it’s not a pinched nerve
well, y’all, it’s been a crazy fucking week. let me start by saying i am alive and doing fine. however, last monday, i was diagnosed with several malignant melanomas in my brain. on wednesday, i had surgery to remove the largest one. i was home and cat napping by thursday afternoon. with the love of carol and our logical, biological, and feline families and you, my friends, i’ll get through this. a long adventure awaits me and i’ll face it with a positive attitude, my mother’s strength, and a morbid sense of humor.
back in december, i got really depressed. i’m a life long depressive and learned to live with it a long time ago, but december was different and harder than anything i’ve ever felt. it took all of my effort just to drag my ass out of bed in the mornings for my one minute commute to a job that i adore. i stopped exercising. i started gaining weight. i stopped listening to music. shit was just hard for no reason at all. since none of my natural coping skills were working, i figured i’d try some medical help and got myself a lexapro prescription.
the medicine did a pretty good job at tuning down my anxiety, but it seemed to make the depression even worse. in hindsight, maybe this was just a symptom of the ping pong ball sized melanoma living it up in my noggin; it’s hard to say. either way, by early february, i started weaning myself off the lexapro. around that time i noticed the tip of my left index finger had become a little bit numb. the only time it bothered me was when i was trying to button my britches. my finger couldn’t find the button hole, my pants were tighter than normal because of the weight gain, etc. since numb and tingling hands is one of the myriad side effects of lexapro, i didn’t give it much thought.
a couple weeks later, i was chilling with my left arm stretched out across the back of the couch when my hand flipped out for the first time. it felt like i was connected to a tens unit with the sensation of electrical pulses running down my wrist into my thumb, index, and middle fingers. the whole episode only lasted a few seconds and basically felt like a pinched nerve or something. the next morning, i went to my chiropractor who did a bunch of tests to rule out the obvious stuff, like carpel tunnel syndrome. he started treating me for thoracic outlet syndrome, which is a fancy form of pinched nerve. it seemed like reasonable diagnosis as we’d just gotten a new mattress that was much firmer than the one i’d wallowed out over the previous decade. and all the symptoms fit.
over the next few weeks, the symptoms only got worse. i started making lots of typing mistakes and eventually got to the point where i was only typing with my right hand. this pretty much destroyed my work productivity. and my depression got even worse. my chiropractor was getting pretty concerned that i wasn’t responding to treatment and that the specific exercises and stretches weren’t making any impact. he said it was time to get some imaging done. i haven’t had a general practitioner since i was 18, so i ended up going to urgent care to try and get an x-ray. (i’ll spare you the hilarity of going to a drop in clinic only to be told i needed an appointment, sigh…) the x-ray showed no signs of boney abnormalities that would support a diagnosis of thoracic outlet syndrome. neato. in the meantime, i made an appointment for a nerve conduction test with a neurologist, but it was going to take over a month to get that done. double neato.
carol got me an appointment with a GP in the hope that they might be able to accelerate the process. i was starting to feel like i was at the end of my rope and getting more and more depressed thinking a dumb pinched nerve was going to turn me into floyd the barber with a dead hand stuffed into my pocket for the rest of my life.
then last monday came around. i was going to do an early work call, take carol to the airport (she was going to the bay area for the funeral of one of her oldest friends), then head to my new GP appointment and get this shit figured out once and for all. during my call, my hand flipped out again and it was the worst episode yet. someone on the call asked me something and when i replied i was slurring badly. i muted my mic and furiously paced around the living room repeating the phrase over and over, wondering if i was really slurring, was i just imagining it, was i having a fucking stroke? i ran to the kitchen and carol looked at me and just said “we’re going to the emergency room” and away we went.
it took less than five minutes to get there and by the time i got to the intake desk, the slurring had subsided. within 5m, they had me in one of those emergency rooms with every kind of crash cart you can think of. within 15m i was getting a ct scan and before i could get back on the transfer gurney, the ER doctor ran in and asked them to get scans of my neck, chest, and abdomen. that’s when i realized i hadn’t had a stroke and that they’d found something just as bad, if not quite as emergent.
they moved us to a less scary ER room and i was hooked up to a bunch of monitors. the doctor came in and i saw the image on his ipad before he gave us the bad news. a giant white spot right where it shouldn’t have been. right then i felt the presence of my mom wash over me and i may have been calmer than i have ever been in my life. freaking out at that point wasn’t going to change the news i was about to hear. he said “i have some bad news. we found several lesions in your head.” the only thing i could think to ask was “plural?” and it was like an episode of oprah, he was swiping thru the CT slices saying “here’s one… and here’s one… and here’s one…” in all, there were eight. the ping pong ball, and seven smaller ones ranging from .3 to .7 cm in diameter. i was just like “fuck.” and i heard it my mom’s sailor voice.
if this had happened just an hour or two later, carol would have been on a plane and i just have no idea how things would have gone. other than being infinitely more scary.
over the next several hours, i had a bunch of MRIs and then got transferred by ambulance across town to the neuro/cranial critical care unit at st vincent’s hospital. tuesday was a blur of friends dropping by (i love my logical family so much) and nurses evaluating my mental capacity, pokes and prods of every sort and more MRIs. the ward was super quiet and dark and i am unbelievably lucky i didn’t have to do this ALONE like i would have if it happened during the pandemic. the neurosurgeon came by and explained everything that would happen on wednesday. that the hand flip outs i had experienced were actually focal seizures (as opposed to grand mal seizures), the size of the incision, the silver dollar sized hole that they would saw into my skull and how the hardware they’d leave in wouldn’t set off metal detectors, how they’d use the 3d map from the MRIs and a powerful microscope to pierce thru the outer cortex avoiding the neurons that control the movement and sensory perception in my left hand and then dig out most of that ping pong ball sized mass from my right parietal lobe, that the mass was most likely melanoma, that melanoma immunotherapies are really really good these days, that there was a non-zero chance that i’d lose motor skill and sensation in my hand (or worse), that my hand would temporarily feel better after the surgery, but i should expect it to get worse before it gets better, and that he didn’t want to sound like he was bragging, but that i was in good hands because he was the head of the neuro/cranial surgical department at the regional hospital, that he did 30 times more of these kinds of surgeries than any other surgeon in the region, and all the hard cases came to him. i don’t remember how i responded to that, but in my head, i thought “shit yeah johnny, at least he’s not a med student”.
on wednesday morning, the doctor came in and drew an R on the side of my head, which made me laugh, but was much appreciated. it would’ve been a pretty big bummer if they’d have dug into the wrong side. they wheeled me into the OR and they shot me up with some valium or something and the next thing i knew, i was back in my room and the surgery had been a success. everybody was all smiles. the night was uneventful (i’ll spare you the catheter talk).
on thursday, barely 24h after having my brains scooped out, they released me and carol took me home to the kitties. i don’t believe in god or a higher power and it doesn’t matter to me one way or the other. i do, however, believe in friendship, community, education, science and the steady progress that humans have made for thousands of years, whether it’s ancient mesoamericans successfully trepanning each other or modern americans successfully trepanning each other. all i can really say is that i love you and what a time to be alive.
the adventure continues.
