Sunday, June 7, 2009

she's eating

We've been at the hospital since 8:10AM. Mom is awake and reacting to our speech, even offering very weak laughter when we attempt to be funny. She's been eating her breakfast slowly but surely, and seems to have a decent appetite.

A doc named Josh, part of Dr. Leiphart's neurosurgical team, came into the room and talked with me for a bit. I asked him about the chronology of the tumor's progress, and whether the cross-hemispheric damage was something new. Josh didn't know, but did mention, in a general sense, that tumor regrowth was a possibility.

However, Josh did note, reassuringly, that the main problem seems to be infection, based on the observed rapidity of the spread of the damage. Unlike the tumor, which will never be entirely killed off, the infection can be fought and beaten. I asked Josh to confirm the chain of causation: "So it's infection, edema, speech problems?" Josh said yes. The bacteria in the abscess is causing swelling, and pressure from the swelling is affecting the brain's language centers.

Mom finished breakfast, and Dad helped Mom brush her teeth with an actual toothbrush. For days, Mom has had to use special "mouth swabs" (imagine a flimsy toothbrush with a tiny green sponge instead of bristles) to clean out her teeth and the inside of her mouth. We were hoping that she would enjoy a zesty session with the toothbrush, but we're not quite sure she understood what Dad was trying to do.

Right now (10:10AM), Mom's sleeping peacefully, having had a good breakfast and having enjoyed a bizarre experience with both an electric and a manual toothbrush. Dad and I are awaiting another team of docs, who may or may not already be doing their rounds.

UPDATE, 10:50AM: The swarm of docs came. What we now know:

1. The course of treatment will focus, first and foremost, on the antibiotic regimen.

2. The docs reiterated their uncertainty re: tumor regrowth, but lean toward the infection/edema theory to explain Mom's current language difficulties. Still, the docs haven't completely discounted the tumor as a possible causative factor in Mom's aphasia.

3. Replacement of Mom's bone flap might not happen at the end the 6-8-week antibiotic treatment period. It might take longer.

4. Mom's anti-seizure meds have been increased.

5. According to the chest X-ray, the lobe of one of Mom's lungs shows some sort of "consolidation," but the docs gave me the impression that this wasn't an urgent issue at the moment.

6. Although Avastin therapy had been mentioned during a previous visit, the doc today said that the team was still thinking of using it only as a second-line therapy. What's good about this is that the docs obviously don't believe the situation has become too desperate yet.


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