By Nicole Holman
In August 2021, then-28-year-old Mike Knudson set out on what he thought can be an adventure-filled mountaineering trip inside Glacier Nationwide Park in Montana. Little did he know on the time that this journey into nature can be the beginning of an sudden life path.
All of it started innocuously sufficient simply earlier than Mike was scheduled to go away for his journey. One morning earlier than work, he felt a faint tingle course by way of his physique and a peculiar style fill his mouth as he ate breakfast. The sensations occurred once more intermittently over the following few weeks and endured into late August throughout Mike’s mountaineering journey. As he trekked greater than 20 miles throughout the mountaintops of Glacier Nationwide Park, Mike started to expertise signs extra incessantly and severely, which pressured him to chop his journey brief. When he returned dwelling, he skilled extra signs that included continual fatigue, sensitivity to gentle, nausea, lack of urge for food, and physique soreness.
At this level, Mike referred to as in sick from work and went to a neighborhood emergency room, the place he examined constructive for Lyme disease and was given antibiotics. But, one thing nonetheless was not proper. “I nonetheless felt horrible, and I bear in mind telling my pals that if I nonetheless felt dangerous by the upcoming weekend after I completed the antibiotics, I’d return to the hospital. However I didn’t make it to the weekend,” Mike says. “That Friday, my legs gave out and I collapsed and handed out in my residence. My roommates referred to as 911 and acquired ahold of my household, and I used to be rushed by ambulance to the closest ER.” Quickly after arriving at a Twin Cities hospital, Mike blacked out. By midnight, he’d regained consciousness and was transferred by helicopter to Mayo Clinic Hospital – Rochester, Saint Marys Campus. “Two ideas crossed my thoughts at this level,” Mike says. “‘No matter I’ve could be very critical,’ and ‘It’s a superb factor I’m going to the Mayo Clinic, as a result of if anybody can deal with it, it’s them.’”
An sudden odyssey
When Mike arrived at Saint Marys, Mayo Clinic neurosurgeon Ian Parney, M.D., Ph.D.says testing revealed that his worsening signs had been being brought on by a variant of a grade IV glioblastoma referred to as an isocitrate dehydrogenase (IDH) mutant astrocytoma. IDH mutant astrocytomas account for roughly 4% of all grade IV major mind tumors and have a 21- to 30-month survival charge common. “A grade IV IDH mutant astrocytoma is much less frequent than glioblastoma however extra frequent in youthful individuals,” Dr. Parney says. “It’s a malignant mind tumor with a robust tendency to recur within the mind.”
Testing confirmed that Mike’s tumor had two distinct elements. “The primary was a really aggressive showing part that lit up with the distinction dye on his MRI in his left temporal lobe,” Dr. Parney says. “The second was a lot bigger however much less aggressive involving his left frontal, temporal and insular lobes.”
Underneath regular circumstances, clinicians like Dr. Parney would have time to debate and take into account remedy choices for mind tumor sufferers. However provided that Mike was “very sick with recurrent seizures and a decreased stage of consciousness because of the stress from the mass inside his head” when he arrived at Mayo Clinic, Dr. Parney knew that wasn’t going to be attainable for him.
“HE IS ONE OF ONLY A HANDFUL OF BRAIN TUMOR PATIENTS IN MY CAREER THAT I HAVE TAKEN TO THE OR FOR AN EMERGENCY CRANIOTOMY,” DR. PARNEY SAYS. “WE USUALLY HAVE MORE TIME TO CONSIDER OPTIONS. IN HIS CASE, IT WAS NECESSARY TO REMOVE THE ENHANCING, AGGRESSIVE APPEARING COMPONENT AS SOON AS POSSIBLE TO SAVE HIS LIFE.”
Due to the severity of Mike’s signs and the swelling in his mind, Dr. Parney made the choice to carry out two separate surgical procedures to take away Mike’s tumor. The primary would require Mike to be awake in the course of the process in order that Dr. Parney and others within the working suite may mitigate the potential danger that surgical procedure may have on Mike’s motor and speech expertise. Mike’s second surgical procedure was much more complicated as a result of it carried a danger of serious long-term negative effects, reminiscent of issue talking or weak spot on one facet of his physique for the remainder of his life, paralysis, and even demise. Regardless of these dangers, Mike knew he needed to maneuver ahead with the second process. To organize, Dr. Parney labored with colleagues from Mayo Clinic’s Departments of Radiology, Laboratory Drugs and Pathology, Neuro-Oncology, Radiation Oncology, Bodily Drugs and Rehabilitation, and Speech Pathology to get the perfect care and remedy plan in place for Mike.
Along with this inner-specialty collaboration with colleagues throughout Mayo Clinic, laboratory testing from Mayo Clinic Laboratories additionally performed an important position in establishing Mike’s prognosis and remedy plan. Aditya Raghunathan, MD, MPHfrom Mayo Clinic’s Anatomic Pathology Laboratory, reviewed tissue samples from Mike’s tumor throughout his surgical procedures, which revealed that whereas Mike’s tumor confirmed a resemblance to glioblastoma, it possessed distinct options with a extra favorable prognosis. Testing additionally unveiled a possible susceptibility to focused brokers in case of tumor recurrence.
A path to therapeutic
Throughout Mike’s second surgical procedure, employees from Mayo Clinic’s electroencephalogram lab performed a important position in monitoring his speech and motor expertise to make sure they weren’t impacted by the process. “Thankfully, probably the most ache I went by way of was truthfully simply from the tightness of the top wrap bandage,” Mike says. “However over the next months, I had some extended signs. Most occurred as a result of my tumor was subsequent to my speech middle. So, whereas I nonetheless understood all of the definitions and knew all of the phrases to an extent, I might overlook them mid-sentence.”
One other problem for Mike was reestablishing his urge for food after the 4 months of fast onset nausea he’d skilled earlier than coming to Mayo Clinic. “I misplaced 40 kilos and went from with the ability to stroll completely nice to hardly with the ability to stroll quite a lot of blocks,” he says. “For 2 months, I used crutches or strolling sticks simply to stroll across the block.”
Immediately, Mike’s continued therapeutic is marked by his resilience and dedication. Following his second surgical procedure, he visited a speech therapist for 3 months. These efforts yielded outstanding enhancements in his speech and communication expertise, which underscored his unwavering dedication to regaining his high quality of life. He’s additionally met with Michael Ruff, M.D., chair of Mayo Clinic’s Division of Neuro-Oncology, each two months for complete MRIs and updates on his situation.
“EVERY TIME I HAD AN APPOINTMENT, I’D WRITE UP TWO WHOLE SHEETS OF QUESTIONS TO ASK MY DOCTORS AND THEY WOULD ANSWER EVERY SINGLE ONE OF THEM,” MIKE SAYS. “I DEEPLY APPRECIATED THE RESPONSES TO HELP ME UNDERSTAND WHAT WAS HAPPENING.”
Along with his docs, Mike has leaned on his family and friends for help all through his restoration. Each of Mike’s dad and mom are Mayo Clinic workers. His dad, Steve, is chair of Contracting and Payer Relations, whereas his just lately retired mother, Terri, served as senior director of Technique Administration Companies for Mayo Clinic’s Division of Laboratory Drugs and Pathology. “Mike is doing unbelievable,” Terri Knudson says. “I imply, discuss going previous the typical. And together with his youth and his energy, he’ll beat this factor. Loads has occurred in 22 months, however Mike’s nonetheless dwelling his life to the fullest. He has a reasonably lengthy bucket record, and he’s checking them off shortly.”
Since returning dwelling to the Twin Cities, Mike has embraced his recent perspective on life by rekindling his love for previous hobbies whereas exploring new pursuits. Notably, he has devoted time to studying two languages, Spanish and Japanese. He additionally has reignited his love for archery, making chain mail, blacksmithing, leatherworking, taking part in piano, studying books, and going for 50-mile bike rides. The longest journey he accomplished just lately stretched for 70 miles, a testomony to his dedication to surpass his personal limits.
True to his adventurous spirit, Mike has additionally revisited his love for journey. Throughout the summer time of 2022, he launched into thrilling quests to the Rocky Mountains together with his pals and a memorable voyage to Australia and New Zealand alongside his dad and mom. Throughout these travels, he fulfilled his lifelong dream to hike one of many world’s Seven Summits, Mount Kosciuszko in Australia, and Mount Doom, New Zealand’s largest energetic volcano, which served as the enduring backdrop for his favourite movie sequence, Lord of the Rings. Whereas in New Zealand, Mike and his dad and mom additionally skydived collectively over Queenstown, a city that some name the journey capital of the world.
With an ever-growing bucket record and the encouraging progress of his well being, Mike stays steadfast in his perception that he’ll proceed to defy the percentages. Having surpassed the two-year milestone of his prognosis, each Dr. Parney and Dr. Ruff share Mike’s optimism whereas recognizing the outstanding trajectory of his journey.
“Mike has carried out very well,” Dr. Parney says. “He went on to enroll in a clinical trial the place he obtained commonplace remedy with radiation and chemotherapy in addition to an experimental immunotherapy. Coincidentally, I occur to be the principal investigator for this scientific trial. His tumor has shrunk even additional on his MRI scans and there was no signal of recurrence even two years after his prognosis. We’re hopeful however might want to stay vigilant.”
Dr. Ruff echoes Dr. Parney’s optimism.
“Mike is doing what I feel all of us hope we’d do after a critical prognosis of most cancers: dwelling his life to the fullest, touring, even skydiving,” he says. “He benefited from an distinctive set of surgical procedures, and a compelling scientific trial utilizing immune remedy along with the usual of care. Within the close to future, he may additionally profit from groundbreaking advances in our subject concentrating on the IDH mutation, which his tumor harbors and acts as a molecular driver of the illness. This previous June, knowledge was revealed concerning the profitable concentrating on of this mutation in sufferers with IDH mutant gliomas with a brand new type of focused remedy. Whereas we don’t know that each one sufferers will profit from the usage of these focused brokers or the optimum timing the brokers ought to be employed, we’ve a now new method with a confirmed rationale. It fills you with a way of hope, and it could profit different sufferers like Mike.”
Along with his well being on the mend and his outlook more and more constructive, Mike is wanting ahead to extra progress in his medical journey with Mayo Clinic in addition to ongoing analysis that would result in improved outcomes for different sufferers. His story serves as a poignant reminder that life’s most invaluable moments shouldn’t be delayed however embraced right here and now.
“NO MATTER HOW MUCH TIME YOU HAVE LEFT, LIVE LIFE TO ITS FULLEST,” HE SAYS. “THAT GOES BEYOND PEOPLE WITH THIS CONDITION. I SPENT A LOT OF TIME DELAYING TRIPS SAYING, ‘I’LL DO THAT IN FIVE YEARS. I’LL DO THAT IN 10 YEARS.’ TAKE THE TIME THAT YOU HAVE LEFT TO GO ENJOY THE LIFE THAT YOU HAVE LEFT WITH ALL THE THINGS YOU’VE EVER WANTED TO TRY. AND LISTEN TO WHAT THE DOCTORS SAY.”
Be taught extra
Be part of the Brain Tumor Support Group on Mayo Clinic Join, a web-based neighborhood for sufferers and caregivers.
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A model of this text was initially revealed on the Mayo Clinic Laboratories blog.