It has been busy in the last few days. This morning, the residents did rounds early in the morning and Sada wouldn't wake up (she even had blood drawn without moving). Since she wouldn't wake up, and since she was only 10 hours past emergency brain surgery, they elected to do another CT scan to make sure there weren't any problems post-surgery. She eventually woke up on the way to CT, and the CT scan was just fine.

Her day consists of nurses coming in to check on her, give her various medications, and check her vital signs. Residents come in first thing in the morning (between 6 and 8 am) and then return about 10 with the supervising physician. They do a quick neurological exam and make appropriate changes to her treatment plan. She has a EVD or external ventricular drain which is a tube that goes into her brain to drain it of excess CSF (cerebral spinal fluid). Since the tumor caused her brain to swell, the drain is alowing her brain to drain off the excess fluid. If all goes well, the drain will be turned off tomorrow, and they will see if her brain can take care of the fluid itself.

Her tumor was thought to be one of three kinds of tumors. I like to think of them as good, bad and ugly, although none of them are actually "good". Prior to surgery it was thought to be a type of tumor that can metastasize to the spinal cord. With the MRI of her spine, the metastasis was ruled out.

After surgery the lab ran a pathology report, and the diagnosis changed to another type with the final diagnosis which came today! It is a Juvenile Pilocytic Astrocytoma (JPA) also known as a benign (non-cancerous) tumor. http://www.cumc.columbia.edu/dept/nsg/ct/jpa.html

The tumor grew behind her brainstem and in front of her cerebellum. The brainstem controls things like facial muscles, swallowing and the vomiting reflex. The cerebellum controls balance and how you move in relation to things around you.

Side effects of the surgery: One rare side effect of the surgery is sometimes kids will come out unable to talk. This didn't happen, thankfully. Because of the placement of the tumor, the surgeons put some mechanical pressure on another part of the brain which affects her eyes coordinating movement. That means that each of her eyes now moves independently of each other. This is something that should get better over time in the range of weeks to months.

Since she had lost her vision in the left eye she needed appointment with an eye doctor. After her visit with the ophthalmologist (eye doctor) her vision is returning to that eye. It is only in the central part of her visual field, but is returning slowly. Another symptom of either the tumor or the surgery is that she is very wobbly. She has a hard time keeping her balance. That is part of what the cerebellum does and should get better as she recovers.

As part of the routine with tumors, Sada had a consultation with an oncologist (cancer doctor). This visit was really just to cover all bases because the oncologist agreed with the surgeon that no other treatment was necessary except for regular follow up with the surgeon.

We feel the heavens have showered their blessings upon us. We have seen many miracles - tis the season!