"There is something on the MRI"

So.... as I set foot in the door not but 2 hours after the first MRI, I received a call from the pediatrician's office.  I could hear my cell phone ringing in my purse, but couldn't get to it before the call ended. 

Father and Son at Mara's.

I then received the call from Adam who told me that he received a call from Dr. Burns and that the found something on the MRI.  Quite frankly, I don't recall very much of that phone call with Adam.  I just remember hanging up and frantically calling the pediatrician back. 

Dr. Burns said to me that they had found what was being labeled a "low grade glioma" on the cerebellum.  After receiving these results she had immediately called the Dept. of Neurosurgery at CHOP and happened to catch Dr. Leslie Sutton while he was in his office.  He was able to review the films from his PC and told our pediatrician that there was no need for us to come to CHOP right away.  He said to Dr. Burns that these are generally slow growing and very common tumors among children.  That quite often they are benign and cystic in nature.  From these first films Dr. Sutton believed that Ethan's tumor had clean margins which make it consistent with a Grade I tumor.  He informed Dr. Burns to have us schedule an office visit for his first available slot.  She tried to ease my mind, and encouraged me not to discuss this with Ethan.  She felt that it would not do him any good to have anything else to worry about.  Dr. Burns  warned us in advance that Dr. Sutton isn't necessarily the "warm and fuzzy type" nor was he a hand holder.  We were assured though that he is quite possibly one of the BEST pediatric neurosurgeons in the country and definitely the best in Philadelphia. 



The atrium at CHOP. Amazing Hospital.

On February 23rd, we set off to meet with Dr. Sutton.  I was terribly nervous.  Because, to be frank, I felt as if I could use a little hand holding.  However, I felt that he was totally appropriate.  As "the mother" he seemed to address a lot of the information directly toward me.  I think that after years of operating on the brains of children, its not lost uppn him that this kind of news weighs heavily upon us mothers.  He started the appointment off by telling plainly, "This is an operable tumor.  One which I CAN get out."  Phew.  Deep breath. Felt as if an elephant had been lifted off of me.  He went onto say that he has patients who have had these types of tumors for years, and have never needed any surgical intervention.  He inquired as to what led us to pursue the MRI in the first place, and then proceeded to tell us that the tumors location in the cerebellum would have in no way led to the hallucinations or headaches.  Certainly, if this tumor was to grow and if any swelling accompanied it, then yes... but at this stage, Ethan has no edema in the brain.  He is currently symptom free.  As such, it was Dr. Sutton;s advice that we could take a "watch and wait" approach.  His only concern during this visit was the tumor's proximity to the brain stem.  He in no way indicated that this would prohibit him from surgically resectioning the tumor but felt that surgery could reveal that the tumor was tangled up in some of the brain stem nerves which affect things such as breathing, swallowing, heart rate and upper shoulder movement.  It was my interpretation that this might ultimately prevent him from a 100% resection.   But he seemed to think that this first MRI film was not sufficient enough to give him an idea of the tumors location in regards to the brain stem and felt confident that it was at a more favorable location in the cerebellum.  He did however ask for us to have another MRI completed with contrast.  This dye is to enhance the tumor, to reveal its margins and provide him with a better understanding of the tumor's characteristics.  But he felt if these results were favorable, that we could simply monitor the tumor with MRI's occurring every 3 months.   We left feeling very confident.  This man is clearly a brilliant individual.  He informed Adam and I that in the coming years, he sees shifting his practice more towards addressing the needs of pregnant women who carry fetuses afflicted with Spina Bifida.  He literally operates on the fetuses while in Utero.  He closes up the spinal cords of the unborn, as a means of improving their odds of being able to walk one day.   He's been a pioneer in this field.   So, if he has the demeanor of Walter Matthau, but the mind and hands of DaVinci...  I'll take it.  Adam and I set the MRI up for March 8th.  Because the MRI requires the contrast agent, we knew it meant another IV for Ethan.  The first IV at CHOP weeks earlier let us know that he has these little thready veins.  They had a hard time sticking him the first time... so I was really dreading the next MRI.  But we put that aside, and tried to take comfort in the good news that we had probably dodged the surgery bullet and headed off to catch a late lunch/early dinner at Mara's in South Philadelphia.