Archive for October, 2012

First update

Hello all

By now you may have heard that I have been diagnosed with cancer.  Here are the nuts and bolts.  Specifically I have been diagnosed with a malignant synovial sarcoma in my upper left calf.  It started last summer and I (and my doctors) initially believed it was a calf strain that occurred in June while I was running.  I was able to pinpoint a specific time that the strain happened.  An MRI confirmed it and the docs saw a hematoma (blood pooling inside from the calf strain) that they believed would dissipate with physical therapy.  I went to physical therapy from June until August and was responding well. Then the pain from the calf strain unexpectedly returned at the beginning of September.  Because I could not pinpoint an exact time of when the pain returned, my physical therapist recommended that I go back to the sports medicine doctor.  After seeing him, he recommended that I see an orthopedic oncologist to rule out anything suspicious.  Not sure about that “rule out” term anymore!

The oncologist examined my calf and ordered another MRI, which I had in the beginning of October.  After comparing the two MRI’s, she determined that the mass in my calf was growing and that she wanted to conduct a biopsy.  I had the biopsy October 19th and she was able to determine the malignancy immediately.  So I knew that day that I had cancer.  She also mentioned that day that she believed it would be a 70% chance of amputation, but would know more when the final results of the pathology of the tumor came in.

She called me last night with those results which narrowed down the type to the synovial sarcoma.  Unfortunately, it’s pretty rare and does not tend to respond well to chemo and radiation treatments.  The tumor is also wrapped around muscle and nerve fibers so surgical removal would be difficult.  Therefore, amputation is the best alternative to minimize recurrence or metastasis (cancer spread from primary site to secondary, i.e. lungs or lymph nodes) months or years down the road.  Jenn and I are on board with her initial prognosis.  I have another scan (PET/CT) this Thursday to determine if the cancer has spread.  I’ll meet with a medical oncologist on Friday to discuss chemo/radiation options, but again, based on what my first oncologist is telling me, results are mixed with this type of tumor.

Monday, November 5th will be the final decision day for amputation or not.  Ultimately, the decision will be left to Jenn and I but we feel very well informed by the docs here at Vanderbilt.  If we do decide to amputate, it may very well happen next Wednesday, November 7th!  Wow!  It would be an above the knee amputation of the left calf.  I would be in the hospital for 4-5 days and go home for another 1-2 weeks to recover.  Once recovered enough, I believe I would go through a round of chemotherapy to ensure any possible metastasis is addressed, but that is still undetermined.  Once fully recovered, I would get a prosthetic leg (wait…faint memory of my Steve Austin kindergarten lunchbox) 6-8 weeks post surgery and start learning to walk again sometime after Christmas.

Right now, the tumor is more annoying than anything.  It is compressing a nerve that runs to the sole of my foot, so it feels like my foot is constantly waking up from being asleep.  Every so often a little jolt of pain, like a pin prick, decides to show me that I really don’t have full control of my body!

Emotionally, Jenn and I are coping.  Usually, after hearing some news, we cry, hug, figure out how to tell the boys, then adapt to the latest situation.  Humor is a big part of my coping mechanism.  I’ve always been pretty good at accepting what can’t be controlled and focusing on what can.  The same applies for this tumor.  While the news has been difficult to digest occasionally, we deal with what we have and focus on the positive.  We’re very fortunate this happened while we are at Vanderbilt.  They have one of the best cancer centers in the country.  I have been in touch with the Army and West Point and both are supportive of keeping me on as long as I can perform my duties as an Army officer with a prosthetic.  Ultimately, that will be decided by an Army medical review board, but my current career field (Nuclear and Counterproliferation) does not have me kicking in too many doors, so I believe I will be able to continue on provided the spread is controlled.  I’m encouraged and completely humbled by the Soldier amputees that I have had the privilege of witnessing in my career.  I realize I am fortunate that I have time to adjust to a potential amputation where many Soldiers do not.  More often than not, they don’t have a choice and only realize they are missing a limb waking up after a large explosion.  They have provided and will continue to provide inspiration to me as we go through this journey.

Jenn has been a source of immense strength through this so far.  She has been nothing less than incredible.  From taking care of the boys while I lie around moaning probably a little more than I should, to helping me change dressings on my biopsy wound; she is a source of overwhelming inspiration and will continue to be through all this.  I didn’t think I could love her more before this, but somehow I do.  I just don’t know how I would have  to go through something like this without her.

We also have been completely encouraged by the overwhelming support that our Nashville friends and family have selflessly provided.  Our neighbors have offered their full help and with the boys, we know we will not be able to do this without them.

So that’s the first update.  I’ll post more as we go through this.  Hopefully, my words will help reassure folks and keep everyone informed.  Thank you for all your thoughts and prayers.  I never realized how much they would mean in a situation like this.  Please keep them up and please let us know if you have questions.

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