27 December 2007
Thursday
[Journal not posted until Friday afternoon due to a holdup in a Starbucks Cafe in New York City where this journal was being written. No joke!]
High-Level Journal Summary: Notes by Susan Miller (Mother) about David Welch's second brain surgery today at New York University Tisch Hospital.
Countdowns:
1.) Brain surgery with Dr. Patrick J. Kelly at NYU at 2 PM (ET) today.
2007 Seizure Activity:
1.) Last Simple Partial Seizure, or SPS, was 2 days ago.
2.) In 2007, I have had 193 SPS's in 361 days. This is an average of 1 SPS every 1.9 days.
Actual Journal: By 7:00 pm this evening, David's surgeon, Dr. Patrick J. Kelly, had come out of the operating room to talk about the surgery. Dr. Kelly reported that David came through surgery well, but would be very sleepy and awake slowly, because he was given additional medication to prevent seizures during the procedure. Dr. Kelly also reported success in obtaining an appropriate amount of tissue from the tumor for additional testing. Another piece of good news is that they were successful in coordinating with NIH to freeze tissue, rather than fixing in paraffin as is customary, which will allow NIH more options in determining tumor genetic makeup. This information will drive future treatments.
Although the goal of this surgery was to obtain tissue samples rather than to remove the tumor, a craniotomy was necessary, rather than a more traditional biopsy. Dr. Kelly explained that if he had performed a biopsy by going through the top of David's skull, he would have to navigate a mine field of blood vessels, and would secure a smaller tissue sample. By performing a craniotomy, he was able to obtain a much larger sample with a greater degree of safety.
As David noted in his 12/26/07 journal entry, Dr. Kelly identified a second "spot" in the frontal lobe which the surgeon was unable to access safely, but the supposition is that the tumor tissue obtained is of the same type as the unaccessable tissue.
The pathology will take at least a week. As Dr. Kelly said, "It's got to cook. Like baking a souffle, it can't be rushed." After David receives pathology results, he will be meeting with Dr. Howard Fine at NIH to determing the next step. He has a 9:00 am appointment on Wednesday, January 2, 2008. David should be released from Tisch Hospital iat NYU Medical Center on the 31st or 1st.
The first visit in ICU was for 5 minutes only. David was still groggy, but talking. He looked at his mother and said, "Susan Ellen Miller." He looked at his dad and said, "Dad, go get a beer!"
