Patient Stories 
An extended saga of medical nightmares triggered by a seizure brought Scott Buchtel under the life-saving care of numerous specialties across Monument Health and, ultimately, closer to his wife.
A Changed Life
One moment, Scott Buchtel was taking his dogs out. In seemingly the next, he found himself regaining consciousness on the floor of his house, his wife, Alisha, standing over him.
“My wife was asking, ‘What’s wrong? Are you okay?’ For some reason I couldn’t get up. I was grabbing the table and real shaky,” Scott, 51, a long-haul trucker from Rapid City, recalled. “And then I remember getting up, and there were these two EMTs standing in front of me. I used to be a civilian law enforcement officer in Ellsworth for 10 years, so I thought they were giving me a field sobriety test because I felt like I was drunk. I said, ‘Hey, I might be drunk, but I didn’t do any driving. I’m in my home.’”
But Scott wasn’t drunk. He was having a seizure so powerful that he had bitten through his tongue. “Right then and there, I knew my life was going to change.”
Scott was whisked to the Rapid City Hospital Emergency Department for scans, which revealed a malignant brain tumor. A biopsy uncovered a grade 3 astrocytoma, a type of brain cancer so named because it forms in astrocytes, cells that resemble the shape of a star, the function of which is to protect brain and spinal cord neurons.
Three months later, Glen Pollack, M.D., a Monument Health Neurosurgeon at the time, conducted surgery to remove the tumor from Scott’s brain. “The tumor was displacing part of my brain as it was infecting it; it was changing my brain into cancer.” Scott said.
As is the case with most brain operations, there was a significant danger in removing the tumor. “There was about a one out of three chance I’d end up paralyzed because of the surgery,” he said. “They told me that I’d probably be paralyzed on the right side. And I said, ‘Just remove what you can and I’ll take my chances with chemo and radiation.’”
What Death Feels Like
After the brain surgery, Scott rested for three months before he embarked on a very aggressive schedule of radiation and chemotherapy—a six-week course of five times per week. “As an active person, it was very frustrating for me to just sit there. I went from working out at least an hour, six days out of seven, to nothing,” he said.
Additionally, the tumor was so pernicious that Scott suffered several seizures in the intervening year and a half. He had to give up his hobby of body building, and his job as a truck driver. He has since been diagnosed as epileptic. Also known as seizure disorder, epilepsy causes brain signals to misfire.
“The area of our brain where the cell bodies of our neurons live, called the cortex, is especially susceptible,” said Donald Barr, M.D., Monument Health Neurology and Rehabilitation, who continues to treat Scott’s epilepsy. “When we have brain cancer or have surgery that disrupts those cells—that can predispose us to seizures, as this is an area of injury.”
The way epileptics experience seizures varies from person to person—from obvious bodily impairment to subtler emotional or cognitive symptoms. For Scott, the seizures were physically severe. “I remember being tased twice when I was a police officer,” Scott said. “And I thought that was the worst thing. I remember thinking, ‘This is what death feels like.’ And that’s only five seconds. Grand mal seizures contract all of your muscles at the same time. So the last two seizures I’ve had, I’ve ended up in the hospital on a ventilation tube.”
Grand mal (from the French “great illness”) typically known as tonic-clonic seizures, have two associated phases. In the initial, 10-20 second tonic phase, a person makes uncontrollable noise and loses consciousness as their muscles stiffen, which can result in falls or other injuries.
In the second, clonic phase, muscles begin to jerk spasmodically, then relax, then contract again. This convulsing can go on for several minutes. The seizures are dangerous and exhausting. The aftereffects can last for days. “It’s like having a Charlie horse over your entire body, all your muscles get rotten,” Scott said of how he feels after a seizure.
“Tonic-clonic seizures are caused by diffuse abnormal electrical activity,” said Dr. Barr. “People can have muscle and joint injuries just from the mechanical component of the seizures. They can also have respiratory arrest or autonomic dysfunction, resulting in strokes and even death. When that abnormal electrical activity is prolonged, we call this status epilepticus, which results in death of the neurons and further brain damage.”
Because of his epilepsy, Scott must now carry emergency medication on him at all times. Should he feel a seizure coming on, the medication helps prevent the seizure from evolving into a tonic-clonic seizure, or if it does evolve, it can shorten the seizure duration.
Trickle Down Effects
To make matters worse, Scott also suffered several other debilitating setbacks. “There was this pain in my side,” he remembered. “I was almost crying. I just couldn’t find a comfortable position to sleep. And finally, I told my wife, ‘Honey, I gotta go to the hospital. I think something’s really wrong.’ When she picked me up from work, she asked me, ‘Why do you look like a pumpkin?’” Scott was showing signs of jaundice due to a malfunctioning gallbladder.
Scott had to pause cancer treatment for six weeks so he could have surgery to remove his gallbladder. He then resumed chemo and radiation, only to get kidney stones. To top it all off, Scott started feeling pain in his left ankle after his chemotherapy had concluded. “I’d been off chemo for about three months at the time. And my left ankle just wouldn’t heal,’” he said.
Seeking treatment from Abbie Metzler, D.O., Primary Care Sports Medicine, Orthopedic & Specialty Hospital, Scott had X-rays and was diagnosed with arthritis in his left ankle.
“When a person’s going through something such as cancer, there’s all these trickle down effects that they are experiencing,” said Dr. Metzler. “We help address those things because it comes down to quality of life. Scott used to be a bodybuilder, and so he was having a lot of identity stuff around that—and rightfully so—like, losing muscle mass. So it’s about how to still feel active and still feel like yourself amongst all the chaos of the medical stuff.”
For Scott, it was especially important to find a solution for his ankle pain, not just because he was starting to develop a limp, but also because the pain threatened one of his treasured ways to spend time with Alisha—dance classes.
“Without my wife, I’d be totally hosed. I would have lost everything,” he said. “The dance classes were an effort first of all, for my wife and I to do something together that we could grow doing, and also to improve my coordination because dancing is completely foreign to me. So, we’re taking these classes at National Dance Clubs in Rapid City. We’ve been doing it for a year and a half now. It’s fun.”
Dr. Metzler gave Scott a cortisone injection, which worked immediately, and worked so well that Scott has not had to return for a second shot. “The dancing has been great,” he said. “It still gets sore if I push too hard, just like a normal ankle would. But I can’t tell you how beneficial that cortisone shot was.”
Coming Back
Now, exactly two years after his first seizure, Scott is working as a truck driving instructor at Welch. Inc, a subcontractor for FedEx. In addition to the many medications and various forms of physical and mental therapy and rehabilitation required in recuperating from such a trying and detrimental disease, he and Alisha are still taking dance lessons—learning to tango, to waltz—which is helping immensely with Scott’s recovery. “It was twofold: it helped my wife and I grow together as a couple, and it helped me rewire my brain,” he said.
His brain cancer is also in remission. “I’ve been cancer free since ‘23. They say for half of the people, it comes back in three to five years. But I don’t accept that. Aim high, you know, aim for perfection. If you miss, you don’t miss by much, right? And here’s something you’ve got to realize: I’m not a quitter. I’ll keep coming back. I have faith that it’s going to work out.”