Saturday, February 07, 2009

Got a few... AVM News! Plus ME!

Gamma Knife Surgery Stereotactic Cancer Non Invasive Cobalt 201 see Website

See Web Gamma Knife Surgery Stereotactic Cancer Non Invasive Cobalt 201 port helmet Tirgeminal Neuragia Radiation Cells Surgery no incision Radio Surgery MD Anderson Brian Tumors Malignant Biopsies Treatment Side EFfects Cyberknife Therapy radiotherapy Injury imaging maping Medications Microsurgery Disorder epilepsy Parkinsons Subscribe

Tags not taking CT Scan alternative Healthcare Cost Saving acoustic neuromas pituitary adenomas, neningiomas chordomas metastases glial chondrosarcoma craniopharyngiomas Brian Nelson

New data.

Gamma Knife Surgery: No Scalpel Needed
Patients with certain types of brain tumors and disorders no longer need to “go under the knife” or endure physically draining radiation therapy to find relief. With Gamma Knife technology, doctors are able to deliver over 200 beams of radiation with scalpel-like precision directly to tumors and lesions.
Although many people have never heard of Gamma Knife, the procedure has been around for a long time. The Food and Drug Administration approved it nearly 30 years ago, and University of Maryland doctors have been administering Gamma Knife treatments for over a decade. In fact, more than 2,500 patients have come to the University of Maryland Medical Center for Gamma Knife surgery.
Unlike traditional surgery, Gamma Knife procedures don’t actually involve the use of a “knife” or scalpel. In fact, no incisions are made at all. The skull never has to be opened up.
Conditions Treated with Gamma Knife
The following conditions are among those that can be treated with a Gamma Knife.
•Benign tumors — including meningiomas, acoustic neuromas, pituitary adenomas, schwannomas, craniopharyngiomas, pineal tumors
•Malignant tumors — including metastatic tumors, chordomas, medulloblastomas, astrocytomas, ependymomas, anaplastic astrocytomas
•Arteriovenous malformations (AVM)
•Trigeminal neuralgia
•Parkinson’s disease
Gamma Knife also differs from conventional radiation therapy. Because patients are injected with such low doses of radiation, they don’t experience the side effects associated with traditional radiation therapy. In fact, several “shots” of therapy can be given during the same session, and treatment sessions can be repeated every few weeks if necessary.

Malignant Biopsies Treatment Side Effects Cyberknife Therapy Radiotherapy

Injury Imaging maping Medications Microsurgery Disorder Epilepsy Parkinsons Scalpel Procedure Epilepsy Doctor Nurse complications Blood beams intersect fractional

CT Scan alternative Healthcare Cost Saving acoustic neuromas pituitary adenomas, neningiomas chordomas

metastases glial chondrosarcoma craniopharyngiomas Brian Nelson

Gamma Knife Surgery Stereotactic Cancer Non Invasive Cobalt 201
End. Studies show strong treatment success rates; for example, local control (successful treatment of a specific site) of tumors in any brain location exceeds an average of 85%. And, despite the name, there is no blade or knife its called Gamma Knife because radiosurgery (one-session treatment) has such a dramatic and precise effect in the target zone that the changes are considered surgical. So theres no incision or blood, and minimal risk of complications.
Through the use of three-dimensional, computer-aided planning and the high degree of immobilization of the patient, the treatment can minimize the amount of radiation to surrounding healthy brain tissue. There are approximately 200 sources of cobalt-60 loaded within the treatment unit. Thousands of radiation beams can be generated from these sources with a level of accuracy of more than 0.5mm, about the thickness of a strand of hair. Individually, each radiation beam is too weak to damage the normal tissues it crosses on the way to the target. But when focused precisely on that target, the beams intersect and the combined radiation is sufficient to treat the targeted area.
Because Gamma Knife radiosurgery is so accurate, the full dose of radiation can be delivered during a single session, compared with multiple visits for linear accelerator (linac) treatments, which use lower doses delivered in fractions (fractionated treatment).
The reduction of excess radiation is important to everyone, but particularly to cancer patients who are receiving other radiotherapy treatments. For these patients, treatment of a metastatic brain tumor a cancer that has spread from the original site might have to be delayed by up to six weeks if certain less precise treatments are used.



While Mike and Karla are at Mayo


My name is Dean Osborne and Pastor Mike is my pastor at Crossroad Evangelical Free Church. I asked Pastor to allow me to assist him and Karla during their time at Mayo and I wanted to share with everyone an experience my wife Kathleen and I had with some other dear friends during Christmas 2006.

Our best friends Randy and Rita live in Minnesota, where Randy is a pastor. Kathleen and I had planned to spend Christmas with them that year but Randy had the flu, or so he thought, so we stayed home. A few days later, Randy was admitted to Mayo hospital with an unknown diagnosis; it wasn’t long before he had life-altering surgery.

We headed to Minnesota after Randy’s surgery to help while he recovered in the hospital. We observed caring friends and family who wanted to help and were eager for information about Randy’s condition. Through this experience, Kathleen and I learned several things about how we could practically express our support to others in a similar situation.

All of us love them and are eager to help and encourage the family during this time. Our purpose is to serve as your point of contact to help you stay up to date and answer questions you might have.

Staying informed

  • I’ll be working with Karla to post updates to the blog — at least daily — and more frequently when appropriate. Checking the blog will provide you with the most accurate information and most importantly, free up Karla to care for Mike and consult with the physicians.
  • If you need to speak to Mike or Karla, want to visit the hospital or have a question, please use me as your point of contact. Call 515-238-3147 or send an e-mail to Please know we’re not trying to be the border patrol, we’re just trying to organize all the love.

Some practical suggestions

Many of you are wondering about the best ways you can help. Here are a few practical ideas:

  • Daily expenses like gasoline, parking, eating out, etc., will quickly add up. You may wish to help cover some of these expenses. As we know from recent posts, Karla’s financial skills are amazing, but it’s still unlikely she’ll convince Mayo to pay them for the privilege of being able to operate on such a fine brain. But seriously, this is a time they need the freedom to buy what will make this trip easy for them, and as we all know, “easy” often costs more.

If you decide to do this, please make your checks payable to Karla Evans and mail them to:

Crossroad Church
P.O. Box 218
Earlham, Iowa 50072

  • Most likely Mike won’t be able to enjoy flowers or balloons for several days after the surgery and they’ll be difficult to transport. We’d suggest that you hold off on sending these to the hospital at this time.
  • Many of you have already sent cards and notes of encouragement. If you want to send any to the hospital, you can address them to:

Saint Mary’s Hospital
1216 2nd Street SW
Mike Evans Patient
Rochester,MN 55902

  • Of course, you can always post comments to the blog.
  • I’ve worked with our church to set up a team in Iowa to assist them after Mike returns home. If you live in or near Earlham and have an interest in helping, please contact me via e-mail at Watch for more information about this later.

On behalf of Pastor Mike, Karla and their family, thank you for your love, support and prayers. I know they have been overwhelmed by your response. We serve an awesome God and ask that each of you keep them before the Lord in prayer daily.

In His Service


Go give them a peek... click here


I've still got a cold.... WTF! I have not been up to much.
What do you want to hear from me? I forget what I have said... so let me know... please... pretty please?

Okay that's enough for now... C-Ya!

Friday, February 06, 2009

Avm News... not mine

Not Me... but a real good post.

Mel's case updated 01

I brought Mel for check-up on 3/2/2009, we reached Tawakal Hospital 12:30pm which the appointment has booked before CNY. We were waiting for around 30 minutes in order to see the doctor. Just because the doctor went to ward visiting.

To be honest, Mel was prepared for the admission to do the angiogram test, and the doctor told us is only 3 weeks the case happen, and worry about the blood clot still unclear, it is better to wait for another week. And next appointment is booked. I'm just curious, since if he knows the test only can be done after 4 weeks, why is he put an appointment after 3 weeks? And RM150 is paid for the short consultation.

He did mention after the angiogram, and it depends on the report, maybe send her to Ampang Puteri Hospital to do the Embolization.

I have done some survey about the embolization:

What is Embolization?

Embolization is a technique in which the blood vessels of the AVM are plugged with non-reactive glue. Under x-ray a catheter is guided from the femoral artery in the leg into the area to be treated. This is repeated for each vessel that feeds the AVM. Patients sometimes require this procedure to be repeated. This method is frequently combined with other treatments. Although embolization can be a complete and successful treatment in its own right; there are occasions when it's not possible to completely manage an aVM with this treatment. In this instance, embolizatin is used as a precautionary measure to reduce risk to the patient whilst undergoing other procedures.

Occiptal AVM before embolization (L) and after embolization (R)

Occipital AVM before embolization (L) and after embolization (R)

What are the Side Effects?

Every patient is different. Some minor side effects maybe observed shortly after embolization of na AVM by some patients, but most feel perfectly fine. The side effects are usually temporary and should subside within a few days to weeks.

Headaches are not infrequently reported. They will usually subside, but if they are persistent, the doctor will prescribe a short course of medication and this will usually take away the headache.

Other possible complications include stroke like symptoms such as weakness in one arm or leg, numbness, tingling, speech disturbances and visual problems. The risk of embolization is low for serious complications such as permanent stroke or death. The estimated risk should be discussed with your doctor.

Bleeding After Embolization Treatment

It is important for you to know that embolization will not usually completely close off an AVM. A person may still bleed from an AVM in such a case. It is not known whether or not partial embolization treatment reduces the risk of future bleeding.

What are the Advantages of Embolization Treatment?

  • Embolization is very useful in making the AVM smaller in size in order to be suitable for radiation treatment.
  • Embolization is very useful to reduce the blood flow through the AVM just before surgery. This makes it much easier for the surgeon to remove the AVM.
  • Can be early repeated and staged.
  • Chances of a cure with embolization alone are about 20%.
  • No open surgical procedure.
  • Short hospital stay.

What are the Disadvantages?

  • This form of treatment can only be done if the AVM is made up of vessels that can be reached with the catheters.
  • Multiple sessions may be required.
  • There is a small chance of a stroke in about 1-3% occurring as the result of the treatment.
  • The chance of bleeding every year in a partially treated AVMs is likely reduced by embolization, but not eliminated.


He seems to be straight about the head.... too bad that is not what they say about me....

I got no news when it comes to my favorite subject... me. I still manage to have a bit of a cold... yuck.
And I'm tired.... gonna go back to bad.... uuuuuuummmmm bed!!!!
on that note.... off I go.


All You Need Is Love - The Beatles

The Beatles Hello Goodbye

There are some really good videos of the Beatles on youtube... go give the a look....

Thursday, February 05, 2009

Still got nothing... but

I did get this...
Yep... the worst movie ever!!!

I picked it up at

Psychotronic Titles

and I find that it makes a fine coaster...
and a nice hat.

ARP... yep.Gotta go... see you later.


oh boy... they just get worse....
one more.... okay.

You asked for it.... WOW!

now buy some stuff...

Yep it is the Angry Red Planet trio....

Stole it from

Look at what is going at

How To Fake Your Clickbank Earnings

I've always wanted to know how all those shysters fake their pics and videos of their supposed Clickbank and PayPal accounts. I just presumed it was a photoshop thing. Apparently not. There's some javascript you can incerpt and You Too Can Earn Millions a Month Online!

Check this out -

go give him a look...
you can do it here



And that's that... No AVM News today... that is good.
I still have my cold! It is just the sniffles. But what a pain in the A@@!

I got to go now... I'll try to talk at you later.

Wednesday, February 04, 2009

I Got No....


I am at home today.
The boy that is staying with us, it suppose to go to jail. (Yesterday)

Let us just say, he is up in the bedroom.

I can't fight him, so he will stay... I don't understand. He knows what he did, he was found guilty, he should go to jail.

I know it looks bad, and frankly it is. But what can I do.

Okay, time for me to go...

...and by the by that is a pic of my AVM... the first time.

okay I had to do it... and

That's strange... who'd a though.

Gotta go...

Tuesday, February 03, 2009

Got a few AVM posts... no pics... I am sorry.

About AVM
I met Dato' Dr. Hj. Fadzli Cheah Abdullah during CNY in my hometown. He is my neighbour's husband's uncle. He is a neurosurgeon who has his own office in Ipoh. I had the chance to show him Mel's brain scan report. He told me that is AVM. He also gave me his contact number, once the angiogram report is out, he is kind to give me second opinion about Mel' case. Thank him so much.I heard about this before, one of my colleague Becky's boyfriend has the same problem.

The different between two of them is Mel's AVM is inside the brain and Ah Teh's AVM is outside the skull.Because of this I have done some research at google about what is AVM.Arteriovenous malformation

An Arteriovenous Malformation is often referred to as an AVM. It is a tangle of abnormal blood vessels (arteries and veins). AVMs can occur anywhere in the body; however brain (also known as cerebral) AVMs are of special concern because of the damage they can cause when they bleed. They are very rare and occur in less than 1% of the general population(1). AVMs that occur in the covering of the brain are called dural AVMs. The cause is not known. AVMs are thought to be due to abnormal development of blood vessels during fetal development. An AVM is not inherited or infectious. An AVM is not a cancer, which means that it cannot spread to other parts of the body. Brain AVMs have usually been there since birth. Dural AVMs are an exception in that they may be caused by injury. AVMs can occur in people of any race or sex in almost equal proportions.

Signs and symptoms

Symptoms of AVM vary according to the location of the malformation. Roughly 88%[citation needed] AVM are asymptomatic; often the malformation is discovered as part of an autopsy or during treatment of an unrelated disorder (called in medicine an incidental finding), rarely its expansion or a micro-bleed from it, could cause epilepsy, deficit or elicit pain.

The most general symptoms include headache and epilepsy, with more specific symptoms occurring that normally depend on the location of the malformation and the individual. Other possible symptoms include:
Difficulties with movement or coordination, including muscle weakness and even paralysis; vertigo (dizziness);
Difficulties of speech (dysarthria) and communication, such as alogia;
Difficulties with everyday activities, such as apraxia;
Abnormal sensations (numbness, tingling, or spontaneous pain);
Memory and thought-related problems, such as confusion, dementia or hallucinations. Treatment options Available There are several options available; the nature of treatment offered will depend on the size and location of the AVM. Your neurosurgeon will advise you of the most suitable options.

Embolisation: is a technique which involves injecting liquid glue or coils into the AVM, using a catheter similar to the one used for an angiogram.

Radiation/Stereotactic Surgery: is also known as Gamma Knife Surgery. The treatment involves narrow x-ray beams being focused on the AVM in such a way that a high dose is concentrated on the AVM with a much lower dose delivered to the rest of the brain.

Surgery: is the traditional technique used to remove an AVM. It is often referred to as a craniotomy. This procedure is carried out by a neurosurgeon who will remove the AVM under general anaesthetic in theatre. Observation: can be used as a fourth option and may be recommended if the neurosurgeon feels that treatment cannot be offered safely or when an AVM is discovered in later life.For more information about AVM, please refer to the link below:




Let's talk about compassion.
I've gotten a couple of comments in the last week that I haven't published. Both of 'em came from women (or a woman, posting as two) who claim to have kid(s) with AVMs on their faces; both of 'em took me to task for a lack of compassion. Apparently, I'm supposed to have compassion when I'm posting here, about my patients, and the doctors, and my nutso coworkers. (I should mention that both comments were personally abusive and name-calling, which triggers the auto-dump feature on the Nurse Jo Robot. That's why they're not here.)
Normally, criticism doesn't bother me. Blame it on the codeine, 'cause I'm gonna answer my critics:
Lady (or Ladies), you don't want me to have compassion on this blog.
Why not? Because, if I'm compassionate here, it means one of two things:
1. I've not used up all my compassion on my patients.
2. I'm drunk.
Let's be real, People: You don't come here for compassion and warm fuzzies. It's like the man said--come for the stories, stay for the snark. And, honestly, who wants to read me tear my heart out over patients that've torn my heart out?
I could talk about walking down the hall with Darlene, her arm around my waist, as we discussed the best way to tell her eight-year-old daughter that Mom wasn't going to live much longer. I could talk about Velma, and how she cried about having to go to hospice, because her mind was still there though her body wasn't. Or I could tell you about Ben, who told me frankly over dinner that he was damned ready to die, but was holding on for the good of his wife and kids, who weren't ready to let him go yet.
But you don't want to hear about that. Nor do you want to hear about the 13-year-old girl with the horrendous congenital AVM that would likely kill her, whose toenails I painted the night before she went into surgery (all but one, so they could put a pulse ox on in the OR), so they'd be pretty for the surgeons. You don't particularly care about the fifteen-year-old boy whose Moya Moya had so screwed up his brain that I was the only one who could get him to consent to surgery, and only then after coming in early and rocking him on his bed like a baby. And I'm certain, as the mother of an eleven-year-old with an AVM, that you don't care about the time I summoned up all the crappy, rusty Danish I could muster to help comfort a dying woman who couldn't remember that she wasn't at home, in Copenhagen.
You'd rather hear the snark, and read the snappy lines. I don't blame you. If my working life were snappy lines and snark, it'd be something for ABC or FOX to run in a half-hour between family comedies. It wouldn't be what I live every day, where real people hurt, and die, and sometimes don't die...and those of us who are living are left to pick up the pieces.
This is an important point for those of us who blog, and those of us who nurse: People will criticize you for not being the constant comforting angel that they think you ought to be. To hell with them. The important thing is that you do what you are meant to do for those people who find themselves in your care.
That means you won't always be unsnarky when somebody wants you to be. You may not always want to talk about work when you get home. Sometimes, if you're a bit under the weather or a little too far into your cups, you might surprise your drinking companion with some heartbreaking story. The important thing is that when it counts, where it counts--with your patients--you aren't holding back.
I spend enough time questioning whether or not I did what was best for my patients. I spend hours after every work day going over every. damn. thing. I did. and trying to figure out if there were a way to say it better, do it more gently. In the middle of my day, I am a nurse. When I come home, I am a blogger. If the nurse part bleeds into the blogger part, it means I'm not doing my job--either job--well enough.
And so, critics, up yours. It's a shame you didn't read farther or dig deeper. I'm sorry for you, and I'm sorry for your kid--but I'm not sorry for my patients. What they get is the absolute best of what I have to give. What the blog gets is the cynical, tired leftovers.
Would you rather it be the other way 'round?



Hi... Umm my Mother has 3 brain aneurysms and an AVM, looking for a little help...
Hi,My Mom on labor day of 2008 had a brain aneurysm bleed. She was life flighted to University hospitals in Cleveland Ohio where they coiled 2 of the aneurysms, her recovery was very fast and she was out of the hospital withing 3 weeks. They took care of my mom's AVM(its like a tangled mass of veins in her brain) on December 5th 2008 in a 2 surgery process. This was by far the worst experience of my life, after the first surgery my mother did not recognize any of her family and acted like a small child. They took her in for the removal of the AVM on December 6th and she came out much better than the first, she knew her own name and most of her family. But our last trial was an aneurysm that had not burst that needed to be clipped. This surgery was scheduled for January 5th 2009, this surgery seemed to be the easiest of them all... but after my mom had recovered she was different, it was like someone else was in her body. My mom was my best friend and now she won't even really talk to me, she is more irritable and just all around unpleasant. She used to be everyone's best friend! She usually worked seconds but now she wakes up late and goes to bed early! I don't know what to do! Its ripping my family apart. I was wondering if anyone has had an experience close to this? I hope with time she will become more of what she used to be, but I don't know what to think. Please someone help.

help if you can... click here


That's it... I am at work... so I have to make it short.
Good bye for now.

Monday, February 02, 2009

No avm's today... a little Me insted.

I got a problem... only a little one... but it sucks none-the-less.
One of my boys, we let stay in our house, last winter, stole my digital camera...and his boy broke it.
So no chance of me getting pics on line.

I've got a few, but they are all pre-head bleed.

I am real sorry for that...

Okay I have to go... take care... R

th th th that's all folks

Sunday, February 01, 2009

AVM News!

Not me... but worth the time...

Stuff the bus for Steven Styles

By Elizabeth MacFarland

A second grade class at Kirk Elementary School in Millington is stepping and helping one of their own, 10 cents at a time.

Ms. Damm's class is trying to stuff a school bus full of pop cans to help their classmate Steven Styles. Last May, 8 yo. Steven Styles learned about a spot on his brain. Doctors diagnosed him with AVM, a medical condition similar to a brain aneurysm. And when Steven stopped coming to school, his classmates wanted to help.

So far more than 100 bags of cans have been collected for Steven, a young boy fighting for life, an inspiration to all those around.

"He is just a joy," Ms. Holly Damm said. "He has touched everybody's lives in that classroom, he enjoys life and has the biggest heart for anyone and everyone. He does so much for kids."

As for Steven's parents, they say Steven has good days and bad days, but one thing is for sure.

"We can't look at the bads, we have to look at the goods," Steven's father Patrick Styles says. "We have to keep going and say everything we do for this boy is going to make him better."

If you'd like to help stuff the bus for Steven you can drop off your pop cans at Kirk Elementary School in Millington.



And thats all... I'm still sick... dagnabit!
Good bye... for now.