Off-topic note. Yesterday, Linda wanted her hair trimmed. She was pleased that her two favorite stylists, Katie and Toni, were on duty, especially since Toni had had the same operation Linda had. Tori's was last December. Linda enjoyed visiting with them.
Before she left the UI hospital, Linda was sent to the Neuro Ophthalmology Clinic for several visual tests. She was still quite nauseous and was unable to complete the tests, so today we went back to the clinic to complete them. We were there almost five hours, from 8:15 this morning to 12:55 this noon. The good news is that the tumor was confirmed to be benign. Yay!!
The most interesting test, to me, was the one in which Linda's head was
placed just inside a white hemisphere and first one eye and than the other was covered. She was instructed to stare at the center of the far
side of the hemisphere. From the back side of the hemisphere, a very
loquacious technician maneuvered small, medium and large points of
light. Sitting behind her, I could see a point of light appear toward
the outside of the hemisphere and then move in toward the center. Linda
would knock on the table with a 2" washer when the point of light became
visible in her peripheral vision. This went on for about 45 minutes. At the end of the test, the technician printed out a mapping of Linda's vision field. For both eyes, the entire left side of the field was normal and the right half was gone.
The doctor, when we finally saw him, said that the swelling around the incision has probably blocked the right half of her range of vision. We will have to wait, for up to a year or more, to see if the problem is resolved as the swelling goes down. The fact that she still has headaches, though painful, indicates that the swelling is still there, so we shouldn't give up hoping for complete remission.
People can be born with this condition, the doctor said, and adjust to it easily and never discover it until, for some reason, they have a brain MRI. This means that even if Linda never recovers her full field of vision, she will be able to adjust for it and lead a normal life.
I asked the doctor why Linda is having trouble walking unassisted, and the doctor said he didn't know--the surgery should not have caused that. We'll have to ask the neurosurgeon about this when we see him in a few weeks. She walks quit steadily using the walker, but so far feels uncomfortable trying to walk without it.
Tomorrow, we start occupational, physical and speech therapy at Progressive Rehabilitation Services, Mercy Medical Plaza, Iowa City.
WARNING: The next paragraph is quite detailed and may be more than some of our readers want to hear about. The curious, and brave, among you should read on.
It should have been obvious to us, just by reading the pathology report that the tumor was benign. For example, (I quote from the report): "(The submitted) sections show a neoplasm composed of meningothelial cells arranged in syncytial groups of focal whorl formation. The cells are fairly uniform in appearance with intranuclear inclusions. In addition to the syncytial areas, extensive areas of spindled growth arranged in parallel storiform bundles in a rich collagen matrix are present. Psammoma {my favorite word from the report} bodies are present. Hypercellularity, sheet-like growth, small cell change, necrosis, cytologic atypia, and mitotic activity are not present. (I think the writer just confirmed the tumor is benign, but I can't be sure.) Adjacent brain is present with slight hypercullularity and reactive gliotic change. No brain invasion is identified. Immunihistochemical {second favorite word} studies demonstrate that the neoplasm is diffusely positive for EMA and negative for synaptophysin, S100 and monoclonal GFAP, which highlight fragments of brain parenchyma {third favorite word}.
Wouldn't you say that should have been obvious to us? Duh!
No comments:
Post a Comment