Loose Strife

We are all doing well up here, except for the ice that still lines my driveway. Laura still has quite a gimp, but she continues to feel so much better and different than she did two weeks ago before her surgery that there’s no adequate way to compare. She still has small troubles: minor “normal” headaches, hand tremors, infrequent momentary dizziness, muscle aches, food tastes wrong, and her vision is worse. But it all seems like small potatoes. Her oncologist was overjoyed to see her today. Laura sees an opthamologist tomorrow about her eyes.
Laura asked her onc if she thought it would be OK if she went to Hawaii after her radiation treatments are complete in about two weeks. The doctor said “absolutely!” Laura said, “Good. I was worried you might say my head would explode if I got on an airplane or something.”
But I’m a little ahead of myself. I forgot to let everyone know that Laura decided to spend the rest of the month finishing up her whole brain radiation. Why do it now if she’s feeling so good instead of wait until serious symptoms arise — since it’s a one time option? Well it’s obvious that she still has cancer and it’s still affecting her central nervous system. Her neuro-oncologist told us that the conventional wisdom is that some undetectable cancer is already in her brain in addition to her spinal fluid. Although there’s no clear evidence one way or the other, the doctor’s feeling was that Laura’s quality of life would be better if she were treated sooner than later. Her radiation oncologist added the obvious closer that cancer, in general, is more successfully eliminated when there is less of it and it’s at least possible that cancer might not spread again for a long time. So Laura began daily radiation treatments on Tuesday and will continue until March 4th — at which time Laura wants to get the hell out of Dodge.
Now I just finished drinking good beer at the Lakehouse with a big group of friends from UMass who all drove up from the valley just for fun. Thanks to all. After a while I couldn’t help but to get talking about Laura’s cancer surgery and treatments and my friend Brian said, “that’s amazing, you should post that stuff on your blog.” So here goes.
First of all, Laura’s shunt is really an amazing procedure even if neurosurgeons consider it so pedestrian. The whole procedure takes only about 45 minutes, but involves the following: a hole is cut in the back of her skull; image-guided instruments are inserted all the way down into the center of her brain where a catheter (tube) is inserted into the ventricular system; the tube extends outside the skull, but remains under the skin; it proceeds down the back of the head, around the neck, down the right side of the chest, and to the abdomen, where the tube empties into the gut. The surgeon makes only one other incision at the gut and the catheter is threaded under the skin through a thin layer of fat from the head to the abdomen! There’s a valve on the catheter that can be “programmed” by a magnet after the surgery. It is set to maintain constant cerebral spinal fluid pressure and can be adjusted later.
The picture at right shows the back of Laura’s head with metal staples around the incision. There’s a raised bump going down where the catheter heads towards her abdomen. Her brother PJ said that it looks like a port site for The Matrix and the bump is just the right size for a AA battery. This device has eliminated all of Laura’s terrible (and life threatening) symptoms.
The whole brain radiation treatment is also interesting or creepy depending on your perspective. In order to ensure that radiation is delivered precisely, a mask is created of the front of Laura’s head (shown here) and a special pillow for the back of her head. Laura lies on a bed and the mask is secured over her face and to the bed. She is then placed under an arc-shaped machine that delivers the rads. If you are claustrophobic, this is not a recommended procedure for you. However, Laura shrugs it off and couldn’t care less! “You do what you got to do,” she says.