We're back at Jayshree & Sanjay's house after the morning at M.D. Anderson.
Dr. L, like everyone else, isn't 100% convinced that Steve's lesion is a tumor. Some images look like a tumor. Others don't. With contrast media, the lesion lights up in a manner similar to a tumor. But the pons itself (the area of the brain stem that the lesion has invaded) isn't swollen, as it often is with a tumor. The spectroscopy's data indicates a tumor, but that deep area of the brain is hard to read, so that data isn't 100% accurate.
Dr. L's recommendation is to repeat a head MRI next Wednesday. If the MRI shows that the lesion has decreased in size -- because of the Decadron or some other reason -- then there will be no biopsy. If the lesion is smaller, that will indicate it's not a tumor. If the MRI shows that the lesion has remained the same or gotten larger (compared with the Dec. 22 MRI), a biopsy would be scheduled for Jan. 22.
He reviewed the risks of the biopsy. The pons is a very small area of the brain, but it is responsible for a large number of bodily functions. It contains pathways for motor skills, sensory functions and breathing. When the needle goes in to retrieve a sample of the lesion's tissue, there's a chance it will also remove healthy tissue. There is a five percent chance of a small hemorrhage and a two percent chance of a large hemorrhage.
He says there are two pathways to consider -- from the front top of the head or from the back. The back is somewhat less comfortable for the surgeon but a more direct route. It seems to be the route Dr. L prefers right now.
Still, we don't have to decide that right now. We're constantly reminding ourselves, often with the help of so many of you, that we need to take this one step at a time. The next step is the repeat MRI.
Sally will fly us home this afternoon, and we'll spend the next few days enjoying the company of Cooper and Katie and our everyday lives. Thankfully the Decadron has kept most of Steve's symptoms at bay, so he's functioning well. He's continuing to experience double vision on the right side of his face because his left eye isn't fully able to move to the far right (a sixth nerve condition). His headache is still there, though it's back to its manageable level.
1. The lesion is still officially a mystery.
2. We return to Houston Jan. 16 for an MRI at M.D. Anderson.
3. The results of the MRI will determine the necessity of a biopsy.