The enemy within
A Seminole man tries to carry on with day-to-day life after being diagnosed with a brain tumor.
Day One:
Today, he has surgery to remove the growth
Day Two:
A day of waiting and worrying
Day Three:
Awake, happy, healthy
 photo
[Times photo: Scott Keeler]
 A Special Report: St. Petersbrg Times
trexler with his wife
[Times photos: Scott Keeler]
Seminole City Council member Paul Trexler shares a moment with his wife, Sue, in the pre-op area of Bayfront Medical Center before going into surgery Wednesday.

MRI scan
A scan of Paul Trexler's brain shows the tumor, center right in red, on a screen in the operating room at Bayfront Medical Center. The view is looking down from the top of Trexler's head.

placing markers
Maria Dambeck,an RN with Neurosurgical Associates, shaves Paul Trexler's head and places markers, known as fiducials on his scalp. The markers create a computerized map of the brain.

blood pressure check
Trexler has his blood pressure checked by Patient Care Technician Rhonda Fleming, center, while RN Staci Martin, right, fills out forms as she asks Trexler questions in the pre-op room.

moment before surgery with his wife
Sue Trexler, spends a moment with her husband , Paul, as he is wheeled into th operating room at Bayfront Medical Center.

sue trexler reacts
Sue Trexler reacts to news that her husband did well in surgery.

 

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A day of waiting, worrying

At 7:45 a.m., Paul Trexler arrives at Bayfront Medical Center to have a brain tumor removed. Nearly 11 hours later, his wife learns his fate.

By MAUREEN BYRNE

© St. Petersburg Times, published May 24, 2001


ST. PETERSBURG -- At 4 a.m. Wednesday, Sue Trexler is wide awake. No way she's getting back to sleep.

She flips on the TV and watches the early morning news, keeping an eye on her husband, sleeping soundly beside her. She worries about what's in store for him today.

A neurosurgeon is scheduled to open Paul Trexler's skull to take out a brain tumor. She checks the clock. Only 10 more hours until the surgery is supposed to begin.

No, no way she is going back to sleep. Might as well accept that this is how it's going to be today: a lot of waiting and a lot of worrying.

* * *

They pull into Bayfront Medical Center at 7:45 a.m. Inside of 15 minutes, Trexler is in a hospital gown and on a gurney in Room 259. Registered nurse Staci Martin runs him through a series of questions.

"First of all, tell me what you're going to have done today."

"Brain tumor."

"Who is your doctor?"

"Casey Gaines."

"Do you smoke?"

"Two packs a day."

"Allergic to anything?"

"No."

"Do you have a headache?"

"I always have a headache."

Trexler, 54, has been having headaches since November, but it wasn't until April 27 that he found out why. On his job as a machinist, he felt like all the blood in his body had rushed to his feet. A CAT scan and MRI showed a mass in the right temporal lobe of his brain.

* * *

8:40 a.m. Trexler meets his surgeon's nurse, Maria Dambeck, whose soft, delicate voice would put any patient at ease. Using a white, disposable razor, she shaves sections of his skull and places 10 white circles, called fiducials, in each of the bare areas.

The nurse explains: The markers are part of a system that uses computer images to navigate around critical nerves during surgery. The computerized guidance system creates three-dimensional images from the patient's MRI and CAT scans, allowing the surgeon to look at the exact location of his instrument and the target area from multiple angles. It is accurate to within a millimeter.

Trexler changes the subject, joking about his new hairstyle. "Hey, you got to patent this haircut, if it becomes real popular," he tells Dambeck.

Rhonda Fleming, a patient care technician, gives Mrs. Trexler a beeper. The first beep means surgery is done and she should return to the waiting room to speak to the surgeon. The second beep means the patient is leaving the recovery room and is being taken to a regular room.

The phone rings. It's a man who read about Trexler in Wednesday's newspaper. He wanted Trexler to know that Dr. Gaines performed the same surgery on him in 1983, and he is doing just fine.

A nurse wheels Trexler to the diagnostic center for another CAT scan and MRI. Then it's back to the room.

10:50 a.m. A stranger pays a visit. Cathy Lay of St. Petersburg felt compelled to come by and assure Trexler that everything will be okay. She would know. She says she has had four benign tumors removed from her brain. The surgeries were in 1969, 1985, 1987 and 1997. And look at her now.

"It's time for me to give back because I have been so fortunate," Mrs. Lay says. "I've talked to a lot of people to help them alleviate their fears. Once you've been through this and have come out of it as well as I have, you want to give back."

Trexler hasn't had any food since a roast beef sandwich before the Seminole City Council meeting Tuesday evening (he's serving his fifth term on the council). All this waiting has him famished.

2:15 p.m. Dr. Gaines drops by. It's almost time, maybe another 30 minutes.

"How are you feeling today?" Trexler asks.

"I'm fine," the surgeon says. He has completed a neck surgery, and he's got another brain tumor scheduled after Trexler's.

Anesthesiologist Ludner Confident (a name Mrs. Trexler likes) gives Trexler a sedative, and 15 minutes later, Mrs. Trexler gives him a kiss goodbye.

"I'm ready," he says. "I'll see you all later."

As nurses wheel him toward the surgical ward, he shouts, "Pizza and wings," putting in his order for when he wakes up.

* * *

5:45 p.m. It has been 2 1/2 hours since Trexler was taken to the operating room. Mrs. Trexler, 60, waits with Edna Brunet, who owns the machine shop where Trexler works; Bob Matthews, a fellow member of the Seminole City Council; and Robin Riedinger, Trexler's stepdaughter.

The beeper goes off at 6:18 p.m. Ten minutes later, the anesthesiologist comes through the waiting room, smiling. "He did just fine," Confident tells them.

A few minutes later, Dr. Gaines sits down next to Mrs. Trexler. "It appears that it is benign," he says, "and it looks like we got it all out."

The mass was a tumor consisting of blood vessels that bundle together. That is good news, Gaines explains, better than a tumor made up of nerve cells, called a ganglioneuroma, which they thought they might find. Blood leaking from the tumor may have caused Trexler's scary spell at work last month.

A pathologist's quick test of the tissue showed benign cells. The permanent report, which rarely differs, should be done by Friday. With that, the doctor is off.

"It's a thousand pounds off my shoulder," Mrs. Trexler says.

Next stop, intensive care. She jokes that she only hopes her husband knows who she is. And she's got those 47 calls to make. At least they're happy calls.

- Coming Friday: The first day of the rest of his life.

 

 

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