what happens next

Tomorrow, we've got two visitors: Mrs. Merrill at 3PM, and Pastor Jeri at 4PM. Sometime in the morning or afternoon, Dad and I will have to go out to the local Honda dealership to retrieve our minivan, which needed more repairs than we had thought (isn't that usually how it works?). If Honda calls us while we have guests, we may have to ask that guest to babysit Mom while we step out for a few minutes.

We also need to finalize preparations for Thursday morning, as we'll be departing for New York City once again. We hope to arrive a little after 3PM so as to be able to check ourselves into the same guest lodgings that we were at before, then we'll have to wheel Mom across the street to get her MRI done around dinnertime (6-something in the evening, I believe). Dad and I will spend the night in the hotel, but Mom will spend her night in the hospital, then have her operation between 7 and 8AM on Friday morning. We'll probably wake up very early-- around 5AM-- so as to be there for pre-op.

The procedure will take around an hour, or so we're told. I'm betting it might take longer if they're serious about blasting every single growth they see in Mom's head. At this point, because the carboplatin doesn't seem to have done a thing, I wouldn't be surprised to learn that Mom now has more than three masses inside her skull. From what we've seen of the aggressiveness of glioblastoma multiforme, two months is plenty of time for more cancer to bloom.

I don't know whether Mom will be allowed to stay at the hotel with us until Saturday morning. More likely, we'll spend most of Friday with her at the hospital, watching her rest and foolishly wondering whether we already see improvement in her behavior and awareness.

Late Saturday morning or early Saturday afternoon, we'll all head home. David and Sean are both saddled by work, so they'll be coming up to New York separately. Sean will drive up to Manhattan, arriving sometime Thursday night; David plans to fly in to New York on Friday morning; I don't think he'll be able to sit through the operation with us, but he'll be there to see Mom come out and begin the recovery process. Both David and Sean will leave Friday afternoon or evening; neither can afford to stay long.

I admit I'm on pins and needles about this whole thing, hoping against hope that we've chosen the right path for Mom. It's a massive responsibility, making choices for people who can no longer make important decisions for themselves. The docs at NYP/WC are treating this almost as if it were minor surgery, and I hope that's what it turns out be: catheter in, Avastin spritz, catheter out, period. Radical tumor shrinkage (and reduction in swelling) within a week.

But the chance that something might go horribly wrong casts a pall over this entire procedure-- which is, of course, still an experimental treatment. Mom is part of Phase I of this clinical trial: she's here to help test the method's safety. Before people start rejoicing prematurely, we need to be sober as we consider the potential risks. Inserting a foreign object in someone's brain is no trifling matter, so I'll reserve my rejoicing for when I know that (1) Mom's safely done with her operation, and (2) her tumors have demonstrably shrunk. That might be a few weeks.

Dad's optimistic. In truth, so am I, but it's a cautious optimism. Dad hasn't said so directly, but he's anxious, too. I know this because I asked him, tonight, "What's happening after New York?" Dad, who normally knows what he's written inside his 2009 plan book, said, "I haven't thought that far."

And that says it all. Cross your fingers.


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