Subject: Lesley Update - 11/12

Well, things sure do change quickly.

Lesley came home Tuesday afternoon but had a lot of external swelling.
At the time, we thought she had no infection, but guess what?  Wednesday
morning the fluid came out through one of her stitches.  After reaching
one of the neuro doctors (that's a story in itself - after getting no
response from trying to reach her neurosurgeon I had to call the nurses
station on the hospital floor where she had been and they were able to
track down a doctor), the doctor advised us to bring her into the
emergency room so they could look at the fluid.  Once we got there they
removed some of her fluid and quickly determined it was infected.  It
turns out her bone flap, the part of her skull that they removed and put
back to do the surgeries, had become infected.  Lucky us, it happens to
only 1% of all such patients.  She was immediately put on some
high-powered antibiotics, prepped for surgery, and operated on at about
2:30.  The doctor described the operation as a low risk surgery where
they would clean up the infection and remove the bone flap.  The one and
a half hour surgery was successful and she was wheeled back to the floor
in the early evening.  ("Why are you back?" asked the nurses.  "Because
they had to operate on Lesley to remove the infection," says me.  "We
thought it was infected and she shouldn't have been released," says
them.  Sigh.)

Yesterday (Thursday) Lesley was doing great.  Very little pain, and
quite perky (I couldn't shut her up!).  She's continuing on heavy-duty
antibiotics while they culture the fluid to see exactly what the
infection is.  We spoke with the Infectious Disease doctors.  They said
it is a type of Gram Negative Rod, but they need to find out exactly
what kind so they can tailor the antibiotics.  The antibiotics will
probably have to be administered for 2-3 weeks.  For now, she's on
multiple antibiotics that they are administering through a PICC - a
peripherally inserted central catheter.  A PICC is a tube that they
insert in a vein at about the crook in her arm and it is threaded
through the vein towards her heart but stops short of the heart.  It
makes administering IV drugs and drawing blood much easier.  We're not
sure at this point whether the chemotherapy will be delayed.  The
neurosurgeon and the neurooncologist have yet to huddle.  The
neurosurgeon said that a 3-4 day stay is usual so Lesley may be home
this weekend.

Lesley had a gauze head wrap (like a turban) that was removed this
morning.  She will have to wear a helmet (a hockey helmet) to protect
her head when she moves around since there is no bone protection where
the flap was removed.  It's like a baby's soft spot (fontanelle?).  I've
read that they sometimes do reconstructive surgery after 6 months or so
to put in a piece of plastic to provide permanent protection.

Other than that, the last 3 days have been ho-hum.

My parents continue to be a God-send, taking care of the house and the
kids so I can attend to Lesley.  In spite of what has gone on the past 2
days, Lesley is actually feeling better than she had been after the
debulking surgery.  We're hoping that she continues to feel good and can
start the chemo as scheduled.

Dave

--
Dave Baldauf, h/o Lesley, gbm, dx/srg 8/99, rad 9/99, rad completed
10/99, debulk srg 10/99, probably starting Temodar 11/99
mailto:dbaldauf@ultranet.com