Wednesday, June 24, 2009

the neurologist says...

We're back from our visit to the neurologist. Dr. Benson saw a lot of improvement in Mom, especially in contrast to how she was during her most recent stint in the hospital-- weak, barely able to talk, etc. The doc did emphasize, though, that his role was to "bring reality" to the situation, to remind us that this particular form of cancer is aggressive and that, ultimately, the outcome will not be a happy one. He also asked us whether we were looking into experimental treatment options-- a question he couldn't have posed out of idle curiosity, since he's the doctor who told us about the spread of the tumor across the corpus callosum to the other side of Mom's brain.

I assume, therefore, that Dad and I will be talking, over the next few days, about eventually having Mom revisit MD Anderson and NCI. Dr. Benson made the common-sense remark that, whatever treatment route we take, it needs to be one that maintains quality of life as long as possible. Why bother seeking experimental treatments that will lead to nausea, loss of appetite, reduced cognitive ability, fatigue from traveling around the country, etc., if they do nothing to extend life and improve its quality somehow? We have a lot to consider.

All the same, Dr. Benson concluded-- after running Mom through the usual neuro checks-- that she has improved to a point where he doesn't need to see her for a few months. I had to go out and get the car while Dad checked Mom out of the office, but I think the next appointment has been scheduled for late summer or early fall. A lot can happen between now and then, especially with the specter of infection always hovering in the background, but it seems that Dr. Benson isn't counting on that being likely.

One final observation: Dr. Benson noted that Mom was having trouble following some instructions during the neuro checks: she would fixate on some element of the instruction to the exclusion of another element. For example, "Hold your head still and follow my finger with your eyes" produced a response in which Mom held perfectly still, using her peripheral vision to follow the doc's finger instead of moving her eyes.

The doc told us that this and other behaviors exhibiting fixation and repetition fall under the category of perseveration, and it's to be expected of someone with frontal lobe damage. Another example: when the doctor asked Mom about the respective ages of her children, she knew that I was 39, but when she turned to look at Sean, she struggled a bit and then said he was 39, too. It was obvious she knew this was the wrong answer: at one point she corrected herself, erroneously saying Sean was 33 (he's 29). The doc said that this situation likely wouldn't improve, given the nature of the damage, and that we should be patient with Mom, allowing her to move and think at her own pace, putting 2 and 2 together as she can.


No comments: