""Life is an ongoing process of choosing between safety ... and risk"

 I am privileged to have spent much of my adult years without toxic stress. There are studies that show that toxic stress (fear of safety of our body, not knowing if we can afford basics like rent or food) actually changes epigenetic signatures. These changes in epigenetics can affect the germ cells in our body. If you are a pregnant woman, it can affect the germ cells in the fetus. Stress can change the genetics of your grandchild this way. It makes poverty and domestic violence a generational affair. As we learn more about genetics, we learn more about the nuances of genetic regulation. It used to be a clear dogma- DNA to RNA to protein. Now we know it's so much more complex, with hundreds of tuning layers in between those steps. I also grew to appreciate the effects of toxic stress more after I read "Between the World and Me," by Ta-Nehisi Coates a few years ago. This is a book about how black identity is a literal threat to the body of a black man. When there is a threat to the body, the soil of life is barren and little else can grow. There's no room for spirituality. No room for academic success. No room to become better at music or sports. All the focus of the mind and body is on safety. It's the bottom of Maslow's hierarchy of needs. That's toxic stress- worrying so much about that bottom layer of identity that you can't focus on the upper layers at all. And it literally changes the hearts of our cells when that stress is present in perpetuity. 

I ramble, but my point is that stress has a very real biological effect. Some people deal with this toxic stress all day, every day. I have had short periods of toxic stress in my life, but never persistent and pervasive. Since we found this threat to Eric's body in July, toxic stress and I have been becoming more acquainted. We have made an uneasy truce in the interest of survival. But I would love to part ways. 

The stress has affected many areas of my life. I have been less motivated at work. I have had a shorter temper with the kids. It has soured some aspects of my marriage. It's hard to think about anything else when that foundational layer, safety of the body, is threatened. 

However, I do bring good news today, friends. After two appeals to the insurance company and months of waiting in uncertainty, Harvard Pilgrim has finally approved the surgery in full at BWH. Which means Eric can have the full tumor resection done by an experienced glioma specialist within the next month. 

You don't realize the weight you're carrying until it's gone. But the moment we learned this, and saw the surgeon and actually got the surgery consented and scheduled (still tentative- either October 31 or the week of November 10, but definitely one of those), we felt so much lighter. The miasma that has been pervading our everyday life for the past two months lifted a little. We have been able to enjoy time with each other and our kids again. There is an answer, and maybe an end, in sight. I can literally feel my gene expression changing, flooding my system with different (better) neurotransmitters. I can focus again on grants and conferences, playdates and board games. 

So here we are. Eric had a repeat MRI done a few weeks ago just to make sure things were stable, and the tumor had not grown, which again is suggestive that it is not something more malignant like a glioblastoma. His neurooncologist was very satisfied with the imaging that our timeline is safe. Eric will have an awake surgery because of proximity to the motor/speech areas. We are trying to get one more fMRI done at BWH prior to the procedure, but the surgeon says it's ok if we do not because Eric will be awake, so the surgeon will know if he is touching one of the tracts carrying motor or speech information from the brain to the muscles (as Eric will suddenly be unable to speak or move if he touches these areas). There is a higher risk of seizures during an awake surgery because of the wakefulness (the awake brain tends to get more excitable about having a scalpel running through it), but overall less longterm deficit risks. If Eric has a seizure, they'll have to put him under general anesthesia to suppress it and then proceed with the surgery based on the imaging and BMC fMRI (or BWH one if the insurance magically approves it). 

We are so happy just to have a plan. The uncertainty has been suppressed under the shell of our everyday lives (violin lessons, work), but it has definitely been weighing us down. Thank you all for your kindness, thoughts, donations, and prayers. We had a visit from an area church leader right before we got this news, and Eric got a blessing from him, and I do truly believe in miracles from God. I pray that we will have one with this surgery, and Eric will have an oligodendroglioma, and we can move on with our lives with only a little bit of weight on our shoulders. 

We will keep you updated. Love you all.