Thursday, July 23, 2009

waiting for Godot (or at least a new PICC line)

We're up on the tenth floor of the Tower Building at Fairfax Hospital. Mom is berthed in a bed, awaiting the PICC line "IV access" team. We were told she had two patients in front of her; that was at 3:30, and these procedures take around an hour, give or take a few minutes. It's never safe to assume anything about the pace or timeliness of hospital service, but if all goes well, the team will be seeing Mom around 5:30PM.

Our visit to radiology earlier today included a talk with Dr. Tonnesen. I asked him about the MRI results and what they might mean. His answer was a bit disturbing: he said that, based on the MRIs done by the hospital, there's evidence that some of Mom's tumor is responding to the therapy, but that there's possible regrowth of the tumor in other areas, about which little can be done. The reason for the qualifier "possible" is that the doctors don't know whether the apparent regrowth is a recent occurrence or something that dates back to some long-ago period between MRI sessions. Perhaps the recent MRI is showing an old growth that has, in reality, been stopped by the current treatment.

More disturbing was the doctor's contention that how Mom is doing externally is more important to him than what is going on internally. He saw her today and said she looked a lot better than last time. "I see this as a good thing," he said. For him, it's more important to focus on how Mom presents clinically than on what might be going on, tumor-wise, inside her head. I'm still having trouble wrapping my mind around what the doc was trying to say, and right now, I wish I had recorded the conversation so I could replay it and digest it. To me, it would seem that any outward improvement not accompanied by internal improvement should be considered superficial at best, but perhaps the doctor's point is that, since the treatment for GBM is palliative and not curative (there is no cure), we should view any clinical improvement positively.

Dad asked Dr. Tonnesen for his overall opinion on how Mom is doing. Dr. Tonnesen gave us a sympathetic look and told us that he can't jump for joy at what he's been seeing. "She isn't bouncing back," he observed, reciting the litany of problems Mom has encountered ever since she became a patient on April 16. Since we already knew this, the news wasn't particularly surprising. Maybe Dad just wanted to hear something, anything, that might be positive about this situation. Can't say as I blame him.

So that's where we are: waiting for the PICC team. We ought to be back home this evening.


No comments: