Cyberknife #2 Complete

I could have sworn that we were told that Cyberknife would take approximately 45 minutes. Now granted, it supposedly stops when the patient moves and starts up again when they are still. If that's the reason for the delay, E. must be one wiggly fellow because it is taking at least double the estimated time.

Today's Cyberknife session wasn't nearly as painful for E. He said it was still uncomfortable to lay on that back incision but it didn't cause the same pain as yesterday. He also didn't complain of the same splitting headache afterwards. He remarked that at some time during the treatment he could smell something burning. We sarcastically joked that maybe it was his brain.

We met with the radiation oncologist and were finally able to see pictures of E.'s latest MRI. The areas where the two tumors had been looked like gobstoppers with circles of colors all around them. When the Tumor Board was reviewing E.'s case for the possibility of Cyberknife, we had been told that they would be looking at the size of the cavities left behind after the tumors were removed. We knew that the original tumors were too large for Cyberknife, but were told that once they were removed, the cavities would shrink in the healing process. The cavities we saw on that MRI were still BIG! Like really big! The radiation oncologist explained that the cavities fill with fluid and the some of it may eventually be reabsorbed into the brain, but we were left with the impression that they would pretty much remain there forever. On a positive note, there was "nothing new" from the original MRI when E. first went to the emergency room (meaning no new cancer and no new suspicious spots).

When we first discussed Cyberknife, we were told that the typical course of treatment for patients with brain metastases consists of between three and five sessions. Today we found out that E. only needs three treatments. That means that tomorrow will be his third and final Cyberknife treatment. We also discussed the need for steroids or other medications. The radiation oncologist explained that frequently patients have side effects from the radiation or Cyberknife that require steroids and/or other medication. Many of the side effects are the direct result of swelling in the brain ... headaches, dizziness, fatigue, nausea, seizures. If E. can manage to avoid all these side effects, he won't have to take the steroids or any additional medications. We'll be keeping an eye out though, because as is the case with most radiation patients, the side effects are cumulative and usually show up after treatment is all said and done.

As of right now, he's still feeling good. Woohoo!

Trained

I'm trained and ready to go. I now know how to flush an IV. I now know how to give IV anti-biotics. We've got a whole bag of supplies ... tubing, caps, sleeves, alcohol wipes, gloves, 4 X 4's, saline syringes and of course, bags of anti-biotics. Thankfully, I don't actually have to insert the IV needle, but I suppose at this point if I had to learn to do that, I would cowboy up and do that too. E. just has a peripheral IV (no PICC line) and it should last for about four days. He has to go back on Monday for labs, as do all the infusion patients (so they've dubbed it "Bloody Monday") and he'll get a new IV then. He only has 8 to 10 days left of anti-biotics left. We're thinking he got pretty lucky after hearing that most of the infusion patients have IV's for a minimum of 6 weeks. This home IV system is real high-tech too ... we hang the bag from the wall with a push pin/thumb tack. He only gets his IV anti-biotics once a day and they take 30 to 40 minutes to run, so no need to drag an IV pole around for that little bit. This little bump in the road will be over before we know it.

E.'s Home

E.'s first Cyberknife treatment is done. Unfortunately, it wasn't nearly as quick and easy as we thought it would be. Laying on the back of his head really gets to be painful (where that back incision is), especially for extended periods of time. And the Cyberknife took well over an hour today. His head rests on a hard plastic piece which they "pad" with a piece of bubble wrap ... one little sheet of bubble wrap. The hard netting mask holds his head in place in an awkward position and they readjust him occasionally. He was told to keep his eyes shut as there were a series of bright lights. E. didn't actually feel anything in terms of the Cyberknife, just from laying on his head post brain surgery. By the time he was done, he had quite the headache that is just finally easing up now. Supposedly, tomorrow's and Friday's Cyberknife treatments won't be as long as today's so hopefully that is better for E.

E. was also able to get discharged from the hospital! Yay!! Tomorrow morning, he has to go to the infectious disease office for an infusion of anti-biotics. I spoke to the nurse there and it sounds like the insurance company has approved E. to receive the IV anti-biotics at home for the duration of his treatment. There was one little twist that I wasn't aware of ... tomorrow *I* will be trained in flushing E.'s IV line and giving him his IV anti-biotics. No time to be nervous, just gotta do what's gotta be done.

E.'s happy to be home. And we're happy to have him here.

S.

Tidbits of Good News

* The infection has been confirmed as Staphylococcus Epidermis. Of the two Staph infection possibilities, this one sounds like the better one to have.

* The infection originated from E.'s port. The port has been removed so it obviously can't cause him any more trouble.

* E.'s EKG looked good and it doesn't appear that any bacteria made themselves at home in his heart.

* E. is responding well to the anti-biotics and today's cultures were clean.

* There are another 8 to 10 days of IV anti-biotics remaining. The infectious disease doctor indicated she's thinking about discharging E. after his Cyberknife treatment tomorrow, but she is awaiting "insurance approval."

(I am dumbfounded by insurance's involvement in E.'s potential discharge. Being at home has to be less expensive than being in the hospital for another 10 days. But I'm going to focus on the positive and that discharge is being discussed ... I'm crossing my fingers that E. will be in his own bed tomorrow night. Well, his rented hospital bed in his own room anyways.)

Still in the Hospital

E. did in fact get his CT today. He also got his face mask mold made. He is all set to start Cyberknife. Still no word about a possible discharge from the hospital, so as it stands right now, he'll be wheeled over from the hospital to the building next door for his Cyberknife treatments. He's currently on the calendar for three Cyberknife treatments ... Wednesday, Thursday and Friday.

We're really hoping that E. will be discharged from the hospital soon. Other than being a little grumpy and a lot bored, he is feeling good. He does have some cabin fever, or is that "hospital fever?" And he says the hospital food is, ummm, how should I put this? ... not very edible. He wants out of there!

Cyberknife's Still a Go

The radiation oncologist was in this morning already and we were happy to hear that a little ole staph infection isn't going to derail the plans for Cyberknife. They'll wheel E. over today for his scheduled CT, and he'll also get his mold/face mask made. Then, whether he's at home or in the hospital, he should be getting his first Cyberknife treatment on Wednesday just like originally scheduled.

Staph Infection

We've learned so much about esophageal cancer in the last 18 months. And diabetes. And brain metastases. And other things I never thought we'd be learning about.

Now we're learning about infections. It can be a tad bit overwhelming. I think I should have paid a little better attention in biology. (And if I get any of the following information wrong, please forgive me. We are learning as we go.)

The hospitalist explained to us that infections are either "Staphylococcus" or "Streptococcus" infections; E.'s being the "Staph" variety. (But there are over 30 species of Staph and many more sub-species as well.) That much we knew last night. The blood that was drawn on Friday and cultured, already grew something by Saturday morning which tested positive ... that is why we wound up in the emergency room. Each day as the culture grows, they are able to tell more and more about the specific kind of bacteria in E.'s blood. That is important to tailor the right anti-biotics. Right now, E. is on two "high-powered, broad-spectrum IV anti-biotics." Depending on what the cultures show in the days to come, those anti-biotics will be changed to specifically target the bad guys and kill them all dead.

The infectious disease doctor informed us today that they now know that E.'s infection is "coagulase negative" which means that it is a "Non-Staphylococcus Aureus." Because it is not Staphylococcus Aureus, it is Staphylococcus Epidermis which means the infections originated on the skin somewhere. And, using my deductive reasoning skills and a little googling, I deduced that since E. has a NON-Staphylococcus Aureus, he could not possibly have MRSA (Methicillin-Resistant Staphylococcus Aureus) since MRSA is a S. Aureus. I really don't know much about MRSA other than the horror stories I've heard which have effectively scared the bajeebers out of me, so I'm pretty thrilled with this piece of information.

There are potential complications from infections in the blood, including when the infections move into other areas like the spine or the heart. E. did have an EKG done yesterday to see if there were any bacteria camping out in his heart and making themselves at home, but we have yet to receive the results. It sounds like there is pain involved when the bacteria move into other areas (such as back pain when the spine is infected) and E. has not complained of any pain, so that is a relief.

And there was still the issue of E.'s port ... One of the problems with having a foreign object in your body (such as E.'s port!) is that it makes a great little breeding ground for the bad guys. It is very hard to clean and sterilize an object inside your body. So, even if anti-biotics effectively treat the infection, the bad guys hiding out on/in the foreign object (port) could reinfect the body in no time. The easiest answer is to remove the foreign object. Luckily, in E.'s case, he's not currently using his port and there are no plans to use a port in the near future ... so out it came! The good news is that the port is out. The bad news is that removing the port disturbed the bad guys. It riled everyone up in the body and now we have to wait about 24 hours for everyone to settle down (and have a couple of shots of anti-biotics while they're hanging out) until blood can be drawn again. Once that blood is drawn again, we have to wait for the cultures to come back.

I attempted to clarify with infectious disease doctor, "So, they'll draw blood on Monday and if the cultures come back clean on Tuesday, we can make discharge plans then?" The response I got wasn't nearly as encouraging as I had hoped, "Wellllll, cultures can take 24, 48, 72 hourrrrrs." Further identification still needs to be made on the infection. And, the blood cultures need to be negative before they'll discuss discharge. Oh, and the best case scenario at this point is that once he's released, he'll be on IV anti-biotics for a couple of WEEKS yet.

P.S. Room #333 this time around.

A Night Away

Who doesn't sometimes want a night away?

A night away from responsibilities.

Away from dirty dishes, dirty laundry and dirty floors.

Away from bickering and arguing kids.

A night to feel pampered.

To have people at your service with the ring of a bell.

To have others cook and clean for you.

Sounds good, right?

Too bad that night away isn't at a spa retreat, or even a hotel.

Yup, E. is being admitted to the hospital. Ugh.

Infected Port

I guess some things grow quicker than others. We didn't have to wait until Monday to find out more information. The oncologist called this morning and there is an infection in the port. Back to the emergency room we go. E. was so hopeful when we heard the news, "So, we have to go to E.R. to pick up a prescription?" Uhhhh, more like we have to go to E.R. for IV anti-biotics and just hope he doesn't have to be admitted.

Possible Infection?

E. noticed some redness and inflammation around his port on Thursday evening. It was tender to the touch too, so we put a call in to his oncologist first thing Friday morning. Luckily, there is no fever and no nausea. No other symptoms that we can tell. But, there is a chance his line could be infected. So, we were sent to the infusion center at the hospital this evening where they drew blood from E.'s port and also from his arm. They'll grow out cultures and compare the two (if there is an infection, they need to be able to determine if the infection is specific to his port or if there is an infection in his whole body). It'll take a few days to grow out the cultures ... we're supposed to call the office on Monday to see if the results are back. In the meantime, we need to watch closely for other symptoms like fever or nausea. Hopefully, there will be no symptoms and no infection.

A Plan!

Before I forget, let me assure you that E. and I both survived the flu. The even better news is that it does not appear to be making its way through the house (knock on wood!).

E. had his MRI yesterday afternoon. Laying flat with pressure on the back of his head (where the back incision is) was uncomfortable, but other than that, the scan was uneventful. We confirmed that the radiation oncologist would be able to access the films and reports in preparation for the Brain Tumor Board on Wednesday and yet were still a tad leery when we left. Information doesn't seem to flow as well between doctors as it does in places like MD Anderson, the Mayo Clinic or other big medical facilities. Once you've experienced the process in a big facility, it certainly makes you wonder why other facilities don't replicate what obviously works so well. Aaaahhh, a tangent I won't go off on right now.

Anyways, the Brain Tumor Board obviously met bright and early. It wasn't even 8:30 a.m. when we received a phone call from the radiation oncologist informing us that E. would be having radiosurgery. That means that E. gets to have Cyberknife! While we were prepared for either of the options, if given the choice, we would definitely have chosen Cyberknife so the news put smiles on our faces. I know some people are confused when we talk about Cyberknife and we were too initially. Just to clarify: it is not surgery; it is more like fancy radiation.

A CT still needs to be done, as both the CT and the MRI are used to "map" out exactly where and what the radiation will zap. Some sort of mask will need to be made to hold E.'s head exactly in place because the radiation is so precise (hopefully I'll be able to provide a picture of E.'s mask soon). E. has appointments for the both the CT and the mask on Monday. Cyberknife will then begin on Wednesday. We were initially told that there would be between 3 and 5 treatments of Cyberknife (one treatment per day) and that each treatment would take approximately 45 minutes. We haven't heard anything different from that at this point.

Other than knowing that E. gets to do Cyberknife, we don't know what else the MRI said. Hopefully we'll get more details about that soon too.

After some recent lab work, it was discovered that E.'s Dilantin level (anti-seizure meds) isn't at the therapeutic level, so the radiation oncologist increased his dosage. While E. has never had a seizure, they want to make sure he doesn't start having them now. I guess radiation treatments to the brain (or really, any time you mess with the brain) can increase your risk for seizures so they do what they can preventatively.

It feels good to have a plan. And a plan that we wanted feels even better.

Flu Rounds

Just about the time E. finished up with the flu, I started. It was so bad that we missed the Wolfpack game that we were so looking forward to. I tried to rally, really I did. We had transportation arranged for the gymnast and we had a sitter for all the kids. We were ready to do a little tailgating and cheer UNR on to victory. Instead, E. had to hoot and holler at the television and I slept through all the festivities, opening my eyes only long enough to see that UNR kicked some butt. Definitely not the date night we had planned. Ah well, such is life. Hopefully we'll get the chance for another date night in the near future.

The flu hung on for a couple of days and just as I was feeling better, E. was feeling worse again. We're hoping that the yucky flu bug isn't coming back for Round #2. And we're hoping that the rest of the house stays healthy as well.

E. has a busy week ahead ... physical therapy a few times, the MRI, hopefully some occupational therapy and possibly a doctor's appointment to schedule our future weeks. We'll keep y'all updated.

S.

Still No Radiation Plan

We met with the radiation oncologist today to figure out a plan. At this stage of the game, we should know better. You can't just get a plan with one appointment. There needs to be tests, and scans, and labs, and more appointments before you can get a plan. Even though we know that is how the process works, it is still frustrating.

Like we anticipated, the two options are Cyberknife and whole brain radiation. The choice is not left up to us, but rather to the Brain Tumor Board. In order for the Brain Tumor Board to even review E.'s case, they need the information from a detailed MRI. Like we were originally told, Cyberknife was not an option to treat the two tumors because of their large size. The Brain Tumor Board now needs to review the size of the cavities left behind. Typically, once a tumor is removed, the cavity left behind shrinks in the healing process. If the cavities are now small enough, E. may be eligible to receive Cyberknife versus whole brain radiation.

According to the literature given to us by the radiation oncologist, Cyberknife definitely sounds like the "easier" and "better" of the two options. Cyberknife delivers high doses of radiation to the tumor (or tumor area) via multiple beams that enter the body from different angles. This makes it possible to "concentrate" the radiation at the point of beam intersection while giving the rest of the brain only a small overall dose. The precise accuracy of Cyberknife minimizes the risk of harming surrounding healthy tissue, and as a result, larger and more effective doses of radiation can be administered. Cyberknife treatment for brain metastases generally consists of three treatments, or sometimes five. The side effects of Cyberknife are usually minimal and the period the patient must be on steroids is short (usually only during treatment and for a few days after). Another benefit to Cyberknife is that a patient can get Cyberknife now and can always get whole brain radiation later, if needed.

Whole brain radiation, on the other hand, radiates the whole brain. (Go figure. That must be why they call it "whole brain radiation.") Whole brain radiation would be given daily over the course of three weeks. It also requires steroid use for about a month. (Steroids help with brain swelling and edema, which is good. But as we all know, steroids make blood sugar levels go wacky, which is not good. Steroids also have their own side effects, which are tough for some people to tolerate.) Whole brain radiation typically affects cognitive skills ... short term memory, mathematic calculations, word recall, etc. Often patients who receive whole brain radiation are not quite as "sharp" as they were. This concerns E. greatly.

So what's the next step? E. is scheduled for a "detailed" MRI on Tuesday afternoon. (I thought all MRI's were "detailed," but they made it sound like this one was more "detailed" or something.) The Brain Tumor Board will then meet on Wednesday and we are hoping they will review E.'s case. For either form of treatment, E. will also have to have another CT scan. He will also have to have a mold made of his face ... some sort of heavy netting material that forms to his face and hardens ... it also extends past the sides of his face and will hold his entire head in place for each treatment session.

We will then meet with the radiation oncologist again. To come up with a plan.

I need a plan. I hate not having a plan.

(Oh, and just to let you know ... that "really quick" appointment wasn't really quick. Even though the appointment was scheduled for 8:30, E. was still 20 minutes late to his 9:30 physical therapy appointment.)

S.

Appt. Rescheduled

We were all set to meet with the radiation oncologist today and get some sort of plan going. I've poked around a little on-line and I'm not really sure what kind of radiation E. will be getting. I think the assumption is that it will be "whole brain radiation." One possible option I've found though is Cyberknife. It is my understanding that Cyberknife treatment could be done in fewer sessions and with fewer side effects. That sounds pretty appealing. At the time that E.'s brain tumors were discovered, we were told that Cyberknife wasn't an option because the tumors were too big. Now that the tumors have been removed though, we're not sure if Cyberknife is an option for the remaining cancer cells. Anyways, these were all things we were hoping to discuss with the radiation oncologist today. We figured we'd collect information, get questions answered and get a plan in place.

But then we got a phone call informing us of a "scheduling error" and that we needed to reschedule the appointment. The receptionist suggested tomorrow morning as there were "all sorts of appointments available." Perfect, I said. E. has physical therapy from 9:30 to 10:30 in the same building, so we could come in at 10:30. Except the 10:30 appointment was booked. And so was the 11:00 slot. And the 11:30. She offered us an appointment at 9:45 ... I explained that probably wouldn't work out so well because of the previously mentioned physical therapy appointment. She then stated that "the appointment should be really quick, so you could come here first and then go to physical therapy." We're discussing brain cancer and that appointment is supposed to be REALLY QUICK?!?

To make a long story short (well shorter than it could be), we finally settled on an 8:30 appointment tomorrow morning. It makes for a crazy morning here ... getting the boys off to school, having Peanut up, fed and ready, and getting us across town by 8:30, but we'll make it work. We're anxious to get this show on the road.

Sick with the Flu?

E.'s had a horrible weekend ... headache, fever, chills, vomiting, diarrhea, body aches, stomachache, and just all-over-cruddiness. His bed and the bathroom are the only two places he's seen since Friday night. He's been miserable.

It's gotta get better soon.

DMV Success

We couldn't put it off any longer. I want you all to know that we braved the DMV yesterday.

It wasn't pretty.

We first went to the DMV (I started quivering just as soon as we pulled into the parking lot). Even the parking lot is a fiasco.

Then we got sent to the police department (to deal with the stolen license plate), and in turn got sent to the police sub-station (where we filled out the report and relinquished the remaining plate). We had to make a quick stop for lunch (Peanut doesn't much buy the "we'll have lunch just as soon as we finish these errands." When he's hungry, he's hungry NOW. And he's not afraid to let you know it.)

We had a little proof of insurance issue. (When E. was in that car accident last month, he took the insurance out of the truck for the police report and never put it back.) You'd think getting another copy of the proof of insurance would have been easy. It wasn't. But we eventually got it.) Then we went back to the DMV yet again.

We walked out of there with new license plates and his temporary handicapped parking placards.

Success!

Physical Therapy

E. had his "physical therapy evaluation" today.

But first, we had to "register." We were supposed to be at registration at 9:00, which would leave enough time to be upstairs in time for his half-hour physical therapy appointment beginning at 9:30. In reality, registration wasn't even done until 10:00. It consisted of waiting for over 45 minutes, going into a little office, giving the gal his driver's license and insurance card so she could make copies, and signing two pieces of paperwork. Physical therapy itself was about an hour too. Peanut was with us and since he's more of a hands-on rather than a sit-back-and-watch kind of guy, Peanut and I took a walk to the park while E. went back for his physical therapy.

That means you don't get a play-by-play. Or any great pictures. Dagnabbit. I hear I missed a great photo opportunity when E. had to try to balance on that half-sphere ball thingie (a BOSU ball I think is the technical name). Ahhh well, maybe next time.

More physical therapy appointments are up and coming. Another one on Friday, and two or three next week. E.'s also been referred for an occupational therapy evaluation. Occupational therapy might be helpful with some of his vision issues, like that little thing called reading. We're waiting to hear when that's going to take place.

An appointment with the radiation oncologist has been made for next Wednesday. Hopefully then we'll have a radiation plan too.

Oh, and the DMV is still on the "to do" list too. Aaaarrgggh!

Son of a Buck!

Son of a Buck!

Son of a Bleepity-Bleep-Bleep.

Bleepin' Son of a Bleepity-Bleep-Bleep.

And an extra Bleepity-Bleep-Bleep thrown in for good measure,

for each of the 35 staples.

I guess staple removal isn't quite as pain-free as they led us to believe.

Matter of fact, after the first five staples were removed,

the nurse stopped to give E. "a breather."

His eyes were watering and he had sweat beads on his nose.

He calmly said to the nurse,

"Thanks, now let me hold myself so I don't pee all over the place."

"Come on, toughen up buckeroo," is all I could think.

You've been through chemo, radiation, kidney stones,

a pneumonia, an errant ingrown toenail,

the swine flu AND brain surgery (and that's just in the last year).

And now you wanna whine about some staples getting removed?

He shot me a look.

I bit my tongue.

This is the staple remover.

Not exactly the staple remover from Office Max I had pictured.

But whatever works, I guess.

First, the staples from the back incision were removed.

Then, the staples from the front incision.

At one point, I seriously thought E. was just gonna walk out

and leave about 9 staples in place.

For posterity's sake.

The nurse commented that the incisions are healing nicely.

Not that I've seen a lot of brain surgery incisions or anything,

but I'd have to agree.

The dried blood chunks aren't really scabs

as they aren't attached to wounds.

They are just blood blobs that dried on his skin.

Such a pretty description, don't you think?

I'm assuming they'll come off in the shower.

Maybe a washcloth would help, for a little abrasion.

"We're not abrasing nothing!!"

(Guess who said that?)

Good Weekend

E. had a good weekend, a really good weekend. Today was probably the best day yet. He was able to go to the movies with the girls, which he always enjoys. He was also able to barbeque. Finally. It is no secret how much the man loves to cook. And it is no secret how much the boys love his cooking. There were some happy, and full, people in this house tonight.

E.'s pretty much ditched his walker already. He's down to one pain pill about every eight hours (despite the fact that he can take 2 pain pills every four to six hours). He's tapered off the steroids, which will hopefully bring his blood sugar levels under control more. Until that happens, I'll remain the "Insulin Injector." (It doesn't even scare me anymore. Woohoo! Now if only I could be as brave about the DMV. Yes, I know, I'm a big baby. And a procrastinator to boot. I still haven't ventured to DMV hell.)

Tomorrow, we see the neuro surgeon. Or actually, we see the neuro surgeon's nurse. It is our understanding that E. will be getting his staples out. Not sure what else happens at tomorrow's visit though. We're assuming it's just a check-up of sorts. We do know that once the staples are out, we can make an appointment with the radiation oncologist to get a radiation plan going, so that will be coming up next.

On Wednesday, E. has an physical therapy "evaluation." That will determine how much physical therapy he'll be getting (the doctor "ordered" two to three times a week for eight to twelve weeks). I think they're going to be surprised at how much progress he's made. I sure am! But then again, this is my first experience with brain surgery. (And hopefully my last!)

I'm not sure when he'll be able to drive again, but I have a feeling that is still a way's off. In the meantime, I'm just going to enjoy all the extra time I get to spend with the big lug. As much crap as I give him, I really do enjoy his company.

If anyone wants to take him to lunch, I'll happily chauffeur his butt there, shoot him up with insulin and leave him in your tending loving care. I promise not to be the helicopter spouse and hover overhead. Or even in the next booth. He'd probably like some time with his wise-ass buddies. Hint-hint.

* Oh, and just as a side note, E.'s vision is still pretty screwed up (hence, the no driving). Reading is out. Texting is also temporarily on hold. So, either call him (or me) or text me (and I'll happily relay the message).

A Couple of Pictures

This is the circa 1970's hospital bed next to our big log bed. It looks even funnier in person ... reminds me of a child's toddler bed next to the parents' bed. It works though. E. likes having the ability to sleep at an incline to keep the pressure off his head, without having to rearrange pillows all the time (the ability to raise his foot also comes in handy with his swollen right foot, although he tends to prop it up with pillows like in the picture). Peanut likes having buttons to push and make Daddy seem like he's on a roller coaster ride. I like having the side rails up at night to ensure that he doesn't fall out of bed. (Notice the walker right next to the bed. And the football, of course. Peanut brings dad the football and wants to play catch, after showing off the three-point stance he learned from his brothers.) And yes, I realize that's a horrible mix of plaids and quilts, but what.are.ya.gonna.do? Focus on the handsome boys in the picture and you may not notice the plaids and colors working against each other. :)

Nothing better than watching a little "Sid the Science Kid" while snuggled up with your daddy. That's a great way to start the morning! Peanut even brought his bowl of Cheerios into bed to share.

Some Random Updates

The head: It continues to heal little by little. E.'s got an appointment next Tuesday to get his staples out. Can you believe how quick that happens? He's still getting some whop-dinger headaches, but only takes minimal pain meds. He's also suffering some yucky bouts of nausea (not related to the pain meds). Sleep comes in short spurts (also affected by the midnight and 4:00 a.m. wake-ups for meds), but the mid-afternoon nap seems to help.

The arm: E.'s right arm continues to be swollen and tender from the infiltrated IV and the superficial blood clots. It is especially sensitive around the wrist area, which makes putting weight on it while using the walker difficult. A re-check with our primary care physician today confirmed that the blood clots are probably superficial as they are below the elbow (anything above the elbow is much more concerning). Since blood thinners and/or anti-inflammatories are not an option, he'll have to settle for warm compresses and elevation.

The foot: The foot, you ask??? Yes, the foot. After the initial physical therapy in the hospital, E. has been complaining about pain in his right foot. Concerned about blood clots, we visited with our primary care physician today. Turns out, it's "plantar fasciitis," which involves pain and inflammation of a thick band of tissue that runs across the bottom of your foot - connecting your heel bone to your toes. The bottom of E.'s foot is swollen and VERY, VERY sensitive. Again, because of the recent brain surgery, the typical medications cannot be taken. It was suggested he ice his foot several times a day and elevate it as much as possible. Generally speaking, it will heal in 8 to 10 weeks.

(So, are you picturing this yet? E., head full of staples, trying to shuffle along in his walker with a bum right arm and a bum right foot? It may not be pretty, but it sure isn't stopping him.)

The blood sugars: E. wound up being released from the hospital with the long-acting insulin, but not the regular insulin. We have been unable to keep his blood sugars in that "below 200" range which is optimal for proper healing, so we paid a visit to our primary care physician. Like we expected, she prescribed some regular insulin which will be given according to a blood sugar level scale. The amount of units given (of both the regular insulin and the long-acting insulin) will have to be tweaked regularly, with the steroid doses fluctuating like they are.

Physical therapy: E. is supposed to be getting physical therapy two or three times a week for eight to twelve weeks. That is what is prescribed. It has not started yet though because insurance authorization is required first, which may take a week or ten days. Crazy. In the meantime, E. is getting around the house quite well and I've even caught him walking without his walker a time or two (which drives me insane!). We've taken a couple of walks down the street. I walk alongside him and his assistant, Peanut, helps by pushing the walker along.

Handicapped parking placard: E.'s doctor authorized him to get a temporary handicapped parking placard. Although E. is not thrilled with the whole idea, I reminded him of the brighter side: front row parking at Wolfpack games! He's already making tailgating plans, so I know he liked the thought of that! The doctor filled out the applicable DMV authorization form. Now I just have to go to DMV, submit the form and get the placard. I dread going to the DMV. I hate the DMV. I am scared of the DMV. But I will be brave. As an added note, while the truck was parked in the hospital parking garage, someone stole the front license plate off the truck! (It appears that they also attempted to steal the rear plate, as the license plate frame is missing, and so are several screws.) I now have to fill out some "Lost or Stolen License Plate" form at DMV as well, and return the remaining plate in exchange for new plates. I did say I would be brave, didn't I? I think a visit to DMV requires more than bravery though.

Attitude: E. may be stubborn and ornery, but he's got an attitude that can't be beat. He never complains about a darn thing. He still dishes it out like always (and gets it back in return). We still laugh. A lot. And these brain tumors? "Just another bump in the road." With an attitude like that, how can you not follow his lead? I'll tell you what ... I fall in love with this man over and over again, each and every day.