Thursday, August 12, 2010

Monday of my last week at my main place

Monday I spent a while talking with PT K. He seemed down. He explained that he had to rethink his plan. He thought he'd decided not to go for the brain biopsy suggested by his neurosurgeon since he'd understood that it would involve the biopsy, followed by 6 MONTHS of radiation, followed by another 6 months of waiting to see what the result was. He further explained that he'd been told that at best he'd get another 2 years of life. Thus, given the ordeal that the treatment would be along with the waiting for the results, he'd decided that it would not be worth it given how little he stood to gain. However, he'd lately been told that he could possibly have another 5 years and it would only involve 6 WEEKS of radiation. Further considerations were that the kind of tumor he has has a tendency to produce blood clots and there was a 10% risk of life-threatening bleeding during this procedure. He was also concerned as to the potential effect on him as a person, either personality change or some kind of incapacity resulting from the biopsy. His surgeon seemed confident that this would be minimal at most and not something to count against undergoing the procedure. He was pondering all these issues.
He further explained that given the initial description of the procedure's risks, the length of the therapy, and possible outcomes he and his healthcare advocate had decided that this was not the way to go. Now a major rethink was called for. They'd had a conference with the neurosurgeon, his healthcare advocate and PT K himself but not with his oncologist who was on vacation that day (and, apparently, hadn't provided enough notice to allow for a rescheduling). The neurosurgeon also said that there was a time window for doing this procedure (PT K assumed - as did I - that this meant in the next few weeks, and not a decision that could be delayed for months, but not something that had to happen over the next couple of days so, he would have time to meet with his cousins and healthcare advocate and give it due consideration). PT K's cousin had suggested that he talk to his original doctor at the first hospital he was at as to his opinion on the possible negative/positive outcomes of the biopsy procedure. He was nervous that perhaps this would require him to impune the skills and reputation of the surgeon he was currently with (who has done this procedure many, many times and is an expert). He asked my opinion. I said that I didn't think he needed to worry about that since he was not asking about the skills of the surgeon, he would be asking about the procedure in general which, no doubt, is performed in many places around the globe, furthermore, if the doctor did not feel comfortable responding, he didn't have to.  He seemed to decide then that he would ask his first doctor.
The chief point of the biopsy is to find out what kind of tumor it is: apparently it could be one of two (of the three kinds of brain tumor). The location is what makes it particularly problematic - at the pons.
I also visited briefly with PT SS. He'd undergone his chemotherapy around four days prior and did seem improved. Certainly he was in much better spirits so, one assumes, he couldn't be in anything like the discomfort he'd been in before.

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