Thursday, July 2, 2009

...and we're back

Dr. Yoho thinks Mom simply needs to finish her dapto regimen. As far as he's concerned, there's no problem with her beginning in-tandem therapy while she finishes the antibiotics. In other words, he's given her about as clean a bill of health as can be expected. Mom's head and leg wounds seem fine to him, though he clucked a bit over the continued bleeding from Mom's leg wound and asked us when our next appointment with the plastic surgeon would be.

Next steps:

1. Restart chemo- and radiotherapy on Monday.

2. Call Dr. Mirali's office (he's the plastic surgeon) and set an appointment with him or with one of his colleagues for sometime soon, just to allay any fears that Dr. Yoho might have (the doc didn't voice anything explicit, but his question about the plastic surgeon was a red flag).

3. Make sure the home care nurses (and the Inova health system) closely monitor Mom's blood count during the 6-week blitz.

4. Start thinking about when Mom should have another MRI done.

5. Put together info packets for MD Anderson and NCI to keep them up to date as to Mom's condition and where she is in her treatment schedule.

6. Contact Dr. Leiphart and/or Dr. Tonnesen about Mom's bone flap. Dr. Yoho felt that she was ready to have the synthetic bone put in soon, but my gut tells me that it would be better for her to do this after the six-week phase is over. The problem is, as always, that Mom is going to be extremely susceptible to infection during this period. Cutting into her scalp sooner, rather than later, strikes me as risky; the timing is awful. The flip side, though, is that Mom's level of immunosuppression might actually be lower at the end of the six-week session, making bone flap replacement inadvisable at that time. Dr. Yoho seems to think that immunosuppression won't be a huge issue if the replacement is done sooner. In any case, we're going to consult with other doctors before anyone cuts Mom's head open a fifth time.


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