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The enemy within

A Seminole man tries to carry on with day-to-day life after being diagnosed with a brain tumor. Today, he has surgery to remove the growth.

By MAUREEN BYRNE

© St. Petersburg Times, published May 23, 2001


A Seminole man tries to carry on with day-to-day life after being diagnosed with a brain tumor. Today, he has surgery to remove the growth.

SEMINOLE -- Like any other day, Paul Trexler arrived at work by 6 a.m. Tuesday. He opened up the machine shop and turned on the lights and the air compressor machines.

Like any other day, he drank his coffee and read the financial news in the paper before he started his shift.

He stood at his neat work station, surrounded by pieces of metal of all different sizes. Wearing orange earplugs to snuff out the whirring sound of machines, he got to work, making tools and parts for motorcycles and boats.

He would like this day to be like any other, but there's no way around it, it's not. It's the day before brain surgery.

* * *

The headaches started in November. His head throbbed so much one time that it blurred his vision.

His doctor couldn't find anything wrong, which meant there was no awful diagnosis to deal with. But not knowing the cause was maddening in its own way. The headaches continued.

"I just kept popping aspirins, and they alleviated the pain," he said.

A friend suggested that maybe Trexler's headaches were from the stress of his run for a fifth term on Seminole City Council. But after he won the election in March, the headaches persisted.

The chest pains started in April. His doctor sent him to a cardiologist, who found nothing wrong with his heart.

April 27 started like another of those routine days at work. Trexler, 54, had just finished his morning coffee when something came over him. "I thought I was poisoned. Everything just went blank . . . this strange feeling overtook my body."

He took a break and felt better. For two hours. When it happened the second time, co-workers called paramedics.

A CAT scan and an MRI helped doctors at Largo Medical Center diagnose the problem. They found a 2-centimeter mass in the right temporal lobe of the brain, the part of the brain that controls the understanding of sounds and spoken words, as well as emotion and memory.

Trexler said the doctors told him it looked like a ganglioneuroma, a rare, benign tumor made up of ganglia-type cells, groups of nerve cells. Surgery is the standard treatment, and most patients continue to lead productive lives. But every tumor is different and every person is different, and you never know.

"When you're first told you have a brain tumor, it's devastating," he said. "When you're told someone is going cut into your brain, it's frightening. It's like no-man's land."

At his first meeting with his neurologist, Dr. Casey Gaines, Trexler says he told him: "Just take it out."

Gaines told him to go about his business. The operation would be in two weeks.

* * *

Trexler and his wife, Sue, got on the Internet. They wanted to learn as much as they could about brain tumors.

What was inside his head? Could it kill him? How many other people have brain tumors?

They read as much as they could on the Web site of the American Brain Tumor Association (http://www.abta.org). They learned that about 185,000 people are diagnosed each year with a brain tumor.

About 36,000 of those cases are primary brain tumors. They begin and grow in the brain, and their cause is unknown. Approximately 150,000 diagnoses are metastatic. They begin as cancer elsewhere in the body and then spread to the brain.

The American Brain Tumor Association says one type of tumor is not preferable to the other, what matters is the type of cells that make up the tumor.

There are no absolutes. The association says that certain malignant tumors can be cured by radiation therapy. Others, that appear "benign" under the microscope, can be deadly because of their location.

The tumor in Trexler's brain is in a spot that is operable. Seizures are the most common type of symptom of a tumor in the temporal lobe. Mental changes can occur, including problems with memory, speech, communication and confusion.

Trexler is not allowed to eat or drink anything after 2 a.m. today. He is due to arrive at Bayfront Medical Center by 8 a.m., and surgery to remove the mass is scheduled to begin at 2 p.m.

Trexler says his doctors have told him the best he can hope for is complete removal of the mass and recovery in three weeks. Thousands upon thousands of people with brain tumors have had that result. The worst, he hardly can even think about.

"I'm not scared stiff. I'm just frightened of the unknown. That is the fear of what people go through when they find out they have one. Am I going to be different? Are people going to treat me differently."

He wanted to keep things straightforward, like nothing was any different. So he kept on working, kept on playing golf, kept up with his duties on City Council.

"As long as I keep being busy and having a good time and don't stop and dwell on it, I'm fine."

That's why the day before surgery, he's at Precision Manufacturing and Sales Co. in Clearwater, acting like it's just another Tuesday.

* * *

The machine shop is a family-run business, with four employees. Trexler has worked there 10 years, making parts and assembling them into cylinder boring machines.

"He's such a good employee," said owner Edna Brunet, tears streaming down her face as Trexler made his goodbyes. "We're a family here. When one hurts, we all hurt."

After work, he stopped by Seminole City Hall to see if any last-minute items had been added to the agenda for the council meeting Tuesday night.

He ran a few errands: Went to the bank. Bought gas for the grill. He already had dug out important papers, his will, retirement pensions. "These are the things you have to think about in a worst-case scenario."

Sue Trexler, 60, doesn't want to hear about that. Instead, she cleans.

"That's my stress reliever," she said. "I took this house and tore it apart and redid the whole thing. That's how I handle my nerves. I cook and clean."

They have no children.

Trexler is glad he has someone to help him deal with fears. "If I had nobody to talk to, it would be very difficult because there are times when you have no desire to do anything. But she keeps me going."

* * *

In the opening prayer at most any Seminole City Council meeting, they ask for guidance to make the right decisions for the city. Tuesday, Mayor Dottie Reeder asked for something more.

She prayed for a successful surgery and a full recovery for her colleague and friend.

Trexler, trembling, bowed his head. In the front row, Sue Trexler bowed her head.

The council got down to business. They approved a $4,500 expense for new equipment for the recreation center; they authorized entertainment contracts for the city's 2001 concert series; they honored Dorothy Phillips, a longtime library volunteer.

After 40 minutes, their work done, the hugs began. A stream of people wished Trexler well.

Jimmy Johnson, the executive director of the Seminole Area Chamber of Commerce, reassured Sue Trexler. "He's a tough cookie. He'll be fine."

Trexler didn't hang around. He was tired, and ready for this day he wanted to be ordinary to be over. He was ready for tomorrow.

-- Coming Thursday: Surgery. How did it go?

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