Finally, the update . . .

Sorry for the delay in sharing the week's events. Mary is feeling better and wanted to do a day trip to "KAM’s Peak," our little dream cabin we are building (for Mary’s 50^th birthday party in September, maybe?). It was a good day after a grueling week.

The summary version of where we are and where we are going is here. For those interested in more medical details and/or sappy ramblings, I'll post more soon.

• We are still in an information-gathering mode
• Dr. Jim Robinson at Piedmont, who is excellent and very affable, wants more info and a new, high resolution MRI. That will be done this week.
• He is not sure the risk is acceptable to do a biopsy. He cannot do gamma knife at that site. One thought is to follow with MRI’s every 3-4 months or until symptoms worsen. Not really sure about that approach, need more info.
• The approach to get a biopsy is different for midbrain vs pineal sulcus; the midbrain has a higher risk. We really don’t know where this actually lies -- we are talking about areas of millimeters next to each other.
• Low grade astrocytoma is being listed as most probable; it can transform into high grade over time.
• Germinoma looks less likely but still a possibility, as is glioma (not what we want); even a hamartoma was mentioned, which is benign.
• Dr. Fred Schwabolt, radiation oncologist at Piedmont, is excellent and has been giving us referrals also; says he needs a biopsy to do any radiation therapy.
• On Friday, Dr. Olson at Emory (who put her shunt in), said he also feels strongly about obtaining a biopsy. If it is an astrocytoma, there is a window in which to act before it could transform to high grade.
• He gave a suggestion of seeing one of the pediatric neurosurgeons to do an endoscope (like one for sinuses or colonoscopy). Since her ventricles are large, they could possibly go via scope to the tumor site and obtain a biopsy. THIS IS VERY APPEALING. The other option is the open craniotomy (taking scull off in back to obtain biopsy . . . Mary calls it her "hatchback"!). They both carry benefits and risks.
• We see one pediatric neurosurgeon at Emory tomorrow (Dr. Wrable??)
• We also see a pediatric and adult neurosurgeon at Scottish Rite tomorrow.
• Duke is still very appealing, and we will probably make a trip there soon. Have not heard back from them. Since Duke lost in the NCAA tournament, we will give them a day to regroup.
• THAT’S ALL FOR THE SUMMARY. WILL KEEP YOU POSTED. Mary is most grateful for everyone’s love, help, emails & blogs.

M/KJ