The Achmed Options

As I lie in bed, completely awake and not able to sleep, with a stomach rolling like a tsunami and my head pounding like a jack-hammer, I am starting to accept the fact that I may not get very much sleep tonight. My meeting with the head, head-man is tomorrow at 12:30. I am wondering if I am facing the best case scenerio or the worst or more likely somewhere in the vast middle. On one hand, I will know exactly where I stand and will begin my course of treatment, and I think that is a good thing, on the other hand, my life as I have known it will end tomorrow afternoon, for better or worse. Either way I am expecting things to look a lot different for me this time tomorrow. All this thinking is calling for a scotch... I'll be right back.

Ok, are you still there?

My life-long dream to see KISS in concert will probably be interrupted, or maybe it will be my trip to see U2... maybe both, maybe neither. Maybe I have played my last game of hockey, or maybe I will be better at that game after this is all over... well, anytning is possible right:) One thing I do know is that my cognitive abilities and personality won't be affected, just possibly my motor skills. My buddy Billy thinks it is too bad that Achmed can't fix my personality... I think he was kidding!

A lot of you have asked me what my options are over the past week. All I can tell you is that there are five options for treatment, of which only one has been ruled out so far. Realize that these are not necessarily Achmed’s options, but options for this particular tumor in general.

1) Wait and See. This option is generally used as a monitoring procedure to see how aggressive Achmed is or if the patient is expected to expire before Achmed kills them anyway. It is primarily used in the case of baby Achmeds or older patients. Achmed is not small and I am not old, so this is the “fantasy option” as I refer to it as.

2) Brain Surgery. This is the layman’s term for it, I don’t use medicalese when trying to explain this stuff. Mostly because I don’t understand much of it, but also because these days I understand more of it than a lot of people so it would just look like I am pretending to be smart! The brain surgery option is exactly what it sounds like, they cut your head open and suck out the golfball, fill the hole with abdomen fat (which in itself may help with the love handles) and screw your head back together. It is probably a bit more complicated than I make it sound, but that is all you really need to know unless you are the one doing the slicing. The side effects of this procedure can be anywhere from moderate to severe, including facial paralysis, complete loss of hearing, extreme vertigo and dizziness... and each of those effects have their own side effects. This is the only known cure for Achmed and the reoccurrence of future Achmeds after this procedure is virtually zero. I use the word “cure” very loosely here, as you can see it has a very high impact on the patient’s quality of life. I have pretty much ruled out this treatment myself, even before I have met with the head-man, Dr. Tony Batten, for this head-problem.

The next three options come under “management” rather than “cure” as far as the medical professionals (Marines) are concerned.

3) Low-dose Radiation. I have not done a lot of research on this option, simply because it is unlikely to be an option for me. To simplify things even a step further, this is basically the type of radiation that you hear about in cancer treatment. In this case it is primarily used if an Achmed is too big to treat in other ways. As far as I know right now, Achmed is not classed as “large” and is in not cancerous, so this option does not seem to be in Achmed’s legitimate list of treatments.

4) Micorsurgical Resection. That even sounds scary, and if you have an imagination you probably already know what I am about to describe. To me it sounds like I am going to look like Jack Nicholson’s portrayal of McMurphy after his lobotomy in “One Flew Over the Coo Coo’s Nest” , which incidentally, I thought was a great movie.

Basically, the Marines crack your skull open and cut out a portion of Achmed to make him smaller, I guess to cripple him...like blowing off his legs with a land-mine so he can’t run away from his beating that the nuclear Marines have waiting for him back at the base... in this case, the radiation room. Once the patient heals from the surgery, the head gets an atomic blast to kill the remaining part of Achmed. Of course you are all thinking right now, why not just cut the whole thing out and be done with it? Well my friends that is an excellent question, one which oddly enough, I have the answer to. The marines leave small pieces of Achmed intact around the nerves that he is growing on to minimize the long-term nerve damage to the three main symptoms, hearing, balance and facial control. So basically, this form of treatment leaves you with slicing off the side of your head, radiation poisoning, and long-term side effects that are not as bad as the full dose of brain surgery. It affects the quality of life, but rehab can help with a lot of it. This is one of the paths of destruction that I have to consider, albeit, not my first choice.

5) Stereotactic Radiosurgery. Some of you who I have spoken with recently may know this as Gamma Knife Surgery. This is the option that Achmed and I are hoping for and I believe it is the one which we are a candidate for. It has the least drastic long-term side effects, shortest recovery time and has approximately a 95% success rate, depending on which study you read. So, if Achmed is still small enough for this proceedure, I am one lucky man and he is one dead brain tumor.

The actual "surgery" is kind of like fake surgery... the marines don't actually cut you open... noooooooooooooo, that would be too easy. They do an MRI to get the exact coordinates for the blast, so there is as little collateral damage as possible, you know.. to your grey matter... just in case you feel like you may want to think agian after it is over; then they screw a steel frame into your skull so you can't move; then they slide you into a 40,000 pound tunnel that is much like a lead coffin, this mountain of lead is to protect everyone in the room from radiation, so Achmed will be screwed because he will be inside the coffin... unfortunately, so will I:-\ ; then they blast Achmed with gamma rays, and if you have ever watched the Flintstones and are familiar with The Great Gazoo, you know all too well the mass destruction of the Gamma Ray Modulator! Then the patient throws up for a while and goes home. It all sounds so simple and can be done in one day.

From all of the studies that I have read, even though the side effects can sometimes be severe with this treatment, they are generally less severe than the other treatments and are usually temporary and last anywhere from a few weeks to several months. On the bright side, at maximum, a year from now I will be normal... or at least as normal as I am now. On the negative side... if the Gamma Ray Modulator doesn't work, statistics show that the side effects from the real brain surgery can be much worse than trying to remove a pre-nuclear Achmed.

Hmmm... no wonder I can't sleep

From Achmed and Me... Live Life!