Monday, April 16, 2018

I originally started to blog as a way to keep my friends and family up-to-date on my recovery from my original brain surgeries in 2013. Initially I refrained from sharing about my brain tumor diagnosis on social media. When I was first diagnosed, I only shared the information with my immediate family and close loved ones. I was diagnosed a month before my wedding and the dialogue quickly shifted from cliché wedding bliss-small talk to questions about my diagnoses and prognosis. In fact, a couple of months later we went to a celebratory barbeque and I left feeling extremely violated. A mutual acquaintance was beyond quizzical. She asked me multiple personal questions about my illness. I was mortified by this encounter and was furious that my very sensitive situation was being shared with others. However, when I was ready to undergo the brain surgeries, I knew that my struggle for privacy would be nearly impossible. I decided that I would share under my conditions. I havent always made the right moves but I can assure you that Im trying my best. A dear Aunt of mine lovingly scolded me about not only sharing the highlights; encouraging me to share the lows as well. She felt it was a disservice to my healing if I was only showing people the highlight reel of my trial. I now, truly understand what she was saying. I didnt realize that loved ones were curious but perhaps uncomfortable to ask. I now realize that making light of my situation has watered down the severity of my ailments. My illness and ongoing recovery are not for the fainthearted. I will try my best to explain things based not only my understanding but from my experiences.

After about six years of being juggled around from one medical professional to another the source of my issue was finally diagnosed. In July of 2012, I was diagnosed with a pituitary tumor known as a pituitary adenoma and a left cerebellar mass. It was later, during surgery that it was confirmed to be another brain tumor.

At Keck of USC, in November of 2013 I was scheduled for surgery. The original plan was to remove the pituitary tumor and then to biopsy the mass. If the mass was in fact a tumor my Neurosurgeon had my consent prior to surgery to remove it. The pathologist report confirmed that the biopsy of the mass was in fact a cerebellar WHO grade II astrocytoma. While resecting this astrocytoma, the team ran into an unforeseen issue. According to the operative reports, there was a significant amount of blood loss. After clamping off the blood loss source they state on the report that they worked quickly to stabilize the issue and concluded the resection. Leaving a small portion intact because Dr. Zada felt it was no longer in my best interest to continue. After the resection of the cerebellar astrocytoma, they went on to the second procedure.  

The second surgical procedure was to remove the pituitary tumor. Dr. Zada and his team were successful in resecting the pituitary adenoma. The issue was that my pituitary gland was inactive which led to the suffering of my endocrine system. Not only was I under the care of an endocrinologist but a reproductive endocrinologist as well. After developing an auto-immune disease and other ailments I decided to consent to the resection. This surgery was successful and so far no issues have surfaced from this resection. After a few months my body started to regain full function of the pituitary gland.

Initially my recovery was off to a good start. Shortly after my discharge I quickly regressed. After being rushed back to Keck of USC in Los Angeles, I was immediately ushered into surgery where they attempted to correct the CSF fluid build up. December 19th of 2013, I underwent to emergency brain surgeries to stabilize the new issue that surfaced. I was diagnoses with pseudomeningocele and underwent a procedure known as suboccipital I and D with repair of pseudomeningocele.

After a short stay in Neuro-Trauma wing it became apparent to the team that I would need a VP Shunt to assist my brain in draining CSF fluid that was accumulating. The complication during the resection of the tumor in the left cerebellum (astrocytoma) led to a diagnosis of Hydrocephalus. December 22nd 2013, it was decided that I would require an insertion of right frontal ventriculoperitoneal shunt. The idea of the VP shunt was to aid my brain in reliving itself of the built up fluids. Once the VP shunt was implanted, I went back to recovering from the brain tumor resection surgeries. 

After several months of vestibular rehabilitation, I returned to most of my normal activities. During 2015, I started to develop unexplained symptoms and unbearable pain from pressure tension. My brain was struggling to maintain the inserted VP shunt. January 2016, I underwent my first VP shunt revision surgery. Several months later I was seen in clinic where he attempted to perform a ventriculoperitoneal shunt tap. He was unsuccessful in drawing a significant amount of fluid. I was then admitted for monitoring and scheduled for surgery the next morning. May 2016, another VP shunt revision was performed to once again switch out the malfunctioned VP shunt valve.

In regards to the hydrocephalus issue, anatomically all appeared to be stable while reviewing the post-op MRI images. During my post operative appointment, I discussed a list I had compiled of unresolved symptoms. Initially my concerns were made light of because it was still early in my recovery from the VP shunt revision. After time had passed, I again addressed my unresolved symptoms with my Neurosurgeon. Dr. Zada immediately sent me for a new MRI series. These MRI reports were conclusive with my unexplained symptoms.

July 2016 I was diagnosed with Syringomyelia and what anatomically appeared to be Chiari Malformation. Once I was diagnosed and given my odds, I retreated from sharing details because I was so overwhelmed. Dr. Zada suggested that I consent to having the CSF fluid manually drained from my fourth ventricle as many times as possible to postpone the inevitable. It was his approximation, that in the next two years the condition would immobilize my extremities, as well as impair my bowel and bladder function. I did not want to discuss the new diagnosis with anyone so I only shared it with those that needed to know at the time. I had gotten pretty good at making light of my situation but these diagnoses were much heavier; too heavy to carry publicly at the time.

I will start with explaining the diagnosis of Chiari Malformation. I was misdiagnosed but understandably so. One of our countries Chiari and Syrinx specialists accepted my request for a second opinion and reviewed my case. Dr. Batzdorf called and spoke to me in length about my current condition and made recommendations in accordance with his opinion of my diagnosis.  He disagreed with the diagnosis of Chiari Malformation. He explained to me that my issue was not a real chiari, even though my images met the requirements. Anatomically, the MRI technicians was right in suspecting a chiari malformation finding. When you review the images it’s clear that my brain is pushed out of the skull and applying pressure to my spine. However, a true diagnosis of a chiari malformation is when an infant develops this deformity of the brain and spine. My brain was in fact pushing out of my skull and applying pressure to my spine. However, I was not born with this malformation. There was a collection of CSF fluid trapped in my fourth ventricle; this collection was pushing my brain outward and visibly causing it to push out from the skull and onto the spine. This not only meant that I needed to surgically correct the issue of the trapped fluid collection in the fourth ventricle but the syrinx issue.

I did in fact develop a syrinx in my spinal cord. Initially, you lose sensation, feeling, and then mobility. As the syrinx gets larger and travels further down the spine these symptoms also worsen. I was in the beginning stages of these symptoms. I was struggling with my reflexes, tingling sensations and intense twitching became common. Had these been my only symptoms I might have stayed in a state of denial. In spite of these issues, I was experiencing pain that would immediately cripple me. There were many moments were I would be unable to find a position or remedy to ease the tension and pressure I was experiencing. I would often wake up from intense twitching and was often unable to regain full sensation of my extremities. Id attempt to aid my arms or legs body in recovering from one of these episodes but with time I was unable to stabilize these episodes.

Dr. Batzdorf made arrangements for me to be seen by his junior colleague, Dr. Fallah. He explained that the complexity of my case required immediate intervention. He felt that Dr. Fallahs expertise with these multiple ailments was the best surgeon for my case. Im eternally grateful to Dr. Batzdorf who made arrangements on my behalf to see his junior colleague. Dr. Fallah is a pediatric neurosurgeon. As I previously explained, patients are born with these issues and its extremely uncommon to develop these issues as an adult. My issues are a result of both brain tumors and the resection of them. Dr. Batzdorf ended our call by assuring me that he would be overseeing my case but trusted Dr. Fallah to perform the surgical procedures. So far this has been true; often times he weighs is on surgical plans and techniques to aid my ongoing symptoms.

In October of 2016, Dr. Fallah performed a shunt revision to ensure that the shunt was working adequately. The idea was to attempt the most non-invasive option first. The surgery initially showed some promise but, after several months I started to regress again. My symptoms were intensifying and it was became very evident that the inevitable was happening. I was warned that once experiencing worsening symptoms of the syrinx that these issues would most likely be irreversible.

In June of 2017 my Neurosurgeon recommended a posterior fossa exploration to fenestrate the 4th ventricle and also to perform an expansile duraplasty. Again, I will explain to the best of my understanding. He was suggesting that he reopen the original surgical incision area and attempt to re-open the pathway to allow the trapped fluid a passageway. This would decrease the issue of the 4th ventricle and the fluid leakage (syrinx) would then reduce, then reducing the syrinx traveling down my spine. Upon deciding on a date he agreed to postpone surgery until after my sisters wedding date. The Monday following her wedding, I underwent the first of five additional surgery procedures to stop the Syrinx from paralyzing me.

The first surgery took place August 7th, 2017 and was initially successful. They were able to reopen the pathway and even created extra space for fluid to move fluidly.  Shortly after being discharged I developed a CSF leak. On August 16th, upon readmission they attempted to stop the leak non-invasively. First by re-stitching the incision area. This proved to be unsuccessful and I was soiled in brain fluid again. They then when on to attempting a bedside-spinal tab procedure which was also unsuccessful.

Another surgical procedure was performed and the leak was successfully repaired. ???? Right when I thought I was in the clear my brains health again declined. My ventricles were struggling to communicate with each other properly.

 I underwent two additional surgeries before they were able to control the Syrinx. During this time, I again lost feeling in my extremities.

 In effort to allow my brain a chance to heal and avoid another CSF leak a drain was inserted; my stay in the ICU for these nine days consisted of them manually draining the CSF fluid, hourly, around the clock. Again, my brain seemed to comply and I was discharged.

Unfortunately, there were again unexplained symptoms that I was experiencing and after more testing it was back to the drawing board for my Neurosurgeon and his team. I was immediately admitted and put on the waiting list for an operating room. Again, I was operated on in effort to stop the Syrinx from worsening. As the story goes, everything appeared stable and again I was eager to leave Ronald Regan Hospital. It quickly became obvious that my fourth ventricle (where my issue was steaming from) was no longer in sync with the others.

After a very lengthy discussion with my Neurosurgeon and his Resident Neurosurgeon we reached an understanding that the benefits still outweighed the risk. I then agreed on the procedure he proposed and I requested that he not admit me for the procedure hed attempt the following morning. I asked that I be able to return to the hospital in the morning for the operation so that I had an opportunity to get my affairs in order. On the drive back to my parents house I received a phone call from him. Ill spare you the details and just tell you that the phone call was to ask my consent to try something somewhat experimental, and definitely more of a gamble. I heard the confidence in his plan and after discussing it all in great detail I agreed to give my consent. The following morning we again discussed the game plan and I gave my written consent. 

Because of the new issue that we were battling the final surgery last summer consisted of three teams: my neurosurgery team, a general surgery team and a team of cardiologist.

My latest battle has been with the cranial nerve damage as a result from the last brain surgery. More specifically sixth & seventh cranial nerve dysfunction/damage. The sixth cranial nerve issue has led me to be diagnosed with Esotropia. I refer to this as double-vision. The seventh cranial nerve issue is known as Facial Nerve Palsy. Both conditions are a bit complex so to simplify things I will explain it based on what I experience. For years I lived with multiple "invisible illnesses" but these new issues are obvious. I wear an eye patch to assist me in being independent with normal day to day activities. When I cover one eye I am able to see the way I normally would have. However, without the patch I see two of everything which makes things a littttttle complicated. It's hard to explain so I will add a video that will give you a visual. 

Unfortunately, life doesn't come with a guidebook for living with chronic illness, so you'll just have to trust that I'm doing my best. I've been navigating through my twenties, one beautiful disaster at a time. My journey to recovery is not for the faint-hearted. While I actively practice staying in the light, there are definitely dark moments. There are often times where the light at the end of the tunnel seems so dim that I'm afraid I will lose sight of it. Without faith and prayer, I'm not sure I would sustain these ailments.


Monday, July 6, 2015

Eat, Pray, Love on a Budget...

It’s been a while since I’ve posted a blog. I wrote many lengthy blogs that I knew I would never work up the courage to actually post but it was therapeutic to write freely; it allowed me to be honest with myself and reflect on my experiences. 

My version of Eat, Pray, Love lol jk

So… I’ve been on this “Eat, Pray, Love” journey if you will. It’s similar to Elizabeth Gilbert’s memoir (or Julia Robert’s if you just watched the blockbuster) except I can’t afford to travel across the world and eat endless amounts of pasta to find myself and grow spiritually. My journey to self-discovery and most importantly self-acceptance has just begun. I invite you to follow; in hopes that we can learn from each other. I catch Alton staring at me quizzically at all my "holistic" ideas & treatments but he remains supportive & hasn't had me committed (YET)


I did some major spring cleaning this year and that ranges from literally dumping every mass produced medicine and toiletry item into a large garbage can, to distancing myself from people who are toxic to my health and my marriage. I have made peace that I cannot remove some people from my life but that doesn’t mean that I need to interact with them. I refuse to continue to sacrifice my own happiness and put my marriage at risk. 

You know by now that I was diagnosed with brain tumors in 2012 and like a wise P.R. specialist would I became public about my situation to control the dialogue. I knew that once I had surgery I wouldn't be able to control what was being posted on social media. I'm glad I did because I've met so many amazing people along the way. When people ask me how I came to the diagnoses I usually give them the same vague answer… carefully giving just enough info to get a reassured head nod but not too much that I risk my vulnerabilities be used against me. 

I’m still not ready to out myself about what brought me to being diagnosed. Perhaps I will in the future, if and when I have won that battle. Maybe one day I’ll blog all about the dragons I slayed but I’m still “at war”, if you will, sooo stay tuned.


I’ve never questioned my God about my illness. I’ve never hosted a pity party for myself. I was raised to have faith first. I knew God had a purpose for my life, my pain and my illness; even if I couldn’t see it. I knew that I was faced with a very real possibility that my condition would break me physically but never did I imagine that it would break me in the most beautiful way spiritually. I am grateful for my struggle. It mended my heart. It casted a much needed light on my life, my beliefs and most importantly the people in it. I woke up many times in my recovery room to loved ones holding my fragile hand, watching me sleep and praying to God for a miracle. While I faded in and out of sleep I would often hear my family members reassure each other that I would pull through because I was strong but I don’t think they realized that my strength came from them. It was their prayers, faith and support that fueled me.


After the surgery my plan was to heal and go on to win the original battle that brought me to this diagnoses. However, God quickly reminds me that he’s in charge. I foolishly thought to myself that I had passed the test and I was ready to proceed with my own plans. Nope! I’m not sure why I’m being constantly detoured on my journey but I know that his purpose for my life is greater than anything I have planned.  

No one has ever accused me of being soft, on the contrary my exterior is solid and tough. I am not proud of my flaws but I accept them and I am on a journey to nurturing them. I’ve recently learned a lot about energy. I see an energy specialist twice a week, I’ve gone to workshops and continue to look for alternative ways to heal my body and my mind. For now that’s what my blog will be about.
I am hungry for knowledge to heal and I look forward to sharing experiences.  

Monday, September 22, 2014

Summer 2014, thank you for being good to me


Cheers to the summer of 2014. A couple nights before my first-two brain surgeries I sat on the porch writing in a custom journal I had made for Alton as an anniversary gift. The traditional gift for your first year of marriage anniversary is paper so I had a custom journal made for him with 365 reasons why I loved him. I wrote him a letter in that journal that night, just in case it was my last one to him. Tears streamed down my face with every word I wrote. It was after midnight and I sat there and reflected on everything. I thought to myself if God forbid something goes wrong what most would I regret. I had distanced myself from everyone for years. I would decline invites with friends and avoid family gatherings. That weighed heavy on my heart because my loved ones and family members were all gearing up to fight this medical battle with me. They were the ones that would call and who kept me in their constant prayers, they were the ones clearing their schedules to sit in a hospital lobby in the early hours of a Wednesday morning. I made a promise to myself that if God granted me a chance at a healthy abled life I would cease the opportunity to strengthen those neglected relationships. As you all know I am still here and I’m proud to say that this summer I have lived a grateful life.

My favorite place to be is my front porch and if you have sat there with me this summer please know that the memories we made are near and dear to my heart, for it’s the same place I vowed I’d change. Some of my favorite memories this summer are there. Watching the sun come up with my best friend and our husbands made me feel like I accomplished the promise I made to myself.

This summer I reconnected every meaningful relationship I neglected. I spent more time with my beautiful cousins, met up with childhood friends and made new ones along the way. Whether I was floating down and inner tube in Bishop or playing “never have I ever” with new friends around a fireplace, in a cabin, in Big Bear…I was living; not just existing. I pushed myself to not allow my condition to slow me down.
The night I turned 25 again ;)

My mom hosted a Disney Frozen birthday party for my twenty-eight year old sister and me. I know it sounds ridiculous to have a Disney Princess party for two adult young women but, it was great to be amongst our loved ones, blowing out our candles like we did as kids and opening birthday gifts in unison. My sister had a custom locket made for me. It has Olaf, the snowman from frozen on the front and inside it reads “some people are worth melting for” with a photo of us a toddlers.

Queen Elsa and Princess Anna
My birthday locket from my sister.
My summer ended with celebrating two of the most important people in my life; my better half and my momma. I tried desperately last week to get rid of the bug I caught. Bless my sister’s heart she tried to stay away from me but we were together for a whole weekend at the Women of Faith conference so I caught the tail end of what she was getting over. Friday morning I woke up drenched in sweat from a fever. I was so sick and Alton’s surprise party was getting closer. I sat in a cold bath, eating ice cream and downing water. With the help of my family, I pulled off his surprise party at Hangar 24. He has always wanted to go so I figured where better to celebrate his birthday. His cake was awesome and I was so happy with it. We spent Saturday evening in San Diego at our Aunt’s wedding. She looked so beautiful and it made me so happy to be a part of her special day. We retired early that night and drove home to celebrate my mom’s birthday the next morning.

Alton's birthday cake & his suprise party.
One of the perks of living in the inland empire is everything is an hour away. She said she wanted to eat by the beach so we had a beautiful Sunday brunch, overlooking the ocean. She seemed to enjoy herself and all of the birthday attention she was getting. My parents stayed and enjoyed themselves on the beach while we headed home. My mother deserves the world so seeing her happy makes me happy. We ended our summer over corn chowder soup and ice tea with our best friends.

Thank you loved ones for all the wonderful memories we shared this summer. 

My mom's birthday at Huntington Beach

 Now bring on the fall! 


Thursday, August 28, 2014

Brain Tumor Awareness Hashtags

thought I would put together a list of hashtags for brain tumor awareness. I have been fortunate enough to meet others online through blogs and other social media outlets. I hope to spread awareness. When I was diagnosed the only form of information I could find was on the internet and google can be your worst enemy. The things you read are often scary and impersonal. Looking through these hashtags I have been able to see others inspirational journey’s. If you or someone you love has been diagnosed with a tumor I encourage you to participate in a walk for awarness. The National Brain Tumor Society hosts a walk around the U.S. Seeing others walk to raise awareness and funds is very moving. Visit their website for more information.

Grey matters too!


#BrainTumor

#BrainTumorThursday
#BrainTumorAwareness
#BTSM (brain tumor social media)
#NBTs (national brain tumor society)


#btpit (#Pituitary)
#btast (#Astrocytoma #glioma)
#btgbm (#Glioblastoma)
#btlym (#CNSlymphoma)
#btmen (#Meningioma)
#btodg (#Oligodendroglioma)

#btsch (#Schwannoma #AcousticNeuroma)

#iWearGrey #GreyMatters #GoGreyinMay
 
“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”
Elisabeth Kubler-Ross

Tuesday, August 19, 2014

“It has been a beautiful fight. Still is.” –Charles Bukowski

Another day, another MRI. Anymore of these and I'll stick to the fridge. 

Sleep doesn't come easy to me so after a whopping two hours of sleep, Alton shook me awake before he left for work. Thank goodness I trusted my instincts the night before to set a "just in case" alarm for after he left. I'm like an errant child when it comes to mornings. I always make him promise me that he'll make me stand on both feet or drag me to the shower before he leaves. All my pleas ending with "no matter what I say or do k?" He always agrees but it never fails, he leaves and I’m still in bed. Even sleep deprived I manage to convince him to leave me alone either that or he just has just surrendered to my stubbornness. So my alarm sounds off at four sharp & I start doing the illumination game in my head, trying to figure out what I can cut out of my morning regimen to hit the snooze button. Ahh yes ten more minutes should do it. At four-ten it goes off again and just before I hit snooze for another ten minutes, I quickly remind myself that my neurosurgeon is gorgeous so I'm going to need those extra ten minutes to cover up this God awful adult acne ha ha!

I remember my first MRI was on a Sunday morning, in July, of 2012. After being ill for so long and countless medications falling short, my doctor told me she suspected I had a brain tumor.  She & I never took a liking to one another. When she told me she was almost certain that I had a tumor I just gave her this half quizzical, half eye roll look & smirked like yeah, sure, ok, whatever, another damn test. I was even more irritated that they scheduled me first thing on a Sunday morning. At the time it seemed a bit exaggerated to me but keep in mind at that point I was tired of being poked & pried at like a lab rat for dead end answers. I woke up that morning & didn't bother asking anyone to go with me. I was used to being at appointments for hours and I didn't want to burden anyone with it. After my MRI, the technician’s demeanor towards me changed. He went from all business to very nurturing. He was suddenly very warm & when he walked me out he said "May God bless you sweetheart" I thought it was sweet but I shrugged it off. I figured well its Sunday, maybe he's just trying to keep the Sabbath day holy & went on my way. 

Less than a week later I woke up to a dozen missed calls & multiple voicemails urging me to call the doctor back because she needed to see me that day! That day? Ugh my stomach knotted up & the MRI technicians voice replayed in my head..."May God bless you sweetheart"...I wondered did he know then? Does he just take the images or does he read them too? My goodness I had no idea how any of this MRI business worked. 

I asked my dad to go with me to my appointment because I knew she was going to confirm her suspicion of a tumor. I needed a second set of ears just in case I missed something. 
I'm sure no one that was there that day will ever forget that appointment. I'm talking about the staff, the nurses, the doctor & my family. She had a box of tissues waiting for me little did she know she was going to need boxing gloves (figuratively speaking). That by far was the ugliest shouting match I had ever been in. Sorry Dr. Reddy but you picked the wrong girl to try and withhold information from. I left with the understanding that I had two tumors and brain cancer.
(I’ll save that for another blog post though oh & no I didn't have brain cancer-she was wrong)

Anywho I dread MRIs! I have been diagnosed with Attention Deficit Disorder so sticking me in a confined tube that you can't move in for an hour is like a torture chamber. It would probably be easier if I took my prescribed Adderall Xr but it zombies me out & I've lived my whole life without it. People who put their kids on these meds are wimps. Learn to deal & get on with it (again another topic, for another blog)  

I've only freaked out during one MRI, it was right after my first two surgeries. I had almost fifty staples in the back of my head, I was in pain, exhausted from several hours of surgery & I panicked. I have never in my life felt so claustrophobic. They give you a remote to press if you want to speak with the technician while you are in there but I didn't even think to push it. I suddenly felt so overwhelmed and I just started freaking out. They tried to convince me to keep still so they could continue but their words were falling on deaf ears. They finally pulled me out & a nurse ran in with Ativan. She injected my IV with so much that I felt like I was in vegetated state. I could hear & see everything but I could hardly move & barely speak. After I had no more fight in me they popped me back in. 

Thank God my MRI today went smoothly. She slid the needle right in and put a heated blanket on me. They always play my Pandora station of choice into comfy earphones and I guess how many songs it will take until it's over. Today it was sixteen :) The contrast always creeps me out but I think I’ve gotten used to it. Whenever they start the contrast it feels like you’ve urinated on yourself ha ha.

After my MRI I went right up stairs to see my favorite doctor-my neurosurgeon. My neurosurgeon is one of the kindest souls to walk this planet and it doesn’t hurt that he’s gorgeous. Alton has even admitted it. He jokes that he’s only keeping him around until I’m healed but it looks like I’m going to be seeing him once a year for the rest of his career or my life-whichever comes first. Sorry Alton the school girl crush will live on J

He was very happy with my MRI results. The remaining tumor has not grown in size or changed in shape; this is always good news! He said that it’s in his opinion that it may have even shrunk. Also the brain fluid collection has been reduced to half since March. There’s no telling if that will ever fully go away but my VP shunt is handling all the excess brain fluid pressure. The VP shunt runs from my head, around my ear, down my neck, under my collar bone and over my intestine. When I woke up from that surgery I woke up pretty much completely bald and I felt a pain right beneath my breasts.  When I looked under my gown, I saw a 4 inch incision stitched up. I was so confused but an IV drip of Dilaudid makes everything okay.

So the conclusion of my appointment was that things look great. I still have a lot of brain rehab to progress through but I remain hopeful. While there is a possibility that the remaining tumor can cause future medical conditions it’s not something that I’m going to dwell on. I’ll continue pushing through because that’s what I’ve learned to do.