Wednesday, 10 October

So much has happened since the last update. We’ve had encouraging news, discouraging news and bewildering news. WARNING! This update may meander a bit due to lack of sleep.

In the last update I wrote about headaches Karen was beginning to experience. The headaches were severe enough to leave her flat on her back despite medication. Then on 3 October she woke to double vision in one eye. It was believed to be a possible side affect from the Gamma Knife surgery so a drug called Dexamethasone (steroid) was prescribed and seemed to help. Shortly after taking the medication the double vision was gone and the headaches were greatly reduced.

When I arrived home from work on 6 October Karen was “feeling pretty good” standing over her cutting table with scissors and fabric in hand cutting out a pattern to make some clothes for the girls. Just a few hours later we were in the emergency room. In just a couple of hours she went from feeling well enough to sew to literally writhing in pain due to her head hurting so bad. She wasn’t able to keep any medication in place long enough to help due to severe uncontrollable nausea.

This time the headache seemed to be over the other eye and the pain was in Karen’s words excruciating. When asked at the emergency room to rate the pain on scale of 0-10 with 0 being no pain and 10 being the worst, Karen said it was a 15. She told the doctors that naturally bearing five children without an aspirin was less painful and that the pain from the headache was the worst she had ever experienced in her life. After several hours of intravenous medication the pain and nausea had dropped to a tolerable level. However the pupil of the eye where the headache was wouldn’t respond to light stimulation and wouldn’t track (move) with the other eye. The eyelid had also begun to drop uncontrollably.

The doctors reviewed an MRI of the brain that was done earlier in the day and since no gadolinium dye was used they were unable to tell if there were any changes in the brain that would cause the symptoms Karen was experiencing.

The reason the doctors are cautious about the use of the dye is its possible harsh effects on the kidneys. Karen was taken for another MRI this with time with gadolinium dye because now they are more concerned about the brain than the kidneys. The results of the scan showed the spots of cancer already treated by the Gamma Knife surgery and a possible thickening of the meninges near the base of the brain. The meninges are the three membranes that surround and protect the brain and the spinal cord. The scans indication the meninges were thickening caused the doctors to be concerned Karen’s body may have developed carcinomatous meningitis which is a rare condition caused by cancer cells getting into the thin sheets of body tissue that surround and protect the brain and spine. These sheets are called the meninges. Meningitis means inflammation of the meninges. Carcinomatous just means acting like a cancer.

At this point, Karen was admitted to the hospital, 7 October, for further testing, pain management and observation. The further testing included blood tests and a lumbar puncture like the one she had on 18 July 07. The doctors explained that in order for her eye to be responding the way it is the nerves controlling it must be impeded by something and since cancer has been found in the brain it would be logical to surmise that cancer cells were now in the meninges. If the results of the lumbar puncture, where they gathered a small amount of spinal fluid for testing, supported this theory they would find cancer cells present. We were told of the treatment options and timelines for procedures and treatment.

Monday, 8 October, Karen remained in the hospital with most of the pain and nausea under control as we waited for the results of the tests.

Tuesday, 9 October, by mid afternoon we had not heard anything from the doctors so we assumed we would spend another night waiting. We were praying for a miracle and preparing for possible outcomes. Just as we were making schedule adjustments the results of the lumber test were available. We were also given the results of all the other testing that had occurred over the last several days before and after Karen’s admission to the hospital.

Test Results:

The blood test showed cell and platelet counts reduced below normal which was attributed to the chemotherapy.

The lumbar puncture was negative. There was no cancer or any other suspicious cells found to be present.

The PET scan results from 04Oct 07, showed the cancer in the rest of the body (neck down) was stable. The term stable is used when two scans taken months apart, in this case June 29th, show minimal or no changes in cancer progression.

The tumor marker test results supported the PET scan in that on 06SEP07 they were 508 and as of 27SEP07 they dropped to 379. This would indicate the chemotherapy is working to control cancerous cell growth.

The results did not support cancer growth; however the test is persistently negative in about 10% of patients who do have carcinomatous meningitis. One of the several doctors caring for Karen said something is clearly wrong but medically speaking you are in “no man’s land”, like being on the line between enemy camps and your neutral yet you are still being shot at and can’t tell for certain who is doing the shooting. You can’t just start shooting back because you can’t be sure where to shoot.

We were told it is possible the results of the lumbar puncture are inaccurate because there could be a blockage further up the spinal cord, more near the base of the brain, which is blocking cancerous cells from being in the lower part of the spine where the procedure is traditionally performed. It was recommended to repeat the test in a week if the symptoms persisted. Karen was released to come home and advised to continue taking the medications that were being given in the hospital.

We’re glad the doctors want to know for certain what they are dealing with before making any offers of treatment. However we are rattled by the double vision and involuntarily closed eyelid. The answers are unnerving and settling at the same time. We are very glad our hope doesn’t rest in man’s abilities or limitations. Karen is in the hands of the Great Physician who formed and knows every part of her body.

Please join us in prayer for the headaches to vanish as quickly as they appeared and her eye to open and vision to return to normal, also for peace and rest to fill our home.

Until next time…