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Sat, Nov 21 2009 

Matt's Blog

Editor Matt Lane offers observations and insight

Dr. Mindfreak: Or how learned to stop worrying and love the brain

Well, I’m in the system and being shuffled from place to place as my Nov. 19 brain surgery continues to come at me like a freight train with no brakes.
On another trip to T-Town today, Dr. Raphael Francisco, an endocrinologist, gave me a thorough going over and it seems the tumor I have is pressing on my pituitary gland causing my body chemistry to go haywire. It’s making me fatter by the day (that’s a real joy), it may be causing my body to forget just how important water really is, it is causing me sleep problems and some more stuff that would be, as the kids say, TMI.
Dr. Francisco is putting his formidable skills to work looking at a blood tests I had taken at McAlester Regional Health Center (By the way, the Saturday morning lab team deserves a big raise and a big pat on the back, Mr. Begs. They are terrific people, dedicated to us patients and I was so blessed by their care). He said we’ll see if some of the pituitary function straightens out after the big cut.
I am set for a pre-op appointment on Monday (Nov. 16) to get the final instructions about the surgery set for the 19th.
My mom, Louise Lane, a very skilled RN, is flying in on the 17th and we are going to pay a visit to my family doctor, Dr. Nelson Onanro (who is as fine a man and as good a doctor as you’ll ever meet). In addition, I am hoping to see my doctor from the Choctaw Nation Indian Health Center, Dr. Paul Chin (a doctor of uncommon skill), before the surgery to make sure all the right stuff is happening and to let him and his nurse, Gardy (a saint among us), know what’s up.
My dad, Carl Lane, will also be here on the 17th. He and my mom divorced I’m sorry to say, but its nice they’ll both be with me on the fateful day.
Am I scared? Sure. But get this: Churches here in McAlester, in Yuba City, Calif., Checotah, Muskogee, Oklahoma City and other are praying for me. Also, I have received so many good wishes and offers of prayer from people that I am left humbled. Thank you all for this. There are no words to describe how I feel about all these good wishes and prayers.

November 09, 2009 03:53 pm

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Counting down the days; counting up the cost

Death.
That’s the worst outcome that could befall me on Nov. 19 when I am scheduled to have a craniotomy to remove a tumor that is causing me no end of problems. I had to accept that I could die during surgery or after or before or in ten seconds or ten days or ten years before I could really settle down and get my mind right.
Was it Thoreau who said that illness has a way of focusing the mind? Whoever it was, they were right. There are myriad little problems and petty battles which swirl around me everyday; however, of late none of them seem to have very much significance to me. A fight for my life is under way and I am focused. Funny thing is I’m not focused on my health; it’s what this is all going to cost that weighs heavy.
The U.S. House of Representatives passed a muddled health care bill late Saturday that will a) save health care from total meltdown or b) turn our country into a socialist state where government decides who lives and dies. I predict it will do neither.
Insurance companies already decide who lives and who dies and health care has already melted down. It was a great idea (I’ll life a lyric from Bob Dylan here) until greed got in the way. Keeping us healthy shouldn’t be about money but you can bet your bottom dollar it is. Don’t believe me? Get sick, I mean really sick, then let’s talk. I should be concerned with how I can recover from my upcoming surgery, instead I’m worried about how my gutted Blue Cross plan is going to pay or not pay for what’s coming up. I’m also worried that the Indian Health Service (I’m a member of the Cherokee tribe and am eligible for (cue the evil music) government-run health care will tell me tough luck buddy, but there be no help from us this time.
Of the two, I much prefer the Choctaw Nation Health Service. They do what they say and my wellness is what matters (I hope that holds true this go around). Blue Cross just wants higher co-pays, $200 out-of-pocket for each day I’m in the hospital plus $70 co-pays to see a specialist, huge deductibles and more money on top of more money.
Private health care isn’t so hot for most of us as corporations cut back on what is paid for and ramp up out-of-pocket costs. I’m not biting the hand that feeds, most companies have had to adjust health plans and I am grateful for the coverage I do have. I’m just saying it costs more and more each year.
Under my plan, generic drugs are $15 a pop, “preferred drugs” are $55 each and the dreaded “non-preferred” drugs are $75 each.) All the while this “insurance” company won’t pay for smoking cession drugs or for a lap band to help a super super morbidly obese fellow like my self get my BMI down from 67 to something a bit less lethal.
So I wait. Under the rules, I can’t check into the hospital the night before my 7 a.m. surgery, Blue Cross says that’s not really needed. They also say four days and out the door. We’ll see about that. Seems to me since they’ll be laying a big chunk of my brain bare to the open air, four days seems a bit slim.
Am I afraid? Yeah, but so what? Worry isn’t going to make this tumor magically disappear – that doesn’t really happen in real life — so I’m going to walk down this road see what lies ahead. What else can I do?

November 08, 2009 03:35 am

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Seeing is believing

I spent some time at Dr. James Dunagin’s office Tuesday doing a visual acuity test. In simple terms, a computerized device measured how well my eyes are working. The result: Not so good. My left eye is very bad, and my right eye isn’t so good either. The good news is the left eye isn’t as bad as it was in 2007. Does that mean the tumor is smaller? I hope.
A word about the office staff at Dr. Dunagin’s eye surgery clinic: Fantastic. They are helpful, courteous and caring. Who could ask for more? They also work for a real hero. Dr. Dunagin is a healer in the truest sense of the word. He works for his patients and their well-being. Don’t take my word for it; ask anyone he’s ever treated.
On Friday I’m off to Tulsa to see the neurosurgeon. I’ll take my visual acuity test results and my MRI films with me so Dr. Patrick Han can have a look. I’ll no much more after that appointment.
So far, moneywise, I’ve had to pay about $110 in co-pays and about $20 for medicines. That’s not bad but the worst is yet to come.
That’s the latest. There may not be much to write about until after the Friday appointment, but I’ll try to fill in some of the blanks after I see Dr. Han.

November 04, 2009 11:13 am

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I'll see the top doc Friday

I heard from Dr. Patrick Han’s office — he’s the brilliant neurosurgeon who removed a tumor from my brain in 2007 — and it looks like I’ll have a consultation with him Friday morning in Tulsa.
Before that, Dr. Han wants me to see McAlester’s top ophthalmologist and all-around nice man, Dr. James Dunagin, for a visual field test to see just how bad my eyesight is. The 2007 tumor caused profound blindness in my left eye and this one seems to be doing the same thing. Dr. Dunagin will know for sure. I don’t have an appointment with him yet, but I hope he can see me this week.
The whole tumor experience is weighing on me. It is hard to know I may face another surgery and maybe even radiation treatments and chemotherapy. I’ll do it all, but I’d rather not. Tough luck, editor, it is what it is.
There is some good in this, however. I’m reminded that there are lots of people who care about my well-being and me. That’s good stuff and will help me as this whole thing progresses. Keep the prayers and good wishes coming — I think I’ll need everyone of them.
I also am blessed in that I have fairly good insurance through the newspaper and as a member of the Cherokee Nation of Oklahoma; I get help from the Indian Health Service in the form of the super folks at the Choctaw Nation Health Clinic in McAlester. Also, I have a great family doctor, Dr. Nelson Onaro, looking out for me. I am using a mix of private health insurance and government-run health care to get through this. I hope I’ll have the wherewithal to write about this in depth as time passes. There are pros and cons to both, and I should be able to offer some first-person observations. First, though, I have to find out what my treatment will be.

October 31, 2009 05:14 pm

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Next stop: The OR (maybe)

It is official – the tumor is back for an encore. The radiologist confirms that I once again have a craniopharyngioma. The tumor is pressing on my optic nerves (I’m going blind); the tumor is messing with my pituitary gland; and it is pressing on a vascular artery.

In case you missed it, here’s the Wikipedia take on this type of tumor:

They are very slow growing tumors. They arise from the cells along the pituitary stalk. They are classified as benign.
Craniopharyngioma is a rare, usually suprasellar neoplasm, which may be cystic, that develops from the nests of epithelium derived from Rathke’s pouch. Rathke’s pouch is an embryonic precursor of the anterior pituitary.
Two distinct types are recognized: adamantinomatous craniopharyngioma and papillary craniopharyngioma.
On macroscopic examination, craniopharyngiomas are cystic or partially-cystic with solid areas. On light microscopy, the cysts are seen to be lined by stratified squamous epithelium. Keratin pearls may also be seen. The cysts are usually filled with a yellow, viscous fluid which is rich in cholesterol crystals. In addition to a long list of possible symptoms, the most common presentation include: headaches, growth failure, and bitemporal heteronymous hemianopsia.
TREATMENT: Consists of subfrontal or transsphenoidal excision (with adjuvant radiotherapy, if total removal is not not possible).

If you would like more information, this is a fairly comrehensive site: http://emedicine.medscape.com/article/1157758-overview

I saw my favorite family physician today, Dr. Nelson Onaro, and he is working with me to get things rolling. Surgery most likely but I’ve yet to hear from the neurosurgeon, Dr. Patrick Han.

Writing about this is a bit hard tonight. I’m still not at terms with it. I went through this two year ago and I’m not ashamed to say I’m not ready to go through it again. What can I do? It is what it is. I’ll do what I must but I don’t see how quite yet.

I want to say thanks to all the people who have wished me well, kept me in their prayers and sent good vibes my way. I need them, every one.

October 29, 2009 08:26 pm

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The waiting

I’ve had my head examined – magnetically – and I’ve looked at the films. Of course I see a brain full of all kinds of mysterious shadows and shades of grey – even at least one alarming white spot – but I don’t know what I’m looking at. It is, like so much of modern medicine, a mystery to a layman like me.

I had my MRI in Texas because the folks who run the imagers in our part of the world say I’m just too big to get on their precious machine. Not so with the folks down south. From the time I checked in until the time I left, I was treated with dignity and great care. The radiologist spent time with me before the scan talking about my tumor two years ago. Like any good doctor, he wanted to know what I thought and how I was feeling. I’ll be having all my MRI’s at this place in Texas (Preffered Imaging in Corinth, Texas).

I am told the results of this test will be sent to my doctor at the Choctaw Nation Indian Health Center here in McAlester (a shining example of just how good government-run health care can be – these people are top notch) and to Dr. Patrick Han, the brilliant neurosurgeon who saved my life two years ago, sometime in the morning. I’ll be here, at home, waiting. I am just too worried to do my job. Too self-centered to give any of my attention to much else than finding out if I’m going to have to have my head cut open again or if some other malady is at work in my body.

When I find out what’s what, I’ll try and write something here but even this has been a struggle. The words are not flowing, the muse is mute and my mind is elsewhere. It has been said that illness focuses one’s mind and separates the wheat from the chaff. I am as focused as I think I’ve ever been. I know what’s ahead if there is a tumor and that is enough to ponder.

October 27, 2009 08:58 pm

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One more for the road

I was at the Brady Theater last night and was lucky enough to catch what was and incredible show by one of America’s greatest poets, Bob Dylan. I watched and listened knowing that later this week I’ll know if I’ll have to face a second brain surgery or if there’s nothing there.
My sight is continuing to deteriorate so I saw the show with a bad left eye and a so-so right eye. I was up front, second row to the left of the stage, so it was OK. Thankfully, whatever is wrong up in my head hasn’t affected by hearing so I heard every note of every song.
Tuesday I travel to Denton, Texas for an MRI — the big, bad test which will tell the tale. I imagine it’ll be Thursday or Friday before I get the news and the prognosis. The waiting is tough, but what can a person do? Borrow trouble? Fret? Wring my hands and demand to know “Why me?” Well, I’ve already done all of that and I’ve come to realize it’s all out of my hands. What is will be will be and I’ll have to move on from there.
In the coming days I hope to explain how the health care system is dealing with my particular situation. I’m using a mix of private health care and a government-run system, so I hope I can shed some light on these very important topics. This is health care for keeps for me and I hope it works.

October 25, 2009 01:51 pm

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A road once traveled

Seems I might be going through the whole brain tumor thing one more time. I’ll find out next week for sure, I’m off to Texas for an MRI on Tuesday. I’m a big guy and my health care professionals had to find an industrial strength machine to support me.
I am torn about blogging about this whole thing. It is very personal, but it also is something I can share with readers at a time when the nation is deciding what road to take when it comes to health care. This is health care made real for me: If there is a tumor its either surgery or chemo and radiation therapy, maybe both.
I am fortunate in many ways: I have a loving family who will walk this road with me the whole way; I have insurance and I am a member of the Cherokee tribe and am blessed with the resources of the Indian Health Service. In fact, it is the staff at the Choctaw Nation Clinic in McAlester who took up my cause and found a suitable place for my MRI. They are very special people and they work very hard for the patients, even fat old men like me.
First, a little about the tumor: This is from Wikipedia and outlines the type of tumor I had in 2007 and may have now:

Craniopharyngioma is a type of tumor derived from pituitary gland tissue, that occurs in children and men and women in their 50s and 60s. (I am 47) It has a point prevalence of approximately 2/100,000. They are very slow growing tumors. They arise from the cells along the pituitary stalk. They are classified as benign. Craniopharyngioma is a rare, usually suprasellar neoplasm, which may be cystic, that develops from the nests of epithelium derived from Rathke’s pouch. Rathke’s pouch is an embryonic precursor of the anterior pituitary. Treatment consists of subfrontal or transsphenoidal excision (with adjuvant radiotherapy, if total removal is not not possible).

What that all means is there may be a tumor located near my pituitary gland that is kinking up my optic nerves so I’m losing my sight (very bad in the left eye, not so much in the right), I have headaches when I wake up, I gain weight like nobody’s business and a whole host of other annoying maladies related to the tumor are afflicting me more and more. It isn’t any fun.
What happens next? I hope there’s nothing in the MRI and this can all be explained by some other disease that can be fixed with one pill a day, some exercise and plenty of fluids. I’ll let you know how that turns out.

October 22, 2009 04:04 pm

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Stuck inside of my house with the newsroom blues again

I hate being stuck at home just because a doctor says I should let something heal before I go back to my normal routine. In this case, the thing is a leg. Great, my leg keeps me from being where I want to be – surrounded by the best journalists in the state in the best newspaper newsroom in the country putting out the award-winning McAlester News-Capital for the smartest newspaper readers on the planet.
Phooey!
Sure, some would say “relax, take the time to recharge your batteries,” or some such rot. Sorry, but when you’re given the privilege of doing the job I have, you really don’t want to miss a day of it.
I called in today and was soundly told to butt out. We’ve got it covered, thank you so rest or whatever the heck you’re supposed to be doing while we cover your, well you get the picture. I know I did.
The problem is with all these electronic gadgets (e-mail, texting, iPhones, Web sites) it’s hard to actually not be involved in this business. The e-mail doesn’t stop because my doctor said stay home. I still get text messages, I still am forced by some unseen muse to either write for (I’m doing it now) or read from the www.mcalesternews.com Web site and the phone lines and cellular circuits are still working just fine. See? I blame all this modern stuff for my inability to actually let go of my work. How could I? I mean my legs gamey, not my brain (I know some of you would argue that point – and often do).
Anyway, I won’t be calling the office anymore. I can take a hint and I know the hard working journalists and editors are doing just fine without me. Sure I know it, but it’s going to be hard to wait for Tuesday morning to roll around so I can dive right back in.

September 18, 2009 12:20 pm

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The poll and the DA

So District 18 District Attorney Jim Bob Miller didn’t find much support on our online poll when visitors to this Web site were asked if he should resign. Here’s how things ended up at 6 p.m. on Tuesday:

Poll Results
In the wake of his deal with the attorney general’s office, should District 18 District Attorney Jim Bob Miller resign? Yes 92.34%
No 7.66%
731 votes counted.

The vote tally was high but always remember this when considering newspaper Web site polls: This poll is not scientific and reflects the opinions of only those Internet users who have chosen to participate. The results cannot be assumed to represent the opinions of Internet users in general, nor the public as a whole.
It would be best if Miller would step down, but it looks like he’s going to dig in his heels and thumb his nose at decorum and what’s right. Too bad.

September 15, 2009 06:02 pm

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