Kevitivity

This is a followup post to Part 1. As I mentioned before, after an inconclusive brain biopsy in February, which did not detect any tumor cells, it was recommended that I go in for a second surgery to get a larger tissue sample and hopefully get a solid diagnosis so that treatment could begin. It’s been a little over three weeks now since that second surgery on April 8th and again, no tumor cells were seen. All that was detected again was inflammation (gliosis).

The current running theory is that I may simply have some sort of possible transitory inflammation that caused my seizure back in July of last year. I still have no other symptoms and haven’t experienced another seizure. My neurosurgeon also mentioned that the lesions seen in previous MRI scans seem to be responding to the steroids I’m now on. The current plan is basically to monitor my situation now with an MRI scan every three months.

It’s been a scary couple of months but it looks like there’s a light at the end of the tunnel. I continue to feel healthy, positive and grateful to my family and friends for all of their support, especially my wife Emily who has remained strong throughout all of this. I have to say that I am very grateful to my doctors too, especially my neurosurgeon, Dr. Gantwerker of the The Craniospinal Center of Los Angeles.

I’ve decided to get a little personal here and write about some health issues I’ve been having lately. I know my friends and family are interested to know more about my situation… And some of my experience may be useful to others out there on the net.

On July 12, 2012 I experienced a grand mal (also known as a tonic-clonic) seizure while I was at home, in front of the computer reading email. I’m grateful I wasn’t still on the highway, driving home from work when this happened. Right before losing consciousness, I remember having a strange problem with my vision, and being unable to read text on the computer screen. I seem to remember hearing what sounded like repeating static as well. The next thing I recall was being found by my wife Emily in an extremely disoriented state and bleeding from somewhere in my mouth. I had apparently fallen during the seizure and bit my tongue.

Emily dialed 911 and I was soon in the ER. Initial MRI and MRA scans didn’t show much except for something very small in my visual cortex. It was thought that this “abnormal signal” could simply be something residual from the seizure itself and not necessarily the cause of it. A follow up MRI conducted in September of 2012 showed that the abnormal signal from the first MRI had not cleared up. A spinal tap was then performed to check for possible causes of inflammation/infection and MS but ultimately came back clear. A third set of MRI scans done in January of this year looked worse, now showing multiple “ring enhancing” lesions. My neurologist and neurosurgeon both felt the next thing to do was a biopsy.

After another set of pre-op MRI scans (see the two images at the bottom), a craniotomy and stereotactic biopsy was performed on Feb 25th, a few days after my 38th birthday. The sample was sent to both the local lab at the hospital as well as UCLA for pathology tests. Initially we were told that the pathology reports suggested I had a grade two astrocytoma, however it now appears that the biopsy was inconclusive and only showed “inflammation” or Gliosis.

CT scan showing titanium plate used to repair my craniotomy.

So, essentially, we’re sort of back to square one now, not really knowing what’s going on in my head. Whats bizarre about all of this to me too is that I feel perfectly healthy. After the first seizure I decided to get my weight and blood pressure under control. I’ve lost over 30 lbs, exercise regularly and take medication for my hypertension. I also haven’t experienced any further seizures (I take 250mg of Keppra twice daily).

Next up for me in the very near future, is a second, slightly more invasive biopsy in the hope of getting a a solid diagnosis so treatment can begin. My neurosurgeon described what he planned on doing by saying he was going to take a “crouton” sized piece of tissue… As scary as brain surgery is, this second biopsy can’t happen soon enough for me – not knowing what’s going on in my head is far scarier, and it’s something that’s hard for me to not dwell on.

UPDATE: Read part 2 here

MRI w/Contrast showing abnormality on right side of brain.

MRI scan 2

Here are a few of the cityscape photos I’ve made over the years. I enjoy exploring big cities, trying to find the best vantage point, and then taking in the view while I play with different ISO settings and shutter speeds.

Rsnapshot is a simple but indispensable Open Source backup script that leverages the power of the rsync command (and SSH) to make backing up your Lunix/Unix infrastructure easy. It’s a must have tool in my opinion.

BTW, The best book for all things Unix/Linux Backup and Recovery (including Rsnapshot) is W. Curtis Preston’s Backup and Recovery from Orielly.

You can use Rsnapshot to write your backups to a second hard drive, an external USB or FireWire drive, an NFS mount from another computer on your network, or simply over the network to another computer via ssh.

I’ve started to incorporate these cheep and very capable NAS devices from Synology, namely the 8 bay DS1812+. I recommend these 3T Seagate drives with the NAS.

Out of the box, the Synology DS1812+ comes with a powerful web-based user interface that makes setting things up easy. It does not support Rsnapshot be default. However, because the Synology NAS is itself it’s own little Linux machine (its OS is based on the BusyBox distribution), it’s possible to SSH into it to make your own customizations. The steps bellow will walk you through installing the “ipkg” package manager (simular to Yum on RedHat based distributions, or apt-get on Debian), as well as installing and configuring Rsnapshot.

Step one: Installing ipkg.

This first step is specific to the DS1812 and assumse you’ve already created at least one volume via the web-based admin interface. If you have a different model, see here for more details.

First thing to do is to enable SSH via the NAS’s web-based admin page. This is in the “Terminal” section of the Control Panel. Once enabled, SSH into your NAS with username “root” along with your admin password.

Next we want to download and install the ipkg bootstrap script. We first change directory to the “@tmp” directory of your first volume, download the ipkg bootstrap with the “wget” command, make the script executable, and then run the script…


cd /volume1/@tmp
wget http://ipkg.nslu2-linux.org/feeds/optware/syno-i686/cross/unstable/syno-i686-bootstrap_1.2-7_i686.xsh

chmod +x syno-i686-bootstrap_1.2-7_i686.xsh
sh syno-i686-bootstrap_1.2-7_i686.xsh


After the script runs, you can delete it if you like. If your Synology NAS is using DSM 4.0 or newer you also have to edit /root/.profile and comment out the PATH and EXPORT statements at the top.

Now restart your NAS via the web-based admin page to finish the ipkg install. Once it’s rebooted, log back in as “root” via SSH.

Step 2: Installing Rsnapshot

Now that you have the ipkg package manager, installing rsnapshot (as well as many other Linux tools) is trivial… Along with Rsnapshot you will want to install “cron” in order to be able to automate/schedule backups. I also installed GNU screen, less, and mlocate to make life easier.


ipkg update

ipkg install rsnapshot
ipkg install cron
ipkg install less
ipkg install mlocate
ipkg install screen


There you go. The rsnapshot config file is located at /opt/etc/rsnapshot.conf

Note also that Cron on the Synology works differently than what you’re used to on most Linux distributions. For details on how to get cron working properly, see this thread on the Synology forums.