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Glen Allen, VA 23060

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Garth Callaghan

Napkin Notes Dad

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It Wasn’t Rocket Science

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The Napkin Notes Blog

It Wasn’t Rocket Science

WGarth Callaghan

(but it was brain surgery)

We always knew this was a possibility. Kidney cancer, when it metastasizes, can often metastasize to the brain. It also metastasizes to the lungs and liver. I am batting 1000.

Since we had seen some new lesions in April and July, we knew that my 53 month stint with Pazopanib would have to come to an end. I was one of the lucky ones, really lucky actually. Most patients taking Pazopanib stop around the 12 month mark when it loses its efficacy. I took Pazopanib for 1621 days, much, much longer than expected. But not as long as my original Oncologist predicted.

I have to have my blood checked every other week because one of the side effects of this medicine is liver failure. The other day Lissa and I were at my doctor’s office. He’d taken me off the medicine for a few days because my liver wasn’t handling it well.
He was also concerned about the cumulative impact of the side effects. I was in rough shape and not dealing with the medicine very well either.
I rebutted his desire to have me take a break. “I am a full-dose patient. I want to go on the record that I don’t like this.”
He smirked a little and replied, “So noted.”
I wasn’t going to win this battle, especially not with Lissa in the room. She was a witness.
Lissa knew that my body was stressed and I was close to reaching my physical limits. She asked the doctor, “How long will he be taking this?”
The doctor turned to face my wife. And he said, “For-ev-er.” Like that. Spaced out. As if the word “forever” wasn’t dramatic enough.
I will most likely take this medicine for the rest of my life. Think about that for a second before you move on.
I may take this for the rest of my life. What would you do?
You’d take the darned medicine. Give your body a chance to win!
Live! Raise your kids! Change the world!
What would you do to live?
This. This is what I do. Medically, it’s what I’ll likely do for the rest of my life.
— Napkin Notes: Make lunch meaningful, life will follow

Since I was changing treatment programs, my Oncologist wanted to run a brain MRI and see what we could see. What we saw was a 3mm lesion.

I was admittedly nervous. Brain surgery. F#*%. This little 3mm lesion was in the visual cortex area of my brain.

For the first time in a long time I was scared.

I had to have brain surgery. Granted, it was gamma knife surgery, but it was still a serious medical procedure. I was going to have 4 beams of gamma radiation focus on the lesion.

I went up to UVA about a week before the surgery to get some pre-op things out of the way. I normally do things like this with Lissa, but she had to work and I really thought I could handle it by myself. It was just an MRI, some tests, and a conversation. It was so much more than that. It was 3 different appointments in 3 different buildings, miles apart. In the last appointment I was informed that there were two more stops I should make since I had to do them before the day of surgery anyway. I was so overwhelmed and stressed I could barely drive home. I should have never thought I could handle brain surgery prep by myself. I won’t make that mistake again.

I kept asking myself over and over, “I mean, really, brain surgery? Has it really come to this??”

I needed to check in at the hospital by 6 AM. Lissa made the call to go up the night before, even though technically staying overnight would save us only an hour that morning. It was absolutely the right call. I was able to ease into surgical mode without the added stress of a drive, traffic, and parking. She really had my back with that decision.

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The whole morning was a blur. I checked in. I changed into a fashionably light purple gown. I got hooked up to multiple machines. I was asked all sorts of questions about my health history and my understanding of the morning’s procedures.

Then came the fun part. I had to have a Halo attached to my head. The Halo would stabilize my head so that I couldn’t move during the gamma knife surgery. How could they ensure that, you ask? Well, the Halo pokes through my skin and into my skull in four places. That’s how! Thankfully I was anesthetized for that part of the procedure. After I woke up, I had this huge weight/pressure on my head and neck. I couldn’t lift it by myself. I had to get a quick CT (again, locked down to the table by the Halo) and then waited for surgery.

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On a side note – UVA took such great care of Lissa that day. She was kept informed 100% of my whereabouts and what was happening. Everyone she spoke with asked for her cell phone number and she was called a lot throughout my time behind the scenes.

Lissa and I finally met up again right before surgery, just outside of the procedure room. (Did I say that Lissa also wore a Star Wars shirt that day? She did! Double bonus kudos!) I was anxious to get this over with and was praying for a successful surgery. CLICK HERE for my thoughts on that.

I was taken into the surgical room without much fanfare. They locked me into another table and then everyone left the room. I was by myself, and the team communicated with me through speakers and a microphone. It was eerie.

I chose my music for the surgery – Guardians of the Galaxy soundtrack. (Spotify Link at end of post) I was placed into the machine, the music started, and of course, I had an itch on my head. I was told not to put my hands above my eyebrows, so I just had to suck it up. I was just getting into the music when it stopped and I heard over the speaker, “OK, we’re all finished.”

9 minutes. That was it. 9 whole minutes. I only listened to 3 songs. I had a much longer session planned out!

Think about that for a second. I was worked up, anxious, and scared, and all I had to do was get through nine minutes of surgery. It was much ado about nothing. The next time I start to get worked up into a frenzy about brain surgery I’ll try to remember this day.

Now, of course, we’re back into high surveillance mode. I’ll have to have brain MRIs pretty frequently over the near future.

The lesion grew, too. My pre-op MRI showed a 4-5mm lesion. That was good news from a certain point of view. We made the right decision going after this. It was, after all, not just a “spot” in my brain. It was definitely metastatic kidney cancer.

I’d like to thank the team at UVA. They were phenomenal. I felt cared for and uplifted every minute of that morning. They helped ease me through the fear and literally held my hands each step of the way. I never once felt like I was just another patient.

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