A very fluid situation

Sometimes I wish brains were as simple as cars

 Yesterday (Friday, 7/30/10) featured another wild and momentarily scary ride on the brain-cancer roller coaster. I went in for my regular MRI scan in the morning. It took about 90 minutes instead of the usual 30-45 minutes because my doctors had ordered some extra studies to zero in on two things I’ve mentioned before: The fluid accumulating around my brain and a new spot (thought to be a surgical abrasion) near the edge of my new surgical cavity from the June 2 operation.  

  I wasn’t scheduled to meet my doctor to go over results until this Tuesday. So after the scan, I just went home and got to work on some freelance projects that have been piling up on my desk. I was happily entering the homestretch of the workday and looking forward to a relaxing Friday evening when my cell phone rang. The woman identified herself as my neuro-oncologist’s nurse.

She said: “Doctor Bobustuc has just looked at your scan from today, and he wants you to come to the hospital right now.”   

When I asked if that meant his office at the hospital, she said: “No, you need to get yourself to the emergency room and have yourself admitted. Now. Like, tonight.”   

When I asked why, she said: “Doctor Bobustuc is very concerned that the fluid buildup around your brain is growing rather than diminishing. He is also concerned that the nodule we are watching has doubled in size since June 30.”   

That’s was certainly not the kind of news I was happy to hear on a Friday night less than a week after celebrating a full year as a GBM cancer survivor. But it certainly got my attention.   

 

  Luckily, Dr. Bobustuc himself soon was able to get on the line to explain the situation in further detail. He said I would probably have to have the excess fluid drained ASAP. He said that we would also have to discuss how to attack the growing nodule at the edge of the cavity — which he said the MRI tests suggested was recurrent tumor. He suspected that would mean switching to yet another chemotherapy routine (my third, after being on my second regime for only one month). I asked him if the Big Brain Drain operation would be that very night, and he replied that it might be hard to line it up that quickly or even any time during the weekend. I cringed, suddenly envisioning two or three days laying around in a hospital bed doing nothing but thinking about my brain while watching the latest, relentless footage from the BP oil spill on a small, ceiling-mounted television. So I told the doctor I felt absolutely fine and would rather wait if we could. He asked if I had any symptoms such as headache or weakness in my left side. I told him absolutely not. That pleased him immensely, and he said it was very encouraging. He said rather than rush me into the hospital, he now believed he could simply prescribe me some steroid drugs to ease or prevent brain swelling and that I could manage on my own through the weekend at home. I breathed a big sigh, then headed over to the hospital pharmacy to pick up the new steroid drugs and (hopefully) get a refund on the extremely-expensive-but-now-useless chemo drugs that I had just picked up that morning. Luckily, I was able to do both.

I got luckier still on my way to the pharmacy when I was standing in a hallway and out of an elevator pops Dr. Bobustuc, himself. He was thrilled to see me in the flesh, and said I looked even stronger and better than I sounded on the phone. He felt the right side of my head and said there was no indication that the excess fluid inside was causing any undue swelling — at least not on the outside. He said he thought the fluid buildup might be stemming from irritation caused by the growing nodule, tumor or whatever the hell it is. I guess we’ll find out. Even though it has grown, it’s still pretty small — maybe just the size of a nickel.      

My doctor will spend the next couple days conferring with my neurosurgeon and some other doctors, and I am scheduled to meet him Monday. He told me to be prepared either to be admitted for an additional operation or perhaps to begin a new chemotherapy treatment featuring direct, intravenous infusion. That’s something I haven’t yet experienced on this journey — I’ve been a pill-popper until now. But IV chemo is actually what most patients suffering through other forms of cancer must learn to endure. So I can’t really complain about the switchup.      

I’ll know a lot more next week. But I wrote this post anyway because I didn’t want to cram all this necessary background information from Friday into a future update that will probably contain more news.      

My mental and emotional state is still very positive. I am still lucky to be alive. I am staying calm. Many people with my diagnosis might be dead by now or dealing with multiple, large and inoperable tumors if they’d even made it this far. And until further notice, all I’m dealing with is a leaky brain and a stray, nickel-sized, something-or-other.      

Of course the news could get worse in relatively short order. But no matter what happens, no one or nothing — not even cancer — can ever take the last year away from me. And that’s what keeps me happy.