Thursday

We met with the UT-Southwestern neurosurgeon today. He said he would bet that Steve's lesion is not a tumor. He says it's unlikely that Steve could have a tumor and look so good. That said, he doesn't know what it is. And he's not ruling out a tumor.

He would like to admit Steve for in-patient care to run diagnostic tests. It is easier to take care of everything that needs to be done if Steve is a hospital patient, as opposed to an outpatient. That allows all the doctors to come see him in one place, and we don't have to go back and forth. We are working on scheduling admission for next week, though that depends on whether we head to Houston next week (more to come on that later in this posting).

The tests would include the lumbar puncture (spinal tap) and a chest scan. The scan would look for other signs of tumors. We need to be sure that the lesion isn't a metastasis (a secondary tumor, which would indicate cancer elsewhere in his body). They'll be looking for signs of infection or anything unusual that could explain what that unwelcome intruder is.

His plan would call for a biopsy, if necessary, after the results of all those tests are available. The surgeon we met with today would not perform the biopsy. There is someone else at UTSW who specializes in deep brain stimulation who would do the biopsy.

To recap the UTSW experience:
1. Steve needs more tests before a biopsy.
2. The surgeon is hopeful it's not a tumor.
3. A biopsy, if necessary, is possible.

Now, in the middle of this we're also working with M.D. Anderson's brain and spine center. We're sending an overnight package with his brain images to Houston. Tomorrow morning, M.D. Anderson will look at the images to determine if they want/need to see Steve. M.D. Anderson treats only cancer. If they look at the images and can determine right away that it's not a tumor, they won't treat him. If they think it is a tumor or think there's a good chance it is a tumor, they'll see him.

So, we have a 9:15 a.m. Wednesday appointment in Houston. (We'll cancel it tomorrow if they rule out a tumor after seeing the images.) We've been told to be prepared to stay a few days if necessary, depending on what they find.

Because we're still in the gathering-information stage, UTSW won't admit Steve for tests until we know which system we're working with. If M.D. Anderson tells us Friday that they don't/won't need to see Steve, we'll work on scheduling further tests with UTSW and commit ourselves now to their directives for care.

To recap the M.D. Anderson possibilities:
1. They'll receive Steve's images Friday morning.
2. They'll review the images and decide whether or not they can help Steve.
3. If they'll see Steve, we'll be there Wednesday. If they won't see him, we'll commit to UTSW for care.

One of the many struggles with this experience is receiving so much information, some of it conflicting, and having little clarity. My sense -- or desperate hope, at least -- is that at some point we'll receive just the right amount of information and will be able to make the best possible decision at that time. I'm finding that my journalism experience is coming in handy -- taking notes, interviewing people, reading documents quickly to find the most essential info. But this is the most personal assignment ever, and the stakes are so much higher than anything we've ever tackled. And, of course, our ability to control or influence the situation is limited.

Thanks again to all of you for everything. The notes have been great comfort (and in some cases welcome levity!). We are surrounded by the best support network, which seems to grow every hour as you all reach out to others. We are forever grateful.