So I fell down the stairs again today. I hit my head pretty hard. And I managed to land on a section of my back that was already hurting quite a bit.
This reminded me that I never posted a “brain update” after my last oncologist entry earlier this month. I guess I didn’t really forget to write about it, I just didn’t because I didn’t know what to say after my appointment with the neurologist the next day.
I’m still not really sure what to say. When I arrived at the neurologist’s office, I took a seat in the waiting room with a double-sided questionnaire about my symptoms. I pretended to fill it out, but I was just sitting there lost in thought. I had just filled the same paper out a couple of weeks prior and my answers probably hadn’t changed, so I thought the time would be best spent staring off into the distance, clipboard on my lap and pen in my hand.
I only had a few minutes of quiet before my neurologist walked out into the big waiting room, purse on her arm. She said ‘hi’ and said she’d be back for me as she walked out of the door. The nurse came out moments later and took me back to the vitals station and proceeded to take my blood pressure, etc. Before he finished, my doctor was back. She said she’d take it from there. She walked me back to the scale, took my purse and coat, and I stepped up to be weighed. We then walked back to the room. She carried my purse, her purse and my coat and chatted with me during our short walk. She set our open purses down on her desk and I took a seat next to her. She told me she was glad I came in because she wanted to show me my MRI so I could see “IT” for myself.
We chatted as though we were girlfriends out having a coffee date and as though we were discussing our husbands, kids, dogs, and the piles of laundry waiting for us at home. The only difference was that the coffees were waters, the table was an exam table, and we weren’t talking about what we were making for dinner. We were talking about the lesion in my brain.
She showed me my brain MRI. There was the lesion. And then the same area on my MRI from about 8 months ago. No lesion.
Not really coffee shop conversation.
When I asked if it was a metastasis, she said that it may not be malignant. She said that they typically see a lot of “mass effect” with malignant tumors. (*Mass effect is damage to the brain due to the bulk of a tumor, the blockage of fluid, and/or excess accumulation of fluid within the skull.) She said that this ‘mass effect’ was lacking on my MRI. I asked, “Could the mass effect be lacking because it is such a new lesion?” Maybe. “But it could also be because it is something benign?” Yes, definitely a possibility. Looking at the lesion’s shape, I wondered, “Could it be because I swallowed a small grape and it went the wrong way and lodged in my brain?” But I figured that was pretty unlikely!
The kicker (well, one of them!) is that it is deep in my brain — within the thalamus. Not an easy place to access for biopsies, etc. So no easy way to know for sure what it is. My neurologist feels the best way to proceed is to wait a couple of months and repeat the MRI. If it is malignant, we should expect changes. If I have an increase of symptoms, it sounds like we can do it sooner.
Then there’s also that abnormal EEG that prompted the MRI. So I don’t really know what to think. On the one hand, I feel sick to my stomach because the cancer may have metastasized to my brain. But on the other hand, I’m really hopeful that it hasn’t. And at this point, I guess I should feel pretty grateful that it’s only a maybe and not a definite.
Cancer is the gift that keeps on giving…
In case you were wondering what the thalamus does:
**”The thalamus has multiple functions. It may be thought of as a kind of switchboard of information. It is generally believed to act as a relay between a variety of subcortical areas and the cerebral cortex. In particular, every sensory system (with the exception of the olfactory system) includes a thalamic nucleus that receives sensory signals and sends them to the associated primary cortical area. The thalamus is believed to both process sensory information as well as relay it—each of the primary sensory relay areas receives strong “back projections” from the cerebral cortex.
The thalamus also plays an important role in regulating states of sleep and wakefulness. Thalamic nuclei have strong reciprocal connections with the cerebral cortex, forming thalamo-cortico-thalamic circuits that are believed to be involved with consciousness. The thalamus plays a major role in regulating arousal, the level of awareness, and activity. Damage to the thalamus can lead to permanent coma.”
* Information from: http://www.mayfieldclinic.com/PE-BrainTumor.htm
** Information from: http://en.wikipedia.org/wiki/Thalamus