Is February really the shortest month?

...because it has felt interminable.
To begin, I'm still feeling healthy.  It has been close to three months that I've been free from acute symptoms.  We started the month thinking that if the next scan showed improvement or even stable disease, we could head back to Australia, get back to my job, and regain a semblance of normal life.  After several weeks of back and forth with the State Department, it now appears that I won't be medically cleared to return overseas and I don't have much input on this.  In some ways, these last two weeks have been harder to take than my original diagnosis.  I suppose I didn't realize the extent to which I had equated returning to my job in Australia with having turned the corner with my cancer - somehow that was the milestone in my mind that would turn our upside down life right again.

Spring

Forget Groundhog day, it has already felt like spring in San Francisco for about a month.  While the "best" (warmest in this context) weather in the City comes in the fall, I can't help but get swept up in the glories of the false spring even if it is destined to come to ruin in a few weeks in the form of premature dropped blossoms and second base marooned in a gigantic puddle.

The Emperor Of All Maladies

Perhaps this isn't a title which would catch your eye in a bookstore - The Emperor Of  All Maladies: A Biography Of Cancer by Siddhartha Mukherjee - but I can highly recommend it.  It was a Christmas present (ha!  Having trouble deciding what to get the recently diagnosed in your life, how about a 571 page history on cancer?) but I just got around to reading it last week.

Qualified Good News

Is there any other kind when dealing with health (or doctor's pronouncements)?
I had my four-month MRI yesterday and saw my oncologist.  I can say for the record that what began as an hour of torture in the Sci-Fi machine has become old hat.  I found myself drifting off, looking at my reflection in the control room window via a mirror attached to my "Hannibal Lecter goes out for the day" mask, wondering if GE was consciously channeling 2001: A Space Odyssey when they designed this MRI machine.  I used to find the hour of lying immobile in a small, noisy (imagine R2D2 getting slowly crushed in the Death Star's trash compactor) metal cylinder was an unpleasant experience that required visualizations (trying to recall the run in Hance in every detail) to endure but honestly, it doesn't seem like a very big deal anymore.  

A good laugh and a long sleep

There is an Irish proverb that says,"A good laugh and a long sleep are the best cures in the doctor's bag."  I have been laughing plenty but sleep has been hard to come by.  One of the most effective medications at helping to reduce brain swelling is the steroid decadron.  It seems that all brain cancer survivors spend some amount of time on decadron.  Unfortunately, decadron comes with a litany of unpleasant side effects - anxiety, irritability, elevated blood pressure, weight gain, and worst of all in my case, insomnia.

The Osher Center for Integrative Medicine

One of the most amazing aspects of receiving treatment at UCSF is that not only do we have some of the best oncologists in the world, we have the possibility of getting holistic, clinical care as part of the same medical system.  Rather than having to seek out treatments outside of the usual health care systems, UCSF offers integrative medicine under the umbrella of the rest of your care.  This also means that the practitioners can access your medical history and contact your other doctors as colleagues.  A few months ago, I wouldn't have appreciated what a profoundly revolutionary idea this is.

Treatment

We discussed our treatment options with our doctor - we could simply monitor the tumor with regular MRIs and hope that it is in fact a very slow growing cancer and discuss treatment when the tumor showed change.  It is a strange thought that I may have been carrying this cancer in my brain for a very long time without showing any ill effects.  We will never know this.  The doctor thought this wasn't the best option in our case and this made sense to us given that I had started to show some symptoms.

Diagnosis

Pre-surgery haircut - I only needed a small patch shaved

The day after my MRI, I saw a GP in Canberra who sent me to see a neurologist. While ruling out a diagnosis strictly from a scan, it appeared that my "migraines" were being caused by a brain tumor.

After talking with the doctor, we decided to return to the U.S., specifically to the University of California, San Francisco Medical Center (UCSF), for further evaluation and treatment.

The next few days were a bit of a blur. Colleagues at the Embassy could not have been more helpful and supportive and by some minor miracle, thirty-six hours later, we were boarding our San Francisco bound flight in Sydney having spent about an hour packing our bags.

When and how did this all start?

We began noticing that something was up around the time we returned to Washington for training after our posting to Yekaterinburg, Russia in March of 2010. I felt exhausted and could never catch up and feel rested. Given the circumstances - a mid-winter move from the edge of Siberia to a demanding training schedule at the Foreign Service Institute (FSI) in Arlington - it didn't seem too unusual and we just plowed ahead.