is proving to be much easier than the anxiety before surgery. I have something to do now, so I am attacking it. I take this recovery seriously. I’m focused on getting back to a normal life as soon as possible.

Thanks everyone for all the support, and especially to Joy for the food. If you don’t know, Joy makes the best chicken pot pie in the world.

Well, I’m home now. Here’s the recap:

1. Surgery was 10.5 hours, and Dr. Pelzer feels very positive about the results. We exceeded the high end of his expectations.

2. My head feels fine, but it appears I have a frozen shoulder. I am working with the doctors to make sure my shoulder is included in my treatment plan.

3. The craniotomy recovery has a very significant effect on my endurance, which basically means I sleep most of the day.

4. I am really not in the mood for visitors.

5. I am so thankful for all of the support  received thus far. Many different people have occupied seperate but necessary roles in providing mental and emotional support. Thank you.

6. I just learned today that my Uncle Mike has passed away. Our prayers go out to everyone, and we are going to do everything we can to provide support. A wonderful example has been set for us, and we will do our best to live up to the support that we have received.

7. Marines: the Petersens need our support. Standby for word on what we can do to help them. Here’s Sgt Petersen’s (Corey) blog: www.welovecorey.blogspot.com

Well, things are doing much better today. Yesterday was very difficult. I had a lot of pain management issues, with three completely out of control pain episodes. This morning, however, we are rocking the house. We started the day with 8 complete laps around the hospital. Dr. Pelzer came in this morning and plans to have me discharged tomorrow (Saturday). My energy level waxes and wanes throughout the day, but I’m trying to do as much as possible. I am excited how much more recovery we can manage today, and hopefully be home tomorrow! My discharge day is being determined by the neuro guys…when they took out the optic nerve my brain was very temporarily exposed and that is what they are monitoring to determine when I can go home. The drugs are making me ramble a bit…..Thanks for everyone’s good wishes, I received the cards from Tim’s kids and the Leafs!

I’d be wasting a great story if I didn’t tell this one…its “R” rated tho…

The background: Anyone who has ever lifted with me knows I have shoulder issues with heavy weights. I have to warm up extensively to avoid chronic overuse injuries. Also I can only lay on my left elbow for about 5 minutes before pain sets in and I have to shift. So, 10.5 hours immobilized for neurourgery causes some amazing pain. Open Cranial surgery requires the patient to be completely immobile, so I was locked down pretty tight. Here’s the script between myself, Margaret, and the other nurse in the recovery room, coming up from anesthesia (keep in mind I am out of my mind on anesthesia)

Me: AAAAAAAAHHHHHHH!
Nurses: what’s wrong?
Me: I’M GOING TO KILL YOU M*****F*****S!
Nurses: what’s wrong Mr. Schrank?
Me: PAIN! PAIN! I”M GOING TO KILL YOU M*****F*****S!!!!

(repeat this a few more times, and the nurses thought my head was in pain. They gave me every pain killer they could think of, to no avail because my shoulders were still strapped in)

Me: AAAAAHHHHH! PAIN PAIN PAIN!!!! I AM GOING TO KILL YOU ALL!
Nurses: you can’t hit the nurses.
Me: I would never hit you…I’M GOING TO KILL YOU
Nurses: where does it hurt?
Me: MY SHOULDER, MY SHOULDER
Nurses: oh, you should have told us, we can totally fix that
Me: ARE YOU ON MY TEAM?? ARE YOU ON MY TEAM??
Nurses: what?
Me: ARE YOU ON TEAM SCHRANK?!?!?!
Nurses: yes, we are on your team
Me: ok

Totally true script, and then apparently I calmed down, or maybe all the drugs finally overcame my nervous system, or maybe I just needed to know they were on my team, since I didnt see any T-shirts.

1. The next few hours were spent trying and failing and trying again to build a position of rolled and taped blankets and pillows for my destroyed shoulder. I don’t want to sound dramatic, but its the worst pain I have ever felt. Worse than when I shattered my other shoulder in high school.

2. Over the rest of the evening, I patched up my relationship with Nurse Margaret. As it turns out, she is truly fantastic.

4. With all that support, I have no choice but to rock this recovery. I am so focused right now. This morning I got out of bed and sat in a chair. That 4 seconds completely exhausted me. This afternoon, I walked a complete lap around the hospital under my own power. I only returned to my room because my shoulder was really causing some big pain. It’s go time for this recovery.

5. It has been such a relief to get through this surgery. My spirit is buoyed by my support system (all of you), and Dr. Pelzer’s satisfaction. He is so happy with the results, that we have put low-dose radiation back on the table for the next step in possible treatment.

Cancer wasn’t prepared to go to the extent that Team Schrank was to win. I am dragging this disease to the woodshed. There is plenty of pain left, but we are downhill to victory now.