Wednesday, September 2, 2009

Latest on Steve

So after everything that happened earlier this month with the two ER visits and the speech problems and losing the use of his right arm, Steve and the rest of us were getting increasingly concerned about Drs. Jotte & Lamond's wait-and-see approach to treatment.

The idea that Steve has a tumor in his brain that has burst and was/is bleeding, therby putting pressure on certain parts of his brain and making certain parts of his body not work is incredibly scary. What's even more scary is when your medical team basically says, "Eh. It'll get better," and sends you home literally without doing anything. Steve is so frustrated with both the arm and the trouble speaking and we've seen no improvement since they sent him home. It's terrifying, for him especially, to think that it might never get better.

With all of us feeling more and more uncomfortable with doing nothing, Steve decided to get a second opinion from the Cutaneous Oncology department at the University of Colorado Anchutz Cancer Center. We got quite a different story from them. Bottom line is that Steve is scheduled for surgery tomorrow to have the tumor removed.

We met last week with Dr. Karl Lewis, an oncologist, and also with Nurse Practicioner Amanda Brill who works for the neurosurgeon Dr. Robert Breeze. We met with Dr. Breeze today. What this team has told us is that the lesion that is bleeding is too big to reabsorb and needs to be removed. The blood/fluid surrounding it may reabsorb but the tumor itself is large enough that it needs to come out or the arm and speech won't improve. They let us look at the MRI and we saw that this tumor and the surrounding blood clot is about the size of a golf ball. And we also found out that there are four to five more small tumors, which was complete news to us. The plan is to get those tumors using the gamma knife (an outpatient procedure) on Sept 14.

This is basically completely the opposite of what the previous doctors were doing but after meeting with the new doctors, we all feel so much more better about Steve's future. It felt a lot like the previous doctors just didn't know what else to do or like there wasn't anything more that they could do. We all have a renewed sense of optimism with this new treatment plan. Basically, they feel like you have to treat melanoma aggressively, and make sure you treat the systemic disease (in the body) in conjunction with treating the brain.

I think the big difference is that Dr. Breeze's and Dr. Lewis's practices have been working as a team for twenty years treating melanoma specifically, whereas Dr. Jotte and Dr. Lamond are just two doctors that I don't know if they ever actually spoke to each other regarding Steve's treatment, let alone formed a plan of attack as a team. I feel personally that Steve's prognosis is much better with this new approach.

Surgery is at noon tomorrow following an MRI at 10:15. It will take 3-4 hours, and then he'll go to recovery so we won't see him until the early evening. He'll spend the first night in the ICU, but then they plan to move him to a regular room early to mid day Fri, and hopefully have him home by Mon. The arm and speech could be better right away - within hours or a week, or it could take a few months - no way to tell ahead of surgery. It's even possible, since they're mucking about in the motor strip of the brain, that the arm and speech could be worse for a while until the swelling goes down. Should that happen, they'll assess him and may send him to an acute inpatient rehab center for a short time until they feel like he can take care of himself.

So, please think of him tomorrow and keep him in your thoughts and prayers, send good karma, rub a rabbit's foot, whatever you can do to help him out. And as always, thank you so much for your support. It means so very much to him and to me.