Monday, June 15, 2009

many visits

Well, well, well-- quite the cavalcade of visitors today! Alas, in their excitement to see Mom, people have been forgetting that they should call us 24 hours in advance... but Mom doesn't seem to mind, and that's all that matters. It's barely noon, and Mom has already seen quite a few people. (NB: dropping in suddenly isn't a big deal, mainly because we're in the hospital. In other words, we don't have to tidy up the house every time someone wants to drop by. That will be different once Mom's back home, as Mom herself is easily stressed by unannounced visits to her home.)

1. Around 10:25AM, Dad and I saw Dr. Mirali, the plastic surgeon. He says that, at least as far as Mom's scalp goes, she's ready for discharge from the hospital as of today. Obviously, Mom will remain in hospital a while longer, as we're still monitoring her for infections and other possible post-operative sequelae. Dr. Mirali saw Mom's helmet, which we had brought in for his inspection, and pronounced it good to use on Mom's head, even though the fit might be snug with the additional dressings. Overall, he's happy with Mom's progress.

2. Around 11AM, we had three people show up: Pastor Kim and his wife, and a certain Dr. Butler, who works with Dr. Meister, the medical oncologist managing Mom's Temodar regimen. You'll recall that Mom is currently off therapy because she's dealing with infection issues, but the oncologists have to remain in the loop: Mom needs to resume therapy as soon as possible.

Dr. Butler confirmed that the cross-hemispheric material was from the tumor. He also noted the presence of cancer around the edges of the cavity where the debulking occurred on April 21. He noted that this was perfectly normal: lack of cancer in that area would have been strange. We have nothing to worry about in terms of sudden metastases in the brain, spinal cord, or the rest of the body: gliomas apparently prefer to remain in the brain; their aggressiveness articulates itself in a slow, steady, insidious way, unlike other cancers that infiltrate large volumes of tissue within the space of a week.

The oncologists promise to coordinate with the other docs to get the timing right for the restart of Mom's radio- and chemotherapy. It'll be at leas another few weeks.

3. A second couple, Mrs. Whitaker-Frevert and her husband Mr. Frevert, came by, bringing Mom a vase of flowers and a wig. Mom was fascinated by the latter, which she took out of the resealable bag and inspected. Mrs. Whitaker-Frevert did a fine job of talking to Mom. As with Mom's other Korean friends, Mrs. Whitaker-Frevert was very encouraging and supportive.

4. Dr. Yoho, the infectious disease specialist, dropped by initially to see Mom's roommate (who I now know is surnamed Faircloth), but spent some time talking with us. Mom is on an antibiotic called Zyvox, but there's a chance she might be switched back to daptomycin when she's discharged.

It's my understanding that more people are on the way-- one couple will be arriving in a few minutes, and another is coming this evening. It's possible that Pastor Jeri will also put in an appearance, but Pastor Kim had mentioned, several days ago, that he and Pastor Jeri have been alternating visits.

Mom is much more awake and verbal today, though still nowhere near capable of extended, fluent conversation. She was also nauseous between visits (a possible result of the antibiotic Zyvox, according to Dr. Yoho), but a nurse gave her some anti-nausea medication through her PICC line. We were told that Mom had been spitting up after breakfast this morning; when she tried taking the fragment of a potassium pill in our presence around 11:40, she managed to keep the pill down, but regurgitated into a plastic basin that Dad got under her chin in time.

Mom is being changed by the nurses right now; she's no longer nauseous. I'm out in the main lobby, writing up this blog entry and waiting for Dad to call me back up so we can feed Mom her lunch. Pastor Kim and his wife had brought some Korean food, and I had brought along a serving of Mrs. Kopf's seaweed soup. Mom ought to have plenty for lunch, but I do worry about whether she'll be able to keep it all down.

UPDATE: Dad forgot to call me back up to help Mom with lunch; he's been feeding her. I'm on my way up now, though it's possible that lunch is now over.

UPDATE 2: We've had more visits, this time from Mr. and Mrs. Harding, more of Mom's friends. The Hardings brought various gifts, including some Korean bakery items. Upon seeing the food, it occurred to me that bringing individually wrapped consumables was a great idea. One of the main problems with bringing food to the hospital is that Mom might not always be able to eat everything, and once she's done, the leftovers have to be thrown out: no one else may eat them, and the food may not exit the room due to the MRSA isolation protocol. The nice thing about small, not-so-perishable items is that they can be saved until the next meal.

A speech pathologist also wanted to come in to see Mom, but apparently decided to wait. She hasn't come back. Three more doctors came by: Dr. Leiphart came in to check on Mom and was happy to see her more talkative. Dr. Wolk of internal medicine, who was pretty frank about Mom's prognosis (we told him we were aware of the survival rates for GBM patients), and Dr. Bresner, a neurologist who had come in to check on whether Mom's nausea might be brain-related.

The upshot is that Mom's potassium level is low, and her blood count is somewhat depressed. She's anemic, too, which makes me wonder why the docs think she can be discharged in a day or two. I'd rather have her stay in the hospital until she's as stable as can be.

Dr. Wolk noted that, because Mom's tumor will only worsen over time, it's necessary to think seriously about things like wheelchair access for the house so that she can be wheeled to and from the car on her trips to the hospital.

ADDENDUM: I hope people don't find my first paragraph too brusque or rude. I didn't write it in a spirit of resentment, but as a reminder that we really do prefer some sort of advance notice before people come to see Mom. She's easily tired out by too many visits, and Dad and I need the chance to coordinate things by putting the visits down on a calendar. As I noted earlier, this will be even more true when Mom is back home. Please respect the 24-hour guideline. Thanks in advance.


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