Monday, 22 October
We met with the neurosurgeon (Dr. Tomaras) today as planned. The results of the lumbar puncture were negative. They were not able to find any cancer cells in the spinal fluid. After scrutinizing the MRI scans, a small tumor was located in an area behind the right eye (which is closed). In light of this, he wants another MRI of the brain and a MRA of the blood vessels in the brain. The key reason for the MRA is rule out an aneurysm being the cause of the loss of use in her eye. As covered in previous updates there are a percentage of people who develop carcinomatous meningitis (cancer of the lining surrounding the brain and spinal cord) that never test positive for cancer cells in the spinal fluid. However, two of the three indicators that are usually present when cancer is growing in the lining are missing: 1. Cancer cells present in spinal fluid, 2. Cancer “lighting up” (as a result dyes used during an MRI with contrast) in the lining, 3. Neurological malfunctions such as loss of control of the eye. Since the doctors and all the tests are only able to be certain of the last indicator they are going to treat Karen as if she doesn’t have cancer in the lining of the brain and attempt to treat specifically the small tumor found behind her eye.

The neurosurgeon is referring Karen to the radiation oncologist (Dr. Cline) who did the Gamma Knife surgery in August. He explained that while the decision of how to treat the tumor will be left up to Dr. Cline, there are really two options open. One is do another Gamma Knife targeting the tumor. The second is low dose fractionated radiation which is less concise than Gamma Knife but more likely be chosen due the extremely sensitive optical nerves located near the tumor.

We also received the results of the testing done twice last week to determine kidney function. The dyes used in the MRI are hard on the kidneys. Karen’s kidney function showed declined test over test.

The added challenge now is managing the doctors. It seems this week will be filled with more testing, more waiting and shuffling hither and yon. We continue to be sent from doctor to doctor as they work to determine what’s causing the loss of use in Karen’s eye and how to treat it. Meanwhile, her kidney function is dropping and she is experiencing severe fluid gain in her abdomen (ascites) and ankles. Despite this, Karen continues to grab life as it comes making every effort to make the most of each day.

Please pray for improved kidney function, elimination of ascites, disappearance of nausea, wisdom and clarity of mind for us and the doctors, peace that passes understanding and above all that we would be able to handle ourselves in a way that reflects our hope rests in God alone.

Until next time…