Bong Bong Bong Bong

The bells, the bells, listen to the bells.

2345 Sunday 31 Oct 10

Michele's day started at eight o'clock with the deafening sound of the hospital fire alarm. The alarm ran for the next forty minutes. This was before she received any happy pills, let alone coffee. A difficult beginning to a difficult day.

The highlight of the day was a long walk down the hall accompanied by her eldest grandson and some visits from friends. The rest of the day is best forgotten.

RKS

Did Some Good

Visit her, gentle sleep, with wings of healing.

Saturday, 2355, 30 October 2010

Ed note: Lost wi-fi today.

Michele exhibited her remarkable resiliency today and made great progress toward recovery. She is back to talking nearly as well as earlier this month and took a little walk around the room. Today around the room. Tomorrow down the hall!

As another indicator, she gave me "THE LOOK" several times. Sparkling humor is simply wasted on her.

But there is still much work to do on the road to recovery. The doc is talking about sending her next door to the rehab hospital for a few days of intensive work. It depends upon how she does tomorrow, but I suspect that we will be moving next door Monday.

Nite all,

RKS

Hello World

Much More Better

1230 Saturday 30 October 2010

Ms Michele Kay van Winkle finally awoke this morning at 1000.



(Artist's representation of Ms van Winkle waking up, after donning Halloween costume.)

She has been awake and talking (after coffee, of course) ever since. She grabbed her phone and has had long conservations with her children (in English) and brother (in French.) There was also a parade of therapists coming through to check over everything, one of which engaged Michele with another long French conversation.

She had brunch, then, a few minutes ago, got loaded up with meds, and, as usual, is expected to conk out again at any minute. Oops, there she goes. Good night darling.

RKS

Sleep and More Sleep

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O Sleep, It Is a Gentle Thing
0830 Saturday 30 October 2010
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Well, this isn't any fun at all. All Michele does is sleep. In the past twelve hours she has barely stirred. I'd like to tell you how she is doing, but the only thing she has said is "Oh, hello darling. When are we going home?" Then back to sleep.

RKS

Moving on Up

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Pomp and Circumstance
1530 Friday 29 October 2010
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At 2:45 pm this afternoon, Michele graduated from ICU 357magnumsumacumlaudielordy and with highest honors.

We are in room 403, the same room we started in last spring. Michele continues to do what she has been doing a lot of lately--sleeping.

Don't expect much of anything to happen for the rest of the day.

Expect the next posting Saturday after Dr Fox makes rounds.

RKS

Still in ICU

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Resting Comfortably

1300 Friday 29 Oct 10

Michele conked out at 2100 (9pm) and scarcely wiggled the whole night long. She had a hearty breakfast (for her--a snack for a bird) and her first cup of coffee in two days--probably a recent record time of abstinence for Michele.

Dr Fox looked her over this morning and thinks that she can go upstairs to the hotel portion of the hospital this afternoon. She is experiencing some brain swelling from the trauma of surgery--not unusual, but bears watching a bit longer. She is somewhat disoriented, but that is thought to be temporary.

Michele had her regularly scheduled post-MRI this morning. We should get the results by 1500.

RKS

Awake and Hungry

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Where's the Beef?

2030 28 Oct 10 (8:30 pm for you civilians.)

Dr Fox stopped by a while back and gave Michele the twice over. He complimented her on how well she could wiggle her fingers and toes. She has had a lot of practice today. Dr Fox declared her in excellent condition. (All the way from the tips of her toes to her fingers?)

After that she was ready to eat. She wanted to order several of everything, then we figured that she was playing hostess and was ordering food for everyone in the room. Michele was also worried because we were a guest chair short.

Don't be surprised if you receive an invitation for her next party soon.

RKS

More ZZZZZZZZZZZ

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All Quiet in the ICU

1230 28 Oct
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No change. Michele continues to sleep and her blood pressure is near normal. It looks like wake-up is at least another hour away.

After wake up, the next big event is expected to be Dr Fox making rounds late this afternoon.

RKS

In ICU

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ZZZZZZZZ

1000 28 Oct

Sleeping away the morning.

Michele was wheeled into ICU Room #2 at 0945 and is hooked up to all the beeping and whirling equipment.
When they wiggle her shoulder she flutters her eyes and looks like she just wants to sleep undisturbed. She counts the nurse's fingers and does the rest of the neuro check about every 15 minutes.

All vitals are returning to normal, and she should wake up in an hour or two.

RKS

Closing

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All As Planned

0905 Thur 28 Oct 10

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Just talked with Kit Fox.

Everything went as expected and according to the plan.

Michele should be in ICU room number 2 latter this morning and should be there for the next 24 hours.

RKS

Early to Rise

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In OR

0700 28 Oct 2010

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We arrived at the hoispital at 0500 because, as everyone knows, Michele never wants to be late for anything. She also seems to enjoy sitting in waiting rooms, waiting for her scheduled appointment time. Traffic on Mo-Pac expressway was the lightest that I have ever seen and we made it to the hospital in record time--all the better to sit around and wait my dear. As near as she can recollect, this may be the earliest (0330) that Michele has gotten up in her entire life.

Everyone in charge of anything in the operating room came in and quizzed Michele about what was going to happen in the OR and asked her birthday--but her birthday is not until December.

They then wheeled her out at 0700 and said not to expect an update before 0900. Will send an update when I hear something.

RKS

Surgery Prep

Preparing for Surgery

Tuesday, 26 October 2010

We spent most of Tuesday at the hospital, filling in forms and doing pre-surgical stuff for Thursday‘s surgery.
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As part of the process, Michele had a detailed MRI performed. We met with Dr Kit Fox, the surgeon, to discuss the results.

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It appears that the original surgical site is stable and Dr Fox plans to look at it, but not touch it during surgery. With no change in months, he thinks that the contrast area we were worried about is most likely scar tissue.

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{ Editor’s note: Doctors do not like to call cancer “cancer” in an MRI. They like to call cancer “contrast area” or “area of concern.” }

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The new area of concern, a few centimeters (an inch) in front of the prior site has grown at a tremendous rate--perhaps doubling in size during the past few weeks.

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Dr Fox intends to remove the "frontal tip" of Michele’s left temporal lobe--a volume of at least 30 cc but less than 50 cc. A quick scaling of two MRI slices looked like the maximum dimensions of the contrast area were 3cm x 3.5cm x 5 cm. (1.2 inches by 1.4 inches by 2 inches.) If all of her circuits are in the right spots, Dr Fox does not believe that he would remove any critical tissue. He believes that he will be able to remove the entire visible tumor.

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The plan is to have the surgery early Thursday morning and be home Sunday. I plan to post updates on this blog rather than trying to send e-mail’s all day long.

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Best,

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Robert

Very Bad MRI

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Very Bad MRI

Friday 15 October 2010

We received the MRI results today. The results are very bad and indicate rapid growth of the cancer.

Dr Chadha, our oncologist, has recommended surgical removal as soon as possible, which will be on Thursday, 28 October, with the same surgeon, Kit Fox, at the same hospital, St David’s Central (32d Street at Red River) as the two previous surgeries.

On the bright side, Dr Fox said that he expects this surgery to be much simpler than the previous surgeries and does not expect the new surgery to impair any mental functions.

On the dark side, we are out of standard medical (chemotherapy) and radiation treatment options. Dr Chadha will spend the next few weeks looking for an experimental (Phase III) study that might accept Michele for treatment. The most promising GBM Phase III trials tend to cherry pick patients who the researchers think will have the greatest chance of success and survivability. With the treatments and surgeries she has been through the past 20 months, finding a promising study may be difficult.

One good result is that Michele will be off the very harsh Carboplatin chemotherapy, which she has been on for the past three months. We hope that, without the Carboplatin treatments, Michele will regain some the mental capacity recently lost.

　

RKS