Hi VP's...As you might remember, the union nurse is back on break in Arizona. Our dear, dear friend Vicky (internal medicine doc from Pittsburgh) volunteered for duty while I was home trying to keep this house running. This was the week that Brenda is seeing all her doctors who are weighing in on the recent CT scans and what to do next. They will give their input to Dr. Hong and he'll decide which path to take. Since Vic was there with Brenda when she had her appointments today, she wrote and excellent medical "bullet" for you all on how today's appointment went. Here's the update:
Brenda's lymph nodes are significantly smaller. Her white count is good and she won't need additional neupogen for this round. This morning she saw Dr. Hanna (an ENT surgeon who specializes in cranial base lesions). He did a fellowship at UPMC in Pittsburgh. His concern is a spot on the CT scan about the size of a penny. They cannot determine if it is up against the brain (the front part behind and slightly above the nose) or through the membrane that covers the brain (the dura). If it hasn't penetrated the dura it's less complicated.Dr. Hanna is proposing a neurosurgical procedure to remove that lesion. That would be done by a neurosurgeon. It would involve an incision behind the hairline from almost ear to ear. Then they fold down the skin and make a bone window to gain access to the lesion. They then repair the defect with her own tissue. It's on the surface of the brain so they don't have to cut through brain tissue to get to it (that's a good thing). It's also not in an area of the brain that controls speech or movement etc. They will be scheduling an appointment to see the neurosurgeon. If she has that surgery (because all of this is subject to change) she would be in the hospital for five days.
The blip in all this is a CT scan of the chest that showed a "prominent" diaphragmatic lymph node. It did not show any suspicious lesions in the chest, just a lymph node by the diaphram muscle that is prominent. We see reports like this all the time in medicine and usually they are nothing. They are going to do a PET scan to look at that. If it lights up it's suspicious. They are very thorough here and are leaving no stone unturned.
This afternoon she saw Dr. Gillenwater. She's the ENT doctor that saw Brenda when she first got here. She confirmed that the nodes are shrinking. She also said if they have to surgically remove any of the larger lymph nodes in her neck they would probably schedule both surgeries at the same time.
Tomorrow she sees the radiation oncologist and maybe the neurosurgeon if they can get her in. Then a big day on Thursday. She will have a PET scan at 9AM, an audiology appointment at 1:30PM and chemo for 7 hours beginning at 3:30PM. Then Friday another round of chemo in the afternoon.
Hope this helps,
Vicky (AKA: Ribby)
So there you have it...the ping pong balls are still in the air, but like Vic says...they really leave no stone unturned at MD Anderson and that's exactly what Brenda needs. We're going to nail this thing!!! Can you all say CURE!!! Remember those words the psychic said..."Good as New!"
Vic will send another update to me tomorrow and I'll get it posted when the radiological oncologist weights in. Keep those prayers and good energy going Brenda's way...they are helping her heal.