Monday, January 30, 2012

Meningioma Monday...

"A well-developed sense of humor is the pole that adds balance to your steps as you walk the tightrope of life."--William Arthur Ward

It hasn't always been easy traversing this meningioma minefield of a journey, but I've found humor not only helpful, but extremely healing.
 
Humor has numerous benefits. It's been medically proven to:

*Reduce Pain.

*Decreases Stress.

*Strengthen Immune System.

Humor also has a positive impact on emotional and intellectual functioning:

• Helps put life’s trials and tribulations into healthy perspective by making them seem smaller.

• Aids us in overcoming fear.

• Allows us to take ourselves less seriously.

• Triggers our creativity.

• Burns calories!

Humor is great health care. I still can't figure out why Blue Cross and Kaiser don’t pay for it!

I now share with a few of my favorite ways to add humor to your life:

*Pretend you are a humor columnist and have to report several funny incidents daily.
*Rent funny movies.

*Buy/check out from library comedy books & tapes.

*View your life as a sitcom. Who would you cast as your family, your boss, your nosy neighbor, yourself?

*Sing your biggest problem set to your favorite song.

*Imagine Woody Allen is filming and starring in your life.

*Give hugs and smile at a stranger—it’s hard not to feel good when you’re doing something that makes you feel good too.

How do you get your daily dose of brain tumor humor?!

Monday, January 23, 2012

Meningioma Monday...

"Creativity is contagious. Pass it on.” — Albert Einstein

I admire creative people especially those with an artistic bent. Being one who works with words, it was only natural to wonder if I would lose the ability to write after my meningioma surgeries. Thankfully, time and lots of healing proved my doubts and fears wrong.

Despite my meningioma, I'm still able to pursue my craft. Along my meningioma journey I've been fortunate to cross paths with other meningioma survivors who are still able to pursue their creative passions.

Today's "Creative Cranium" shout out goes to Linda Roman, a meningioma survivor who is the creative genius behind Solcreations for you. Linda also pays her talent forward by supporting meningioma survivors and research.

Check her out at:
http://www.etsy.com/shop/solcreator

Monday, January 16, 2012

Meningioma Monday...

"You have a meningioma."

"A wh-what?" I stuttered.

"How do you even spell that?"

"Men-in-gioma sound more like a group of guys test-driving the latest foreign import with all the bells and whistles, not to mention the 8.9 percent available financing option."--From intro to Curveball: When Life Throws You a Brain Tumor (Ghost Road Press)

So what exactly is this tongue twister that also happens to be the most common primary brain tumor?!

Today's Meningioma Monday features an excellent primary on meningioma. Now if I could just pronounce it properly after all these years!

Thank you to Brigham and Women's Hospital.

What is a meningioma?



A meningioma is a type of tumor that develops from the meninges, the membrane that surrounds the brain and spinal cord. There are three layers of meninges, called the dura mater, arachnoid and pia mater. Most meningiomas (90%) are categorized as benign tumors, with the remaining 10% being atypical or malignant. However, the word "benign" can be misleading in this case, as when benign tumors grow and constrict and affect the brain, they can cause disability and even be life threatening.

 
In many cases, benign meningiomas grow slowly. This means that depending upon where it is located, a meningioma may reach a relatively large size before it causes symptoms. Other meningiomas grow more rapidly, or have sudden growth spurts. There is no way to predict the rate of growth for a meningioma, or to know for certain how long a specific tumor was growing before diagnosis.

 
Most people with a meningioma will only have a tumor at only one site, but it is also possible to have several tumors growing simultaneously in different parts of the brain and spinal cord. When multiple meningiomas occur, more than one type of treatment may have to be used.

 
Meningiomas vary in their symptoms and appropriate treatment options depending on where they are located.


A primary brain tumor originates in the central nervous system, while metastatic brain tumors spread to the brain from other parts of the body. Meningiomas account for about 27% of primary brain tumors, making them the most common of that type.


Who is at risk?


Meningiomas are most common in people between the ages of 40 and 70. They are more common in women than in men. Among middle-aged patients, there is a marked female bias, with a female: male ratio of almost 3:1 in the brain and up to 6:1 in the spinal cord. Meningiomas are very rare in children, with pediatric cases accounting for only 1.5% of the total.


How is the diagnosis made?


Meningiomas may cause seizures, headaches, and focal neurological defects, such as arm or leg weakness, or vision loss. Patients often have subtle symptoms for a long period before the meningioma is diagnosed. Sometimes memory loss, carelessness, and unsteadiness are the only symptoms.





How are meningiomas classified?


Meningiomas were originally classified into 9 major subtypes based on their structure and form. However, more recently it’s become more common to group them into three major classes, or not to distinguish subtypes at all. Multiple classifications exist today, but the most commonly used is the World Health Organization’s (WHO) "Classification of Tumours of the Nervous System," most recently updated in 2000. The WHO 2000 Classification of Meningiomas is located here.


What difference does the location of the tumor make?


Convexity meningiomas


These grow on the surface of the brain, often toward the front. They may not produce symptoms until they reach a large size. Symptoms of a convexity meningioma are seizures, focal neurological deficits, or headaches.




Falx and Parasagittal meningiomas


The falx is a groove that runs between the two sides of the brain (front to back), and contains a large blood vessel (sagittal sinus). Parasagittal tumors lie near or close to the falx. Because of the danger of puncturing the blood vessels, removing a tumor in the falx or parasagittal region can be difficult. Large parasagittal meningiomas may result in bilateral leg weakness.


Olfactory groove meningiomas


Olfactory groove meningiomas grow along the nerves that run between the brain and the nose. These nerves allow you to smell, and so often tumors growing here cause loss of smell. If they grow large enough, olfactory groove meningiomas can also compress the nerves to the eyes, causing visual symptoms. Similarly, meningiomas growing on the optic nerve can cause visual problems, including loss of patches within your field of vision, or even blindness. They can grow to a large size prior to being diagnosed due to changes in the sense of smell and mental status changes being difficult to catch.


Sphenoid meningiomas


Sphenoid meningiomas lie behind the eyes. These tumors can cause visual problems, loss of sensation in the face, or facial numbness. Tumors in this location can sometimes involve the blood sources of the brain (e.g. cavernous sinus, or carotid arteries), making them difficult or impossible to completely remove.


Posterior fossa meningiomas


Posterior fossa tumors lie on the underside of the brain. These tumors can compress the cranial nerves causing facial symptoms or loss of hearing. Petroclival tumors can compress the trigeminal nerve, resulting in sharp pain in the face (trigeminal neuralgia) or spasms of the facial muscles. Tentorial meningiomas or those near the area where your spinal cord connects to your brain (foramen magnum) can cause headaches, or other signs of brain stem compression like trouble walking.


Intraventricular meningiomas


Intraventricular meningiomas are associated with the connected chambers of fluid that circulate throughout the central nervous system. They can block the flow of this fluid causing pressure to build up, which can produce headaches and dizziness.


Intraorbital meningiomas


Intraorbital meningiomas grow around the eye sockets of your skull and can cause pressure in the eyes to build up, giving a bulging appearance. They can also cause an increasing loss of vision.


Spinal meningiomas


Spinal meningiomas account for less than 10% of meningiomas. They tend to occur in women (with a female/ male ratio of 5:1), usually between the ages of 40 and 70. They are intradural (within or enclosed within the dura mater), extramedullary (outside or unrelated to any medulla) tumors occurring predominantly in the thoracic spine. They can cause back pain, or pain in the limbs from compression of the nerves where they run into the spinal cord.


How common is each location?


Falx or parasagittal 25%


Convexity 20%


Sphenoid wing 20%


Olfactory groove 10%


Supresellar 10%


Posterior fossa (petrosal) 10%


Intraventricular 2%


Miscellaneous (e.g., optic nerve, clivius) 3%


What factors predispose people to meningiomas?


The only known predisposing factors associated with meningiomas are exposure to radiation, and certain genetic disorders (e.g. neurofibromatosis). Some have reported an association between meningiomas and the site of a previous injury (e.g. head trauma). However, the relationship with previous head injury isn’t well understood. Some have suggested that viruses may play some role as well, but this is unsubstantiated at this point.


Meningiomas are also more common in women than in men, and have shown increased growth during pregnancy. They have hormone receptors and progesterone and estrogen may play a role in their development, but that role is still unclear.


Previous Trauma


Meningiomas have been found at the site of previous trauma (such as near a previous skull fracture, scarred dura, or around foreign bodies), but the relationship isn’t fully understood.


Radiation


Exposure to radiation has been found to be associated with a higher incidence of meningiomas. For example, survivors of Hiroshima have an increased incidence of these tumors. The more recently developed methods of delivering radiation therapy that use focused beams help to limit unnecessary exposure to areas outside the target, and so are expected to be safer. Patients who have undergone broad radiation treatments in the past should take care to watch for symptoms and monitor themselves for meningiomas. Meningiomas caused by radiation exposure are generally more aggressive.


Genetic Predisposition


People with a genetic disorder known as neurofibromatosis type 2 (Nf2) are more likely to develop meningiomas. Of people with malignant meningiomas, a higher percent have mutations in NF2.


There are some genes that may act as tumor suppressors, and the lack or deletion of these genes may make people more susceptible to tumors. For example, patients with Nf2 are, unfortunately, more likely to develop meningiomas because they have inherited a gene which has the potential to cause normal cells to become cancerous.


Viruses


There is a possibility that viruses may be related to meningioma formation, but the relationship is not defined.


What are the indicators of a good or less good outcome?


Age


The age of the patient at the time the tumor is removed influences outcome. Younger patients tend to do better after surgery than older patients do do. However, older patients in otherwise good health should not assume that their chances of a good outcome are diminished.


Tumor location and accessibility


People with tumors that invade the brain tend to do more poorly than patients with tumors that do not invade. Similarly, people with tumors on the outer surface of the brain (convexity) tend to better than those with tumors that are difficult to access, like those on the undersurface of the brain, in regions adjacent to important structures like those needed for breathing or movement, or near large blood vessels. Incomplete removal of the tumor, which is usually due to limitations caused by the location of the tumor, is associated with a higher chance of tumor recurrence. Residual tumor cells are a potential source of new tumor growth.



Extent of removal


The major clinical factor in recurrence is the extent of resection/ removal. How completely the surgeon is able to remove the tumor is highly affected by the location of the tumor, whether it is adjacent or attached to anything else, and the age of the patient.


Survival estimates show a marked difference when grouped by type. Benign meningiomas have the highest survival rate, followed by atypical meningiomas and then malignant.


Age at the time of diagnosis is also indicates an increased chance of survival. The younger patients have better survival rates.


Brain invasion indicates an increased chance of recurrence. Brain-invasive benign meningiomas act like atypical meningiomas overall.




http://www.brighamandwomens.org/Departments_and_Services/neurosurgery/Meningioma/Meningiomafacts.aspx
Diagnosis is made by a contrast enhanced CT and/or MRI (magnetic resonance imaging) scan. While MRIs are in some ways superior, the CT can be helpful in determining if the tumor invades the bone, or if it’s becoming hard like bone.

Monday, January 9, 2012

Meningioma Monday...

"Call it a clan, call it a network, call it a tribe, call it a family. Whatever you call it, whoever you are, you need one." ~Jane Howard

Your second family of support will never leave your side during your meningioma journey.

For more second family resources, check out:

American Brain Tumor Association
http://www.abta.org/
Includes an in-depth overview about brain tumors and what to know before and after surgery.
 
Brain Tumor Foundation

http://www.braintumorfoundation.org/
This New York-based foundation provides up to date information on tumor types; support groups for patients & caregivers; the latest medical technology, treatment options and clinical trials; and more.

Brain Tumor Foundation of Canada
http://www.braintumour.ca
Their goal is to reach every person in Canada affected by a brain tumour.
Toll-free # for more information: 1-800-265-5106


International Brain Tumour Alliance
http://www.theibta.org/
Seeks to be an alliance of the support, advocacy and information groups for brain tumour patients and carers in different countries and also includes researchers, scientists, clinicians and allied health professionals who work in the area of brain tumours.

Meningioma Association UK
http://www.meningiomauk.org/
United Kingdom support group for those diagnosed with meningioma.

Musella Foundation For Brain Tumor Research & Information, Inc
http://www.virtualtrials.com/
Supplies information and support for families dealing with brain tumors, raises money for brain tumor research.

National Brain Tumor Society
http://www.braintumor.org/GeneralMenu/
Recently merged west and east coast based organization that provides excellent resources on various types of brain tumors, support groups and upcoming events for patients and their families.

The Tug McGraw Foundation
http://www.tugmcgraw.com/home.asp
Named after the Phillies and New York Mets pitching legend who lost his life to brain cancer, this foundation raises funding to enhance the lives of children and adults with brain tumors.

Saturday, January 7, 2012

Location, location, location!

You've just been diagnosed with a meningioma and one of your first questions is how could my tumor's location impact me?

The following information will help! Thank you www.braininjury.com

A wide variety of symptoms can occur after "brain injury." The nature of the symptoms depends, in large part, on where the brain has been injured. Below find a list of possible physical and cognitive symptoms which can arise from damage to specific areas of the brain:
Image

Frontal Lobe: Forehead

Loss of simple movement of various body parts (Paralysis).
Inability to plan a sequence of complex movements needed to complete complete multi-stepped tasks, such as making coffee (Sequencing).
Loss of spontaneity in interacting with others.
Loss of flexibility in thinking.
Persistence of a single thought (Perseveration).
Inability to focus on task (Attending).
Mood changes (Emotionally Labile).
Changes in social behavior.
Changes in personality.
Difficulty with problem solving.
Inability to express language (Broca's Aphasia).

Parietal Lobe: near the back and top of the head

Inability to attend to more than one object at a time.
Inability to name an object (Anomia).
Inability to locate the words for writing (Agraphia).
Problems with reading (Alexia).
Difficulty with drawing objects.
Difficulty in distinguishing left from right.
Difficulty with doing mathematics (Dyscalculia).
Lack of awareness of certain body parts and/or surrounding space (Apraxia) that leads to difficulties in self-care.
Inability to focus visual attention.
Difficulties with eye and hand coordination.

Occipital Lobes: most posterior, at the back of the head

Defects in vision (Visual Field Cuts).
Difficulty with locating objects in environment.
Difficulty with identifying colors (Color Agnosia).
Production of hallucinations.
Visual illusions - inaccurately seeing objects.
Word blindness - inability to recognize words.
Difficulty in recognizing drawn objects.
Inability to recognize the movement of object (Movement Agnosia).
Difficulties with reading and writing.

Temporal Lobes: side of head above ears

Difficulty in recognizing faces (Prosopagnosia).
Difficulty in understanding spoken words (Wernicke's Aphasia).
Disturbance with selective attention to what we see and hear.
Difficulty with identification of, and verbalization about objects.
Short term memory loss.
Interference with long term memory.
Increased and decreased interest in sexual behavior.
Inability to catagorize objects (Categorization).
Right lobe damage can cause persistent talking.
Increased aggressive behavior.

Brain Stem: deep within the brain

Decreased vital capacity in breathing, important for speech.
Swallowing food and water (Dysphagia).
Difficulty with organization/perception of the environment.
Problems with balance and movement.
Dizziness and nausea (Vertigo).
Sleeping difficulties (Insomnia, sleep apnea).

Cerebellum: base of the skull

Loss of ability to coordinate fine movements.
Loss of ability to walk.
Inability to reach out and grab objects.
Tremors.
Dizziness (Vertigo).
Slurred Speech (Scanning Speech).
Inability to make rapid movements.

Monday, January 2, 2012

Meningioma Monday...

It's not always easy to get motivated on Mondays, so I'm trying a new feature called Meningioma Mondays to highlight all things meninigioma. I might share an inspirational meningioma blog, share a meningioma related link, a meningioma fact...

Your participation is encouraged and welcomed!

Q: What do all these ladies in the photo share in common?

A: They are all meningioma survivors and proof that meninigiomas don't discriminate.

Sunday, January 1, 2012

MIND OVER MENINGIOMA...

As a nearly 12-year meningioma brain tumor survivor, my motto and mantra has become "Mind Over Meningioma."

It is my goal to further increase meningioma awareness in 2012 via my 9-years-and-counting, nonprofit, Meningioma Mommas, www.meningiomamommas.org , our MAD ABOUT MENINGIOMAS Facebook Cause, http://www.causes.com/causes/242100-mad-about-meningiomasand through my writing, www.lizholzemer.com

I'm also hoping you'll help pass the mind over meningioma message. Feel free to chime in at any time to share your meningioma moments, milestones and musings.

Happy New Year!