This just in…

 078DUMC Action News, here, live on the scene of an apparent hostage situation currently in progress.

We have one hostage, a 35 year old man. And a male captor of unknown age at this time.

We are currently at the home of the 35 year old man where, my sources tell me, this situation has become increasingly volatile.

Authorities are on the scene at this time. They have brought in a negotiator to communicate with the captor and hopefully end this situation as soon as possible.

I will update you as information becomes available.

This just in.

We are remaining on scene, at the home of a 35 year old male that had been thrust into an unimaginable hostage situation.

The chief negotiator, Dr. Allan Friedman has been one on one with the suspect for some time. It appears as if he’s trying to remove him from the scene. Negotiations are in progress.

I will update you as soon as information is available.

This just in.

Our chief negotiator has left the scene. The suspect remains, but is seemingly less powerful and angry at this time.

Updates on the 35 year old man are as follows: He is in a lot of pain. He is having extreme difficulty speaking and is disoriented.

But, the negotiator, in no uncertain terms, said that the man will be ok.

Back to you in the studiNOOO!!!!

WAIT! There’s a new captor on the scene! I say this in hushed tones, as the situation is growing more intense and dangerous by the minute.

It appears that this new captor is trying to hurt the victim in a way that is indescribable at the moment. They seem to want to make the victim sick in some way. Negotiators are enroute back to the scene with follow up.

Chief negotiator Friedman says that, indeed, this is a new captor and he’s just as, if not more, sinister than the first. Both remain with the man in the house, but apparently the second captor has taken over negotiations. It’s anyone’s guess at this time on how this situation will proceed. Tensions are very high here.

What we do see now is a HazMat crew, dressed in full garb, headed into the house! They are using chemical warfare to try to neutralize the second captor’s strong hold on the victim. It will take time before the outcome of this extreme measure is fully understood, but as of now, they are saying the second captor has been neutralized. They have promised the use of more chemical warfare if he should try to regain his power.

This just in.

The first suspect still remains with the victim. He’s requesting ransom.

It appears that instead of taking the victims life, the suspect will instead take his full ability to speak and his cognitive ability.

What is this? What kind of captor takes a persons ability to speak and to think clearly? How could they be so cruel? So incredibly and undeniably selfish and sadistic? This situation is a first for me, folks. A first in my 36 year career.

Chief negotiator Friedman has asked the suspect if he can talk to the victim. The suspect has agreed.

The man has emerged! His is pale, slight and has a look of fear and confusion on his face. Friedman is communicating, but the victim can’t talk. No everyone. It’s not that he’s refusing to talk, it’s that for some reason, despite their best efforts, the captors have managed to get one over on the authorities at this time. I am just as surprised as you are, guys. I cannot fathom how this will play out.

The next step is to bring in the big guns. This isn’t what the negotiators want to do, I’m told.

The big guns include the use of radiation and a more intense chemical weapon than before. They are discussing options. They want to see how the suspect responds.

Right now the victim, the 35 year old male, is trapped. The situation seems hopeless. The captor wants more than the man will give. He wants his life, but the man is adamant that he won’t get it. His resolve is strong and his fight is obvious, even from an outsiders point of view.

I’m told now that we wait. Wait? What the hell?! We can’t wait. This man may die, I tell you!!

Chief negotiator Friedman has explained to us that in situations like this, it’s best to wait and if the suspect tries to create a stronghold again, they will use their other options. He also is explaining that the man, now a 35 year old man named Chris, will have irreparable damage from the suspect’s, now named Chuck, first assault. He will have to learn to speak again and he will have to learn to orient himself in a disoriented world. The man, it was said, can only speak a few words at a time.

Apparently, the suspect got what he wanted.

What kind of hell is this man going to live in?

That remains to be seen, at this point.

Authorities have left the scene.

This has been DUMC Action News, reporting live from the scene of a Brain Tumor and it’s friend, Serratia Infection.

Back to you…

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So, we had a little set back…

A set back.

Twice.

Last week we were fine. Chris was getting better and we thought the worst of the healing was behind us.

Then, it happened.

He didn’t know my name.

What? You don’t know my name? I’m Allison. You know? The only name he remembered after the first surgery?

Yep. Gone.

So, I called the doctors and then I gave them two choices. Either they would see him in the clinic or they would see him in the ED. They wanted to see him the next day. I told them they would see him in the clinic or the ED. They chose the ED.

We got to the Duke ED and there were people everywhere! I knew there would be a hell of a wait, but I knew we were in the right place. Then I heard from behind the counter “Hello, Mrs. Branch Padgett!” It was my friend Jeff who I had worked with so many years ago, but who still remembered me and whose face was a shining beam of sunlight at that moment. We were triaged and taken back quickly. Not because I “knew people” but because Chris was sick and they knew it.

The ED doctor looked at him and immediately called the neuro team. About 45 minutes after being back in the room Dr. Allan Friedman stood at Chris’ door. He just happened to stop by the hospital on his way back from Colorado when he heard the page. Seriously?

He looked at the incision site, now obviously infected, and said to get an OR ready and he’d take him to surgery.

Right now?

Yes. Right now.

So, they started an IV and wheeled him to the OR. By this point, Chris is holding his head going “No. Not again. Not again” It was awful, but I knew it needed to be done and this time he would be asleep. That calmed him a bit. When we got to the OR doors I had to kiss him goodbye. There was fear in his eyes, but I could only reassure him that he was going to be ok and they had to do this now. I kissed him and told him that I loved him so much.

Then they shut the doors.

The silence that I heard after those doors shut was deafening.

There I stood with his belongings in a bag, holding his tennis shoes and it was silent.

So, I walked to the waiting room. The same waiting room that we were in before. This time it was night and most of the people had gone home. I sat. Alone.

I cried. Alone.

I cried like I haven’t in a long time. I sobbed from the very bottom of my being.

I needed that sob. I needed that time. I needed to be alone. But, I was happy to see his mother after an hour or so.

Dr. Friedman came out and told us that everything was done and that he’d be in recovery soon. That he had an infection and that he would be treated with antibiotics and he’d be ok.

The man I met in recovery was not ok. He was a different person. I didn’t know him. And I was confused. I chalked it up to the drugs that were wearing off and that he’d get better when he was more comfortable. He didn’t. He was agitated. He was angry. I didn’t know what to do. The nurse told me that it’s from the swelling. “When the swelling goes down he will get better” So I sat in the recliner by this man that I didn’t know and hoped that the swelling would go down.

It hasn’t

We were discharged home with a PICC line and IV antibiotics and a reassuring “It will get worse before it gets better, but it will get better!”

It hasn’t

The days that followed at home were trying, to say the least. He is often and easily agitated. He only has sounds instead of words. No words? Yep. No words. Just sounds of frustration and periods of sleep.

Yesterday, I noticed some drainage coming from the site again. And he seemed more confused than just a few hours prior. So, I called the doctors. Again. And we went back to the ED.

He was seen. A CT Scan was done and they decided to let him go home and then to just monitor him. But, as I got my car from the valet the resident comes running outside.

“Wait! Dr. Friedman was driving home and had a second thought. He wants to take him back to the OR!!”

What? We were just going home, but ok. So, they do another CT scan and I can see him for a second before he goes back this time.

“I love you, honey. It will be ok.” I gave him a kiss and he just said “Ok”.

Then the doors shut. Again.

The man that they took back isn’t my person. He doesn’t even know my person.

Chris will show tiny bits of emotion every now and then. A little smile here and a little chuckle there. There are bits and pieces of the man I love trapped in this body ravaged by brain surgery and its subsequent infection. It is scary. It seems hopeless.

But it’s not hopeless. There are pieces in there and I’m grabbing those pieces. Every single one. I will grab every piece and I will gradually put him back together.

It is a daunting task for one person. One that is full of uncertainty.

And I wouldn’t have it any other way.

An open letter to my husband’s brain tumor

Dear Chuck,

Dare I say “dear”, you quarter sized asshole? Well, I guess I should, as I do want to be as nice as possible, so you’ll act accordingly.

My name is Allison. We actually haven’t met, but I’m sure you know my voice. I’m the high pitched, female, muffled sound you’ve heard for your whole life. You know? The one that at one minute is loving and sweet and the next minute reaches octaves only our dogs can hear? Yep. That’s me.

I thought I’d introduce myself so you and I could get to know each other better and you can begin to see things from my point of view. You see, I understand you already. You are happy and warm and just’a growing away in my husband’s cranium. I’m sure that grey thing that you’re pushing on, his brain, is nice and smooshy. I’m sure it’s pretty comfy in there.

Now, I know two weeks ago, when a mean man opened up Chris’ skull with a saw and cut about 75% of your gelatinous body away, you got pretty mad. Understood. That had to suck for you, Chuck. I mean, damn, I’ve never been cut into third’s, but I’m sure it’s no fun. I really do see that.

What I need you to understand and the reason I’m writing this letter, is I would like you to see things differently. You’ve been “in the dark” about all of the things going on on the outside of my husband’s skull and I think it’s time you have a reality check.

I fucking hate you.

Period.

You see, in the past year and a half you’ve been causing some problems and I’m going to need you to stop. I’ll start from the beginning and work our way up to now, so you’ll be able to get a true understanding of what life on the “outside” is really about. I assure you, this will be life changing and it is my hope that we can come to a genuine and adult agreement.

A few months before August of 2014, I’m assuming you took up shop inside what you now call your home. The reason I say this is because in that month, of that year, you began to show yourself.

I appreciate your subtlety in the beginning. Chris would’ve been really scared if you started off the way you do things now.

You picked a pretty crappy area to live. You see, you don’t know it, but you live at exactly the part of my husband’s brain that controls his speech and language. The part that allows him to talk, think and express himself. So, by growing right there, you started to effect his speech and cognition.

At first, it only happened every now and then. You’d grow and he’d not be able to speak for a few minutes. He’d not be able to think. Then, I think you got a little too comfortable and just grew your happy ass off.

From the outside, I didn’t know that, of course. I stayed oblivious to your devious course of action and watched the man I love suffer with fear and frustration. I watched in confusion as he would stare blankly for a few seconds. Then his eyes would show pure fear. Next he would try to speak, but NO, you wouldn’t allow that. You’d just push a little more. Finally though, he’d gain control again. Slowly, he’d fight you and he’d win. You tried your best, but damnit, he was stronger. Every time you tried to do this, even when you started to do it more, he fought. Why, Chuck? Why did you keep doing this to Chris?

We’d had enough of your antics and went for an expert opinion. This is when we finally saw you for the first time. I have to say, we were surprised. In your day you were a pretty large tumor. Albeit, gelatinous and gross. But, large nonetheless.

That expert was that man you met two weeks ago. The man with the saws and knives. He’s on our side, if you haven’t guessed and he pretty much despises you, too. Even more because he had to leave some of you in my husband’s brain.

Now, this is the part that I talked about earlier. The part where we come to an agreement?

You see, I love Chris. I know you need him for life, but I’m not sure that you realize that I do, too. He’s the part of my soul that God misplaced when I was born.

And there’s something else. Actually, “something’s” else. You know those tiny muffled voices that you hear all day? The laughing, crying, playing, loving voices? Those are Chris’ children. You probably didn’t know about them when you moved in. I understand that. That’s why I’m telling you now. There’s a girl. There’s a boy. And they need their Daddy. He’s their knight in shining armor. The foundation of their playhouse and the blanket of safety they sleep under every night. They love him. They need him. They deserve him. And you simply cannot take him away from them. Without him, they won’t have their Tickle Monster. They won’t have their Red Light Saber wielding bad guy or their handsome date for the Daddy/Daughter dance. His boy won’t know to open the car door for his first girlfriend and his girl won’t know that a gentleman does that every time. His boy won’t have a best man at his wedding and his girl won’t have him to walk her down the aisle and (much to his dismay) give her away.

See, Chuck? I’m going to need you to stop. Just stop. I’m asking nicely in hope that we can come to this mutual agreement without arguing. Arguing will only make things worse for you and Chris. Mostly you. You remember that mean man? Want to see him again? Stop growing. Do you want to be chemically poisoned to the point that you wither and shrivel? Stop growing. Want to be hit with a beam of light and burned alive? Stop growing. For the love of all things HOLY, STOP GROWING! (Sorry for yelling)

You can stay, Chuck. Just chill out. I mean, damn. Just leave him alone. Chris will give you that nice cushy home you’re accustomed to and we can all be one happy family. I’m all for it, Chuck. Chris, me, the kids and you.

So, from me to you, please hear my cry. Please, try to understand. Life on the outside is very different. Life on the outside is complicated.

What I need you to comprehend is that life on the outside isn’t life without Chris. It will cease to exist without him and with all that I am and all that I’ll ever be, I beg you. Leave him alone and let him live. Let him be the light that he is and let me keep that piece of my soul.

Sincerely,

Allison B. Padgett

A Happy Little Misstep

My first attempt at a Daily Prompt….

Misstep

Upon reading this word, I have two completely different thoughts.

Beginning and End.

Is it not true that a misstep can cause you to look at things in a whole new light?

Is it also true that a misstep can mean the end of something that was important to you?

I’ve experienced missteps in my life more than a few times. I think we all have. And I’d be willing to bet that most of us have pretty strong feelings that said missteps were either the beginning of a brand new chapter in our lives or the closing of an entire novel that we never imagined would end.

There was a time in my life, as a teenager, when I felt as if I was on top of the world. Remember that feeling? The no responsibilities, invincible feeling? I also felt, and had been told and lauded mercilessly, that I was the best singer this side of the Mississippi. So I sang. In school, in plays, for the Governor of North Carolina! And boy, that feeling was pretty great. All those eyes on me and then the applause for a job well done. After high school, I decided to sing at a HUGE university. Within about a week or so, I realized that I just might not be as good as I thought I was. Humbling. Oh, so humbling. So to compensate for this new found “flaw”, I began to fail my classes. I began, what later in life, would be called a misstep. I had all of the pieces to a perfect puzzle laid out in front of me and instead of choosing to put them together peacefully, I chose to toss them onto the floor and walk away.

I failed out of college. I failed out of college because my self esteem received a blow that I found devastating. Little did I know that this misstep would lead me to the school, that led me to the job, that led me to the career that would change my life.

I am a Paramedic. I hated college classes with a passion, but paramedic school was so enthralling to me. I enjoyed every single lecture. Every single hour of clinical and hospital time that are seemingly countless.

Dropping out of college because of my immature and damaged self esteem, led me to take a nursing assistant class to get by. That led me to a job in the Emergency Department at Duke University Hospital. And finally, that job led me to a love of emergency medicine that has no bounds.

So, I ran with that passion. I went to Paramedic school! I had a few rough starts, but in the end, landed in the right class, with the right instructor, at the right time, and with the right people to endure/enjoy the trials and tribulations that is Medic school. I had found my niche.

And it was all because of a misstep.

Misstep

The Diagnosis: Oligodendroglioma Grade III

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Have you ever found a stray animal and not wanted to name it because you couldn’t keep it and naming it would make it yours? It would make you own it?

Well, it has a name.

Oligodendroglioma-Grade III

We own it.

 The Preston Robert Tisch Brain Tumor Center at Duke University Medical Center

What a lovely place. What a big place. What a very easy to get lost and walk five miles in, place. I wondered as we rushed in, who is Preston Robert Tisch? He was clearly someone special. Clearly someone who made an impact with his life. I thought Mr. Tisch probably had no idea the impact that just his name would mean to so many people for years to come. And then I thought that Mr. Tisch probably would never know. Mr. Preston Robert Tisch is most likely dead. Forever associated with the very thing that took his life, but forever associated with the ray of hope that thousands of people seek out during the scariest, most uncertain time in their lives. The time when they hear the words, “You have a brain tumor.”

Dare we think positive? Dare we think the word benign? Dare we doubt the best neurosurgeon in the world’s preliminary diagnosis? I’d be lying if I didn’t say that a tiny, itty bitty part of me still believed in a miracle at this time. Naivete! But, nonetheless, a woman, in love with her husband, who wanted an answer that I knew wasn’t going to come.

Oncologists are like robots. They have to be, I guess. They can’t care too much about each and every patient they encounter because the nature of their very discipline has a high mortality rate. They try things on patients that work and then they try things on patients that inevitably shorten their lives. It’s all the nature of the beast. The beast called cancer.

Chris’ doctor is matter of fact, but with the information she had to relay, matter of fact was welcomed.

Brain tumors are measured in Grades, not Stages.

Chris has Grade III Oligodendroglioma.

There are only four Grades.

His cell proliferation index shows a high level of tumor recurrence.

He will be monitored with an MRI every two months for the next year.

At any point, during that year, the tumor recurs, repeat crainiotomy, chemotherapy and radiation will be discussed.

The chance that it will regrow or reappear is high, as some of it still lies in wait, deep within his brain.

Some people live for 15 years with a tumor of this magnitude.

Some people last only a year or two.

Genetic markers in Chris’ tumor suggest he lies somewhere in the middle of the life expectancy range.

He will continue on an anti-seizure medication to stop the “episodes” he was having, were they to somehow come back.

Chris agreed to participate in a clinical trial for a new medication that’s being developed.

He donated his tumor and doctors will use it to see if the drug will kill the cancer cells and at what rate. 

All in all, a close eye is what they want to keep on him and MRI’s will be very important in the next few months.

Any proliferation of cells by the first MRI in two months is something that could potentially kill him in less than a year.

Non-growth shows the potential for many more years of a happy life.

Only 34% of patients with malignant brain tumors live past FIVE years.

And that’s it. I have feelings about this list, but as of now the thoughts in my head are so loud that not a single, solitary emotion can be heard.

One Week Later: A day in the life of a CANCER patient

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A day in the life of a cancer patient is just like the day of any person really. All except for that one thought in the back of their mind. “Is today the day that I become the past?”

We all do it. We wake up. Go about our days and never once think about the day that someone will refer to you in the past tense. “So and so WAS so nice. So and so WAS a good friend.” It never occurs to us to think that way. We haven’t been told that something foreign is invading our bodies or our brains. We go on about our day and are blissfully unaware of our own mortality.

Why do we do this? Because it’s easier. Because no one wants to talk about the end. Hell, we barely want to talk about the future. Much less, the end.

But to a cancer patient, the future is the end and now is all you have.

6:00 AM

Wake up. I hurt. I hurt bad. “What hurts?” Everything.

6:15 AM

So many pills. Do I need this many pills? “Yes, honey. Just take them two at a time”

6:45 AM

I’m starting to feel less pain. Is that right or am I still in a fog from sleep?

7:00 Am

OK. Pain is controlled. Not gone. Controlled.

7:30 AM

More pills? “Yes, honey. They are your steroids, remember?”

8:00 AM

I’ll drink this coffee and think about what to do with all of the junk under the carport “Honey, time for your medicine.”

8:45 AM

Should I blow off the driveway? I should blow off the driveway.

9:00 AM

I’m going to blow off the driveway

9:30 AM

Blow off the driveway

10:00 Am

Driveway looks great! “Honey, time for your medicine.”

10:30 AM

I’m going to get this junk out from under this carport!

11:00 AM

Damn, my carport looks nice!

11:30 Am

Come look at the work I’ve done! “Honey, you’ve done too much, again and it’s time for your medicine.”

12:00 PM

“Medicine, love!”

1:00 PM

What a nice conversation I just had on the phone! My speech is getting a little better…at least I think that it is?

2:00 PM

“Do you need medicine right now, love? One or two? Whichever you need.”

2:30 PM

 “I wish you’d take a nap!” I wish she’d just leave me alone. I’ll sleep when I damn well snnoorreeeeeeee……….

3:30 PM

“Here comes the steroid train! Choo Choo!” Oh my God she’s a dork, but you gotta love her.

4:30 PM

“You need to eat something.” I’m not hungry.

5:15 PM

I’m so hungry. What’s for dinner?!

6:00 PM

“It’s pain medicine time, love. Do you need any?” Just one this time. Just one.

7:00 PM

“Time to clean your staples. They look so good!!” How can staples look good?

7:30 PM

“Time for my muscle man to take his steroids!!” Wow. The woman will do anything to try and make me laugh.

8:00 PM

I think I’ll watch TV

8:30 PM

There’s nothing on TV

9:00 PM

Yes! Harry Potter on ABC Family! Score!

10:00 PM

“Anti seizure medicine and pain meds if you need them” Just Anti seizure for now, thank you

10:00 PM

Sleepy Time

12:00 AM

whisper “honey, it’s time for your medicine. here’s your water. i love you.” Ok, ugh.

2:00 AM

whisper “honey, it’s time for your medicine. here’s your water. i love you.” Ok, ugh.

3:30 AM

whisper “honey, it’s time for your medicine. here’s your water. i love you.” Ok, ugh.

6:00 AM

Wake up. I hurt. “Where do you hurt, love?” Every damn where.

What will you do today? What will your choices be? Will you choose to stay complacent or will you look outside yourself and reach? Reach for that one thing that’s been in the back of your mind for years? Step outside your comfort zone and break the mold? I think you should. I know you should.

Because one day, all of our names will be used in the past tense.