Fortes fortuna iuvat

On Thursday the 8th of March we had our MRI with contrast.  It took three attempts to place the IV.  It was heart wrenching to say the least.  By the third try, Ethan was clawing at me, begging me to keep them from sticking his again.  Finally his first nurse abandoned the effort and turned the reigns over to another nurse who got the IV in right away in the arm as opposed to the hand.  Poor little bug. 

Just a little pinch they say.  Liars.

So, they dismissed us to the waiting room and Ethan once again did a fine job at holding still for the test.  He was out an hour later.  Do these people know kids or what?  they come out of the MRI, and there in the hallway is an ICEE machine.  Is there ANY boo-boo or procedure that an ICEE machine can't improve upon?  I doubt it.  I'll probably be installing one in my kitchen before this is all said and done. 

I think we're going with the arm from now on.

We had hoped for results that afternoon.  But didn't hear anything until Friday morning.  I received a call from Dr. Sutton's nurse Laura.  At first I was optimistic.  I felt that she would simply be calling to say, "Hey, MRI results were in line with what we expected.  See you guys in three months."  But this unfortunately wasn't the case.  She tried very hard to not provide me with any of the details I was looking for.  I had a whole line of questions ready to go ahead of her call.  What were the margins like?  Had it grown?  Did it enhance?  Was it well vascularized?  Etc.  She only said this... "Dr. Sutton would like you and Adam to come back down for an office visit.  The tumor is bigger than what was previously thought and he wants to discuss other treatment options with you."  I was thunderstruck.  So I pressed her....  I said, "Does this mean that we are no longer taking a watch and wait approach?  Does this mean we are now looking at a surgery?"  She simply said "Yes".  I then told her that I had no objectons to returning to CHOP but that I couldn't wait a week before having some concrete information.  She understood and said that Dr. Sutton was in the office and that she would speak with him and that either she or he would call me back.  And hour or so later, it was her again.  As before, she said he wanted to see us.  He wanted to discuss the results in person with us.  And that he wanted OUR input concerning treatment option.  Now, during our first visit to meet Dr. Sutton, he explained there are only 4 options in treating a brain tumor.  1.  Do nothing (watch and wait) 2. Surgery 3. Chemotherapy and 4. Radiation.  Assuming that Option 1 is no longer viable, I can only assume that we are moving onto #2.  that is if he still believes this tumor to be operable.  During the second phone call from Laura, the only additional information she provided to me is that the tumor has some diffuse and local margins.  This makes it more consistent with a Grade II glioma.  These are a bit more invasive, hence, the diffuse margins.  Additionally, these are more likely to return after a resection. 

This is horrible news for any parent to hear and digest.  We are now scheduled for a 3 pm appointment with Dr. Sutton at CHOP on Wednesday, March 15th.  

It is my intent to try to provide timely updates concerning how things proceed from here.  Please keep Ethan in your thoughts.  I should note, that he is aware of the tumor.  He understands what the surgery will entail.  He doesn't seem very phased by it... or at least I hope he isn't.  But if you really know Ethan, you know how intuitive and sensitive he is.  He's an old soul and I don;t doubt that he probably is a  little anxious about things, but we are going to do our best to be as brave and strong as we possibly can for his benefit.