17 Aug

Normalcy

The views and opinions expressed in these posts are those of the author(s) and do not necessarily reflect the official policy or position of the Epidermoid Brain Tumor Society.
Any content provided by our author(s) are of their own opinion and are not intended to give medical advice or instruction, nor to malign any religion, ethnic group, club, organization, company, individual, anyone or anything.

 

After getting through over a year of this virus (which included seclusion from everything we know and love) we are starting to return to a sense of normalcy: seeing loved ones, giving hugs, eating out, gathering with others.

 

This pandemic has stopped us from doing everything we once took for granted. Ironically, the last time we dealt with a global pandemic, over 100 years ago, our tools to fight it were largely the same: socially distance from others and wash your hands frequently (although an mRNA vaccine wasn’t developed at break neck speeds then). We are now able to begin returning to doing what we love. Unfortunately, this is a cautionary article, reminding us that while the finish line is in sight, we are not out of the woods yet (sorry for using multiple metaphors). As a physician, I fear that we may undergo yet another surge in large part due to this Delta Variant. 

 

I completely understand, we ALL want this pandemic to be over, developing COVID fatigue. But I urge you to help us cross that finish line – continue to mask and socially distance when possible. As a physician I also must urge you to get vaccinated. Suffering from Epidermoid brain tumors puts many of us at elevated risk, thus even further emphasizing the importance of getting the vaccine. When coming up with a treatment plan for patients, I try to avoid the angle of “scaring” them into treatment, as I strongly believe that playing on a patient’s fear and vulnerability not only is a poor tactic, but also only leads to fleeting results. But regardless of this philosophy, I feel I must share this story with you: (In an attempt to respect his/her privacy I will not give out any of his/her identifying information)

 

My wife (also a Family Physician) had a patient who she constantly urged to receive the vaccine. The patient always refused, stating that he’ll/she’ll “be fine without it.” She saw him/her on a Monday afternoon and again pushed for vaccination – this person again refused. Two months later she received a note telling her that this patient had been hospitalized with COVID. Ten days after that she received a notice that he/she had unfortunately passed away from COVID complications. I share this sad story with you, not to scare you, but to underscore the importance of this vaccine. Had this person received the vaccine, his/her life could have been spared.

 

Thus, I implore you to stay vigilant. Keep washing your hands, continue to try to socially distance, and get vaccinated. We are so close to the finish line, but I fear yet another surge is on the horizon.

 

Thanks guys!

Chris

03 Apr

Bright Side #2

In this uncertain, unprecedented time it would be easy to see all of the negative, disastrous effects of COVID-19, but what is not seen and needs to be addressed is all the positive that may come from this. I do not want to come across as callous; I do see the numerous harmful aspects of this – besides the obvious detrimental health effects, I believe the recent economic downturn is only the tip of the iceberg, but I do not want to focus on this, instead I hope to turn my focus instead to possible upsides – a true ‘glass is half full’ exercise.

Our sanitary habits will improve.
I, like many Americans, I’m sure, never gave a second thought to simple actions like washing my hands or avoiding contact with my face, eyes, or mouth. Before, while I would always wash my hands after using the bathroom or before cooking, I would rarely, if ever, get up in the middle of the day to randomly wash my hands. I also avoided use of waterless hand sanitizers as I feared they would ‘dry out’ my hands. I hope and believe that our sanitary habits will forever change for the better when this disease is long gone.

Our appreciation of those in the healthcare field has grown.
I realize that me, a physician, touting this as a benefit creates a conflict of interest. But even from the outside looking in, I have to believe our view of healthcare profession
als has changed.  I just watched a moving video of a city in Spain cheering for healthcare workers at their shift change: https://www.youtube.com/watch?v=5MIjynl6nYc&feature=youtu.be. People in the healthcare field are on the front lines, putting their health in harm’s way for ours, this pandemic has shown us this.

We get to spend more time with our kids.
I know that many of you do not have children, but for those of you who do, in this ugly me
ss of Coronavirus, we might one day look back and think of this time as a the most time we have had the chance to spend with our kids. I know many of you may be pulling your hair out thinking, “more time with my kids is good, but this is TOO much time!” I have had those moments, too, as I have two boys at home (ages six and 13). Besides finding out that seventh grade math is hard, I have come to cherish this time I get to spend with them. Never before would I have thought that I would be spending an entire Saturday morning with my family, putting together Legos.

The elderly were often a forgotten demographic, no more.
While the statistics tell us that this disease can afflict ANYONE at any age, the elderly, especially those with con
current medical conditions, seem to be more adversely affected than other age groups. The elderly population is often neglected, but this virus has highlighted this population. Ever since this began, I have called my parents every day to ‘check in’. When the proverbial smoke clears, this demographic will be forever remembered.

Public health is a thing!
Before this, to me, public health was simply a topic that many would-be physicians took after college in their graduate studies. Now, as a doctor, while treating the individual, I find myself thinking of the health effects to the public – Public health! You do not have to be a physician to think this way – we have all become mini public health experts since this began and I hope this continues long after Covid 19; for in every action we take, besides thinking of the consequences to us as individuals, we ought to also consider ramifications to everyone else.

We are together.
This is perhaps the most important positive outcome from this crisis. As a nation we are more divided than ever. If someone thinks up, someone else thinks down, and inevitably an argument breaks out between the ‘uppers’ and ‘downers’. But with this disease we realize that while we may disagree on just about everything, we are one. Perhaps it took such a drastic event to realize this.

I’d like to reiterate that I do see the direness of this situation. I do not want to come across as callous or daft to this crisis we are in. I simply hope to shed some brightness in your day, after being reminded time after time of soul draining topics like the ever growing death toll. I am sure there are many positive aspects of this I forgot. Please comment on the EBTS Facebook group page and let me know what I forgot.

20 Mar

Calmer Heads Prevail

Calmer heads prevail. I have lived my life by this saying. In times of crises this seems to hold true, now more than ever. It seems as if every time I pick up my phone a new news flash pops up, “Death Toll in the Thousands,” or “Colleges Go to Online Lectures,” or even “NCAA Basketball Tournament Canceled.” In times like this it is important to try and keep a level head. There are aspects we CAN control (hand washing, face touching, etc.) but also some aspects are out of our control (for example: death toll, vectors of how it’s spread, countries it is prevalent in.)  In the face of such adversity it is vitally important that we keep a level head. Yes, the situation is crappy, but I can assure you that constantly worrying about it does not help. I liken the situation to trying to hold your breath under water: the person with their heads calmly submerged is going to last longer than someone who is thrashing about under the surface.

As I said in the beginning of this piece, it is important to realize that with this virus, there are aspects of it we can and cannot control – but there are also aspects we can control – diligent hand washing, no face touching, and social distancing. One of these under our control that is never mentioned is our reaction – does fighting over toilet paper really help or would keeping a level head amidst this crisis be a better and more productive reaction?

As a medical professional, the adverse effects of such a mass panic become more tangible, manifesting as lack of staff, lack of equipment, and lack of supplies. I realize that this and many of my other posts may come across as preachy, but I am by no means downplaying this dire situation, I am simply imploring you to remember that a sense of calm can help in this adversity.

19 May

SITUATIONS

I must warn you before you read on, that all I am about to say, you have heard before. At some point in your lives, someone has told you “it’s not about the problems you face, but how you face them.” This piece is going to be no different, the main thrust of this piece is that we will all will have some problem or obstacle put in front of you; however it is not the problem that defines you, what is important is how you react to it.

Problems face many of us, some on an almost daily basis. These obstacles come in different shapes and sizes: for many of you reading this, you have been diagnosed with an Epidermoid Brain Tumor, for others maybe your favorite shirt got a stain on it – different shapes and sizes. But while the problems themselves may vary, the underlying principle remains: the issue you face is not as important as how you pass this obstacle.

Allow me to give you my personal example: in 2013, I was diagnosed with a golf ball sized Epidermoid Tumor along my brain stem. A 16 hour surgery to remove it followed by a one month stay in the hospital was required. Before the surgery, I was very active, playing tennis and various other sports. I was also in the midst of my medical residency, training to become a Family Physician. However, the tumor and its removal left me using a cane to walk with my motor skills seriously diminished – obstacle. Instead of obsessing on what I cannot do, I focus on what this tumor has given me – like time with my family I didn’t have before or a chance to share my thoughts with you in this great group – obstacle passed. I am by no means infallible and find myself sometimes thinking of what this tumor has stripped from me but thankfully these thoughts are becoming more and more sparse.

Thus, when you are faced with any obstacle, remember it is not the obstacle itself but how you conquer it. Years from now, when you think back to the time you were diagnosed with an Epidermoid Brain Tumor, you will not think about how you were diagnosed as much as how you dealt with it.

22 Sep

Adaptation

What makes us human? After all, we are often reminded that our DNA differs from chimpanzees by only 1%. Thus why is it while they are swinging from trees we are accomplishing feats like creating beautiful art, or bring technology to uncharted areas? There are notable physical differences, like an opposable thumb or our larger, more developed brain, but our differences run far beyond the physical. As a human race, we have the ability to adapt like no other. This ability to adapt has moved our race forward, and can move you forward on a day to day basis. 

If you study our history, even crudely, you will come across countless examples of us adapting: in our humble beginnings food was scarce and dangerous to catch: thus we developed ways to make this process easier- we began to hunt in packs, we developed weapons to more easily hunt our prey. To be able to live in even the most frigid of conditions, we made warm clothing that allowed us to survive. More recently, to satisfy our insatiable need for accessible information, the internet was created. Now, if I were thinking, “I wonder when William Shakespeare was born?” the advent of the internet and our ability to adapt has made it possible for me to type “Shakespeare birthday” into my internet search engine and have the answer in seconds.[1] As a human race we have an uncanny ability to adapt. Even if the rules change we can (and will) master any game. 

This idea of being adaptable need not only apply to the whole of the human race though; if applied to our daily lives, we can enrich ourselves as individuals. I realize this is an abstract concept, so allow me to give you a more concrete and personal example: I attended college and went to school to obtain a medical degree. I trained as a medical resident in Family Practice. I currently hold a Medical License in Michigan. I tell you this only because I am hoping to make it clear that my life was geared toward working. Then, in March of 2013 I was diagnosed with a brain tumor that brought my plans to work to a screeching halt. Given this abrupt change, it would have been easy to throw my hands up and surrender; however embedded in my genes (as well as in the genes of every single human being) was a trait that implored me to adapt. The field goal posts might have moved but I still wanted to play the game.  Even though I was on a path to opening my own practice, now with the curve-ball life has thrown me I still use my medical knowledge for the benefit of others. I ask you to do the same: adapt. As a human race we have adapted to progress; as individuals we can change to further our lives. I will leave you with a quote from Bruce Lee, “Empty your mind, be formless. Shapeless, like water. If you put water into a cup, it becomes the cup. You put water into a bottle and it becomes the bottle. You put it in a teapot, it becomes the teapot. Now, water can flow or it can crash. Be water, my friend.”[2]

[1] He was born on April 23, 1564 by the way.
https://www.history.com/this-day-in-history/birth-and-death-of-william-shakespeare-celebrated

[2] h

25 May

Unicorns!

Let’s do a thought experiment together: Let’s take a middle aged woman and for one year everyone she encountered told her that they saw a unicorn that day.  Her dad would slip in a casual, “did you see what that unicorn did?”, in conversation. Even kids would ask their parents, “mommy, did you see that unicorn at the zoo?” (At the exact moment this person is walking by; at the exact right sound level for her to overhear). My guess is that the year would start with this person wondering why the hell is everyone saying they saw a unicorn?  Is that a euphemism for something else?

Then, after a month, doubt would start to creep in. Unicorns are fake right? She might google “unicorn” to make sure (according to the first hit, Wikipedia, “The unicorn is a legendary creature that has been described since antiquity as a beast with a single large, pointed, spiraling horn projecting from its forehead.”)[1]  Ok, why did it say ‘legendary’ and not ‘mythological’? Does legendary mean it never existed?After six months, she would seriously question her previously held belief that unicorns never existed. Maybe a trip to the local library to research unicorns takes place. Instead of just brushing off her dad, and ignoring his ‘unicorn comment’, she might ask him about it. At the year mark, my bet is that a significant percentage of these (hypothetical) subjects would in fact believe in unicorns.

Even if one out of 1000 were converted into unicorn believers (or ‘unicorners’ as we in the know say) then the hypothesis of the experiment is proven. I used a middle aged person to emphasize the fact that they previously held solid beliefs that unicorns were mythological (and legendary). However, through external forces, this belief was put into question. But it is not until these external forces are internalized that doubt starts to creep in. Finally, it is not until internalization is complete that this person begins to believe in unicorns.

The point of this experiment is not to highlight the gullibility of some of these subjects, but to portray the power of human thought. We have all heard of the cliché power of thought (from Socrates to pop culture in movies like Inception), but this experiment proves the limitless power that it truly has. A creature that we all know does not exist, through thought and persuasion, reversed a strongly held belief. Thus, we can convince ourselves that bad luck only happens to us, or we can harness the power that made our subject think that unicorns are real, and believe in our abilities. If a person is faced with any situation or obstacle, there are countless ways they can react to it. Use the power of your thought to react in a beneficial way. In this age of superheroes, little did we know that we each had a superpower within us. Maybe unicorns are real.

[1] https://en.wikipedia.org/wiki/Unicorn

31 Jan

Bright Side

I recently had the thought, “I wish I could do that”. I then realized how counterproductive it was for me to think this way. We all have fleeting thoughts of objects or abilities we wished we had; those we cannot avoid, but when these thoughts become more than fleeting, even consuming, that is when we must remember to focus on what we have and can do, rather than on what we cannot.

Even though the premise of this message seems straight-forward, it is one that is often forgotten. We all wish we had more money; maybe you wish you wish you were taller, or had different color hair. Perhaps you desire more power at your job. We all wish and hope for different possessions and talents, but we cannot let these desires consume and overtake us. Instead, we should be grateful for what we do have and can do. Personally, I mentioned earlier how I wished I could do that; my 4 year old son had just asked me to play catch with him. I knew my poor motor skills would not allow me to do so, so it was at that time I wished I could do that. Thankfully though, that only lasted a minute, as I have not had thought again. . . Until now. But my point is, that if I allowed these thoughts to consume me I’d either go crazy or sink into depression (or both); I think it’s important instead to hone in on what I can do instead.

Many people, much smarter than me, postulate that our minds are like basins being filled with water that are our thoughts and emotions. Thus, according to this theory, that Pythagorean Theory we learned back middle school (you remember it, right?), takes up some space in the storage of our minds. Some facts might be hidden deeper in there and tougher to find, like counting to ten in a foreign language, but they’re in there. It just might take some time for you to fish them out. Thus, why fill this precious space with useless thoughts of what you do not have or cannot do?

Yes, at the core this is a piece about optimism; I am simply telling you what you already knew: be optimistic, not pessimistic. But if this message is so simple, why is it so often forgotten? Studies show that optimists succeed more than pessimists. This makes sense when faced with a problem; while a pessimist would fold and surrender early to let it go and deem the problem unsolvable, an optimist would instead find a way to solve it with the tools he/she has. Thus, my last 445 words to you can be boiled down to one straight-forward message: be an optimist, not a pessimist.

Please know that the reason I devoted a whole article to this thought is that it is an important one.

08 Dec

Beauty

As the saying goes, “a few bad apples can spoil the bunch.” The underlying idea is that you can have a basket of crunchy, delicious apples, but the mere presence of a rotten one can ruin all of them. The aftermath of the shootings in Las Vegas and Texas had me constantly harping back to this saying.

Why?” you may wonder. After devastating events like these, when I turn on the television, or pick up a newspaper, I am bombarded with notions like ‘these events signaling the demise of our culture’. While for me, my first thought was for the families of the victims of these horrific events and how another human being could commit such horrific acts.

But then I thought more, as sappy as it may sound, human beings are beautiful and while these isolated horrible events may skew our outlook, I implore you to see through this fog to humanity. Don’t let some ‘bad apples ruin the batch’.

During this time you may hear people from the left or right claim that this is either a gun control or mental health issue, but do not forget that these are the same people who gave such wondrous gifts as human flight, or produced moving words such as, “to be or not to be: that is the question.”[1]

I, by no means, wish to belittle the tragic events from these past several months, but I do hope to remind everyone reading this that while some people may commit some ugly and heinous acts, this is the same species that gave us poetry and music.

With this being the holiday season, our thoughts on who and what to give ‘thanks’ to is part of the tradition; for me, amidst all these horrific events, I will (counter-intuitively) give thanks to the 7.6 billion people living on this planet (minus 2). These accomplishments and feats are so numerous that me giving you specific examples here would be fruitless. Yes, these horrific events tell us that change must be undertaken. What that change is, is up to you.

But do not let the few ‘bad apples’ we witnessed in Las Vegas and Texas ruin our appreciation for the batch of humanity.

[1] Shakespeare, Hamlet

20 Sep

All You Need Is Love

I was diagnosed with a brain tumor in 2013, right in the middle of my medical residency. Before that, I was just going through the motions, making sure I saw enough patients to reach my numbers, graduate, and practice on my own. But on March 13, 2013, my view of medicine changed drastically—and I owe it all to love.

Love diagnosed me, treated me, helped me through the hospitalization, and aids in my recovery to this day. In short, love saved my life. On that day in 2013 when I developed double vision, a prominent, local neurologist obtained the MRI and laboratory work that gave me a diagnosis. Unlike me, he wasn’t merely going through the motions. He loved his craft and it was because of this love that I was diagnosed.

When I needed surgery, the neurologist consulted with a neurosurgeon who performed the 16-hour surgery. What possesses someone to operate for 16 hours? What drove him to wake up every morning before the sun rises to visit me? Only love of his art could motivate him, I believe.

In my initial post-operative phase, I was in the ICU for one week, followed by a month-long stay on the general floor where I received dozens of visitors, including my primary care physician; a rehabilitation doctor; speech, occupational, and physical therapists; a neurologist; an ophthalmologist, and a neuropsychologist.

Many of these visits, especially from the physical therapist, were frustrating. Saying words like bumblebee, or putting pegs in a board did not thrill me. Many times I wanted to skip these appointments, but the love of my wife and two sons always urged me on.

It was the love of my friends that reminded me that I would get better. It was their love that gave me the hope I needed. Now, when I am doing balance exercises at the gym, I close my eyes and picture my friends and family. Their love makes me do that extra exercise; they are the reason I try to recover.

My words may sound cliché, but no matter how I spin it, I can’t get around the fact that love has been the driving force behind this whole journey, from diagnosis to recovery.

As a physician, I hope to use this love in all my encounters. The days of going through the motions are behind me. I realize it is unrealistic to love every one of my future patients. Instead, I will love the art of medicine and the fact that I am fortunate enough to be in a position to help people.

speakup_1.jpgChristopher Chiou, MD, practices family medicine in Okemos, MI, where he lives with his wife, who is also a doctor, and two sons. He has recently begun writing about health in various journals.

 http://journals.lww.com/neurologynow/blog/speakup/pages/post.aspx?PostID=72
16 Aug

Supplements

If you are looking for a profound article describing the meaning of life, then read no further, this is not that kind of article. I was just reminded recently about the idea of supplements. In fact, one of the EBTS members, Andrew Walker, recently posted, “A nutritionist suggested some supplements to support [the] brain…” Now before I go on, you might finish this article and think, jeez, does Chris not like supplements? I want to answer that right from the onset; my response is a little complex, but ultimately the answer is, “I do not know.” Let me explain:

In medicine, we are trained to be weary of dietary supplements. The idea behind this is that these supplements are not researched and approved by the FDA. This does not mean that they are disapproved, it simply means that that particular drug or dietary aid has not been studied. Numerous supplements like multi-vitamins, glucosamine chondroitin, and melatonin, I actually encourage my patients to take. While these have not been approved by the FDA, they have stood the test of time. However, for every one of these effective remedies, many more questionable ones exist. My mind cannot go away from e-cigarettes when mentioning this. I know they are not technically a supplement, but many of the ideas are the same. While, the idea of replacing a ‘regular’ cigarette with a device that delivers nicotine in a different way is a good thought, the problem is that we have absolutely no idea what is in them. For all we know, e-cigarettes could contain trace amounts of rat poison. Or it could contain some magical compound that stops smoking. The point is that we have no clue what is in e-cigarettes or supplements; they lack the research needed to know their contents or effectiveness.

So, in the end, my thoughts on supplements is one of uncertainty. I have been fortunate enough to be on both sides of the conversation: I have both suggested and been advised to take a certain supplement.

My only advice to you is to be your own FDA, and research and study what you are considering to put in your body. Part of that research may include asking your physician, in hopes that he/she also has studied the supplement in question and can share their findings and thoughts with you. Your research may include posing a question to a group like the EBTS (like Andrew).