Wilbur...your days are numbered!!

December 2, 2013 -- 2:00 pm Mountain Time -- My appt for my functional MRI

I was a little nervous walking into the appointment today, not because of the MRI itself but because this meant that things were finally moving forward and I know what's coming up next and am already anticipating how I'm going to feel or react to the surgery.  It's kind of like me with books, movies or shows; I want to know what's going to happen already!  Patience is not my strong suit.  For instance, I made plans with friends to go see the Doctor Who 50th Anniversary special in theaters the Monday after the worldwide simulcast on Saturday.  And my friends were shocked that I watched it on BBC America on Saturday when it premiered instead of just waiting to see it in 3D on the big screen.  Please!  I always read (or watch) ahead (so that I know what's coming and can prepare for it)!!

Well, shortly after arriving for the appointment, Mercedes and I went back to meet with the nice gentleman I'd spoken to when I made the appointment, we'll call him Dr. J.  Almost as soon as we sat down, I explained about "Wandering Wilbur" and asked if Wilbur and I could get our picture with him.

Dr. J, Wandering Wilbur, and me

Shortly thereafter, the doctor from neuropsychology joined us, we'll call him Dr. B, to talk about what would occur during the fMRI.  As I understand it, the basic premise behind the fMRI is that when you use part of your brain, more oxygen is needed and shows up as a cloud (if you will) around the area of the brain controlling that particular movement or thought process.  So the fMRI allows doctors to compare what your brain looks like at rest to what your brain looks like when you're moving a part of your body or thinking of words.  The "clouds" are colored so that doctors can map the specific controls.

Dr. J and Dr. B walked through everything I would be asked to do beforehand.  Mercedes and I agreed that some of the tasks would be harder for me than others simply because I tend to dwell on some things and overanalyze others, neither of which are helpful in this situation.  I had to tell myself, "don't think too hard," "go with the first thing that pops into your head," "don't overanalyze!" Interestingly, many of the tasks somehow seemed to relate to board games.  Mercedes brought up that one of the tasks was like Scattergories.  For each task there would be a 20 second rest and then the task, then a break and then the task.  Melody took me back to the scanner and got me adjusted before I went into the MRI.

Picture time before getting ready to go in.

I'd told Melody and Dr. J that Wilbur was based off the image I'd seen of the blobfish, so that was the first image waiting for me once I got situated.  But since the picture made me laugh to see it, Melody ended up taking it down because she didn't want me laughing during the scan.  So the first part involved an initial scan, no tasks and I was allowed to pick my music to listen to over the sound of the machine.  I was feeling some Beethoven and if you're ever in need of something relaxing to listen to in an MRI, I highly recommend it!  I was once again thankful that I'm not afraid of small spaces, no anxiety medication needed.  Just a warm blanket because I got cold.  So after Fur Elise and Moonlight Sonata (and one other song I know but can't remember the name of), it was time to start the tasks and put my brain to work!

See that image on the far end of the machine, that's a picture of Wilbur that Melody had waiting for me!

There were a couple of different types of tasks.  The physical tasks involved moving my right thumb back and forth and tongue tapping (not clicking).  There was also a multi-level test where I had to silently make an association and then click a button.  For instance, I was asked to identify which objects I saw on the projection were living; those images I clicked the button for.  The multi-level test also switched between having me identify objects and having me identify similar patterns.  This was one of the ones where it was really hard for me not to overanalyze.  Had to go with my gut, as Gibbs would say!

You know I've never really spent a lot of time pondering how my brain does what it does.  Or thinking about how things are connected or distinguished up there.  Like I had never thought about the fact that just hearing something doesn't mean that you comprehend it as language or understand its meaning.  In the day to day, any sound you hear you can automatically make sense of and when someone is speaking, even if not to you, you understand what they are saying.  Or if they are speaking in another language, you can probably still identify the emotional tone behind their words.  So to have your auditory signals distinguished from your auditory comprehension was a little disconcerting.  So for this one task, my rest break involved me hearing scrambled speech and the task was repeat what I heard back to myself once I could comprehend complete sentences.  I had my eyes closed during that task so I could just concentrate on when the sounds began to make sense again.  Most of the tasks focused on my speech and language control centers of my brain.  I would read the sentence on the screen and fill in the blank with the first word that popped into my head or see a letter and come up with as many words as I could that started with that letter or have a sentence read to me and then repeat it back in my head silently.

Overall, Dr. J said I did great and that he expects all the images will turn out clear because I was able to keep so still.  Afterwards, I ended up going through some similar type tests with Dr. B, only this time I had to say my answers out loud.  I think those are going to work in conjunction with the tasks from the fMRI to give Dr. B and Dr. S a better understanding of how my brain works.  I also found out that Dr. B and Dr. S have been working together on brain tumor surgeries for more than a decade.  Dr. B is going to be the one I talk to and focus on during my time in the OR.  I am definitely going to be wide-awake during most of the surgery and fully aware of my surroundings.  I left feeling like I have a more clear picture of what this is going to be like during the surgery.

Maybe that's why I always read ahead or watch ahead with books, movies or shows.  If you know what's coming, you can prepare for it.  I don't like being scared or remaining in suspense, I don't think I ever have.  I mean I am the child who woke my parents up at 2 or 3 a.m. EVERY Christmas of my childhood to open presents!! Mom has almost no pictures of me opening presents as a child because I always drug her or Dad out of the bed to watch me open presents before either one was awake enough to think of taking pictures.  So by understanding what exactly is going to happen, before it happens, I can try to prepare myself so that I don't worry about ALL the unknowns.  If I can get rid of some of my fears and uncertainties now, then when the surgery happens, I'll still be scared but not quite as scared as I would have been otherwise.  What's that saying, "Forewarned is forearmed!"  Well, consider me forearmed!

The MRI images will be processed by the end of this week.  Dr. B will consult with Dr. S in the next week or so.  Dr. S will schedule another appointment shortly thereafter.  I'll be able to delay surgery long enough to make sure insurance goes into effect.  In all likelihood, I will probably be having surgery sometime in January.  What a crazy way to welcome 2014!