I finally fell asleep late last night despite my intention to get to bed early. Instead I spent the evening sitting bedside for several hours waiting to hear the results of a late evening CT scan. I had just finished reading Lance Armstrong's book "It's Not About the Bike" to Phil from his Kindle around 5:30 p.m. yesterday when Phil started twitching his arms and legs and squeezing my hand. This continued and increased and it became obvious that he was having a generalized seizure. He was unable to respond to me although his eyes were open. The nurses came in immediately and started taking vitals, etc and the doctors were called. In summary, it only lasted about 2 minutes and he had no lasting effects. His CT was normal and he's had none since. It was just another indicator of the infection and swelling in his brain and the need for immediate surgery.
Surgery got underway at 7:30 this morning as planned and Phil was smiling and mellow, ready for what was ahead of him, yet subdued.
By 9:45 he was finished and Dr. Ghosh came to give us his report. He had indeed found a large abscess (3cm or about 2 inches) in the frontal lobe and was able to remove all of it. In doing so he confirmed that the source of the infection in the brain came from the eye and sinus infection. Although he had wanted to identify the infectious pathology in the OR he was unable to so we won't have those results for another 2-3 days. Phil did very well in surgery and had no complications and we are all breathing a huge sigh of relief.
So, Dr. Ghosh debrided the abscess and put in a paracranial flap to increase the efficacy of the antibiotics. Phil got his titanium plate and is now a million dollar man. He will have a repeat CT scan tomorrow to see that everything is holding steady and once the pathogen(s) been identified and a plan of treatment is in place, he could come home as soon as Monday.
When he wakes up in the Medical ICU I will tell Phil how he's been covered by the prayers of hundreds. And I will tell him how God works through people like Dr. Ghosh to perform nothing short of a miracle today.
Wednesday, September 29, 2010
Monday, September 27, 2010
GPS Surgery
For those of you who don't live in San Diego or follow our local weather, it is hotter than Hades here. I mention it because it has added a little something to the backdrop of our lives right now. While our time together has been sweet it has also been hot and intense. Yesterday Olivia spiked a fever of 102 and this morning my stomach didn't feel so good. It was bound to happen. On top of it all, although Phil has a nice big room, "the corner office" is a full exposure room almost all day and he (and his visitors) tend to roast. An extra fan has been brought in to keep him cool. As if he hasn't got enough to deal with...
After a weekend in which I was treated to sleeping in, being cooked and cleaned for and having all my laundry done by my sister-in-law Michelle, I am back to reality and we have received the results of today's MRI.
There were many words we didn't want to hear when talking with our physicians today, but unfortunately we heard several of them. The frontal lobe process looks ominous and it appears to Dr. Ghosh the neurosurgeon that an abscess could easily be forming. In his words, if he were to send Phil home, something "catastrophic" could " blow up" at any moment that could be devastating if not "life ending". Very graphic words with a clear message.
Phil needs to have a small scale surgery to determine once and for all what the infectious source is in his frontal lobe. There is a deeper brain infection going on as well but those areas are not amenable to surgery. So at this point a biopsy/debridement will be undertaken in the frontal lobe. He will have a high falootin' GPS MRI tomorrow to place markers to use during surgery then have the actual surgery very early Wednesday morning.
On a scale of 1 to 10, Dr. Ghosh rates this a 2 - it aint nothing! We're just going to open up the braincase, remove some tissue and replace it with a small titanium plate, ok? Anyone grow up with Steve Austin, the 6 million dollar man? That'll be Phil, minus the new eye because he gets to keep his. So far that part looks stable.
Please don't take me wrong here with the humor and levity. I am scared and exhausted and wrung out and sick to my stomach. I am also hopeful, relieved to finally be doing something about that damn thing in his head, and a witness to the power of God's people in prayer. My husband is willing to undergo a surgery that carries above average risks and is only a stop-gap measure. But he's still fighting. So, I've got to find things to laugh about. There have been too many tears of late.
After a weekend in which I was treated to sleeping in, being cooked and cleaned for and having all my laundry done by my sister-in-law Michelle, I am back to reality and we have received the results of today's MRI.
There were many words we didn't want to hear when talking with our physicians today, but unfortunately we heard several of them. The frontal lobe process looks ominous and it appears to Dr. Ghosh the neurosurgeon that an abscess could easily be forming. In his words, if he were to send Phil home, something "catastrophic" could " blow up" at any moment that could be devastating if not "life ending". Very graphic words with a clear message.
Phil needs to have a small scale surgery to determine once and for all what the infectious source is in his frontal lobe. There is a deeper brain infection going on as well but those areas are not amenable to surgery. So at this point a biopsy/debridement will be undertaken in the frontal lobe. He will have a high falootin' GPS MRI tomorrow to place markers to use during surgery then have the actual surgery very early Wednesday morning.
On a scale of 1 to 10, Dr. Ghosh rates this a 2 - it aint nothing! We're just going to open up the braincase, remove some tissue and replace it with a small titanium plate, ok? Anyone grow up with Steve Austin, the 6 million dollar man? That'll be Phil, minus the new eye because he gets to keep his. So far that part looks stable.
Please don't take me wrong here with the humor and levity. I am scared and exhausted and wrung out and sick to my stomach. I am also hopeful, relieved to finally be doing something about that damn thing in his head, and a witness to the power of God's people in prayer. My husband is willing to undergo a surgery that carries above average risks and is only a stop-gap measure. But he's still fighting. So, I've got to find things to laugh about. There have been too many tears of late.
Friday, September 24, 2010
Resting
Phil is resting today as we all are; catching up on sleep and catching our collective breath after the whirlwind of the last several days. His parents have arrived and my brother Peter and his family have driven down. There are still a few more members yet to come in over the next days as we gather to be with Phil and enjoy our time together as family.
Unless there are any changes I will be taking a break from posting as we rest, recharge, and enjoy one another. The last time we were all together like this to join our two families as one was at our wedding 15 years ago. It will be a sweet time of communion, thanksgiving and prayerful petition to God for all that He has done and for all that He has yet to do.
I will be back here on Monday. May the Lord sustain you as I know you will be feeling the absence of news of our dear Phil. Know that he is in the hands of the great physician and in the arms of his loved ones as you hold him in your hearts and prayers.
Unless there are any changes I will be taking a break from posting as we rest, recharge, and enjoy one another. The last time we were all together like this to join our two families as one was at our wedding 15 years ago. It will be a sweet time of communion, thanksgiving and prayerful petition to God for all that He has done and for all that He has yet to do.
I will be back here on Monday. May the Lord sustain you as I know you will be feeling the absence of news of our dear Phil. Know that he is in the hands of the great physician and in the arms of his loved ones as you hold him in your hearts and prayers.
Thursday, September 23, 2010
Phil's Progress
Since my last posting, the decision was made to repeat Phil's MRI this morning before going to surgery. His surgical team felt that with the invasive nature of the surgery, Phil's underlying fragility, and the many risk factors, it behooved them to gather up to the minute information before taking him to the operating room. Additionally, his immune system has just begun to function on it's own and they wanted to give him every opportunity to mount his own response to this infection, to better equip him for the challenges of surgery.
Clearly, whomever said no news is good news hasn't sat around waiting for an MRI to be completed. However, the wait was worth it. The scan showed that there has been more improvement and Phil's immune response has made a difference. His eye is definitely better since yesterdays MRI. It also shows that the infection has been spreading through the venous system into he brain and not through the dura, which basically means that the antifungals should be able to penetrate the infection given more time. So, NO SURGERY IS NECESSARY TODAY. In fact, Phil will continue his current course of treatment and have his next scan on Monday - 4 days from now!!! This is the first good news we've had and we couldn't have been happier to receive it.
He will need the antifungals for at least 6 weeks and chemotherapy is still on hold. Surgery is still a very real option and not one of us is deluded into thinking Phil is out of the woods. This is still a day to day existence of prayer and thanksgiving and enjoyment of one another. Family is gathering and we continue to ask for and bask in your enormous outpouring of prayers, love and support. Team Conrad continues to grow as word has spread of Phil's fight and we feel connected to you in a powerful way.
Let us celebrate Phil's victory today. Livestrong!
Clearly, whomever said no news is good news hasn't sat around waiting for an MRI to be completed. However, the wait was worth it. The scan showed that there has been more improvement and Phil's immune response has made a difference. His eye is definitely better since yesterdays MRI. It also shows that the infection has been spreading through the venous system into he brain and not through the dura, which basically means that the antifungals should be able to penetrate the infection given more time. So, NO SURGERY IS NECESSARY TODAY. In fact, Phil will continue his current course of treatment and have his next scan on Monday - 4 days from now!!! This is the first good news we've had and we couldn't have been happier to receive it.
He will need the antifungals for at least 6 weeks and chemotherapy is still on hold. Surgery is still a very real option and not one of us is deluded into thinking Phil is out of the woods. This is still a day to day existence of prayer and thanksgiving and enjoyment of one another. Family is gathering and we continue to ask for and bask in your enormous outpouring of prayers, love and support. Team Conrad continues to grow as word has spread of Phil's fight and we feel connected to you in a powerful way.
Let us celebrate Phil's victory today. Livestrong!
Wednesday, September 22, 2010
All In
We are no longer living day to day around here, time is now marked in 12 hour increments. That's how quickly things are changing and progressing.
Phil had another MRI this morning and the cultures have yielded more definitive results. Today has been a big and unfortunately, very difficult day. The cultures show absolute evidence of a mixed bacterial and fungal infection in the sinuses and henceforth in the brain. The fungus is called Mucormycosis and is very common in diabetics and immunosuppressed patients. The MRI shows advancement since yesterday of the infection to involve new portions of the brain. So despite having been on high doses of antibiotics and antifungals, ground is not being gained.
The optimal treatment for this fungus is surgical debridement, which although radical, is Phil's best chance for eradicating the infection. Combined with his antifungals, tomorrow morning he will be having a very involved neurosurgery to remove his left sinuses, his left eye and orbit and portions of his left brain that are infected and non-functioning anyway. It's hard core -- as if it wasn't before. During the next several weeks his chemotherapy will have to be put on hold lest any further immunosuppression allow the Mucor to take the upper hand.
We are awaiting the final debriefing from the team of surgeons and are covering Phil with our prayers and love. We (Jeff, David, Anita and I) are also telling stories and laughing a bit too. Phil is tired and a bit fearful for tomorrow's events but he is also ready to go. He's not one to sit back and do nothing if there's something to be done. He's going for it. Bravest man I know, facing down terrible odds and "fighting a raging fire in the middle of a hurricane".
If Phil were playing poker, I'd say he was all in. Trusting God, and all in.
Phil had another MRI this morning and the cultures have yielded more definitive results. Today has been a big and unfortunately, very difficult day. The cultures show absolute evidence of a mixed bacterial and fungal infection in the sinuses and henceforth in the brain. The fungus is called Mucormycosis and is very common in diabetics and immunosuppressed patients. The MRI shows advancement since yesterday of the infection to involve new portions of the brain. So despite having been on high doses of antibiotics and antifungals, ground is not being gained.
The optimal treatment for this fungus is surgical debridement, which although radical, is Phil's best chance for eradicating the infection. Combined with his antifungals, tomorrow morning he will be having a very involved neurosurgery to remove his left sinuses, his left eye and orbit and portions of his left brain that are infected and non-functioning anyway. It's hard core -- as if it wasn't before. During the next several weeks his chemotherapy will have to be put on hold lest any further immunosuppression allow the Mucor to take the upper hand.
We are awaiting the final debriefing from the team of surgeons and are covering Phil with our prayers and love. We (Jeff, David, Anita and I) are also telling stories and laughing a bit too. Phil is tired and a bit fearful for tomorrow's events but he is also ready to go. He's not one to sit back and do nothing if there's something to be done. He's going for it. Bravest man I know, facing down terrible odds and "fighting a raging fire in the middle of a hurricane".
If Phil were playing poker, I'd say he was all in. Trusting God, and all in.
Tuesday, September 21, 2010
Surgery Update
The surgeon has just come out to talk with us and Phil has done well this morning. He ruled out fungal activity and was able to clear the left sinuses. Thanks be to God--best scenario for today though there are many issues that remain. He will have an MRI tomorrow morning for further information about how to proceed. It looks like it is bacterial and we will have to wait for the cultures for treatment decisions to be made. He is not out of the woods by any stretch and we are grateful for each positive bit of news. He has some blood clots in the area that concern the surgeon and the neurosurgeon will weigh in on them soon. More news as we get it. Love you all.
On Our Knees
Today's blog is going to be short and to the point. There are too many details to report and frankly they change with the hour yet don't change what you really need to know. Phil needs prayer and lots of it.
As I am typing this he is undergoing surgery to diagnose the cause of this horrible infection in his brain. Since I last posted, the infection in and around his eye has worsened and it looks like we are dealing with a particularly "wicked" fungal infection (to quote Dr. Kossman). He and the 3 or 4 other specialists who've been consulted in this case are very concerned about the infection because it is extremely difficult to eradicate short of surgical debridement.
Debridement means going in and cleaning things out and since we're talking about the brain, well, you can grasp the gravity of the situation. As of today Phil has lost the vision in his left eye and there is reason to worry about the right eye as well. Fungal infections can spread quickly so information needs to be gathered quickly as well so the appropriate therapies can be continued or started.
The goal for today's surgery is diagnosis, not therapy or cure. That much has been made clear to us. Having said that, our hopes for today are for an uncomplicated surgical course, sufficient biopsies that will lead to productive treatment and no further surprises or obstacles.
The kids and I are surrounded by family and good friends, including Jeff Breland, and feel the love and prayers that have been pouring in. Phil is in excellent hands and Dr. Kossman has brought in the county's finest specialists in ENT oncology and neurosurgery. The rest, as ever, is in God's hands.
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